Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review

Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.

Comparison of endodontic medicaments on bond strength of fiber post to root dentin using resin cement

Statement of the Problem: Endodontic irrigants and medicaments may affect the bond strength of intracanal posts to root dentin

Purpose: The aim of this study was to compare the effect of calcium hydroxide [Ca[OH][2]] and 2% chlorhexidine gel [CHX] on bond strength of fiber post cemented with resin cement to root dentin

Materials and Method: This in vitro experimental study was conducted on 36 mandibular premolars. Canals were prepared using the step back technique. After root canal irrigation, the teeth were divided into three groups of 12. Ca[OH][2] paste and CHX gel were used as intracanal medicaments in the first and second groups respectively. No intracanal medicament was used in the third group [control group]. Access cavities were then sealed and the teeth were incubated for one week. The root canals were then filled using gutta percha and AH26 sealer and the teeth were incubated for 72 hours. Tooth crowns were then cut at the level of the cementoenamel junction and intracanal posts were placed. The teeth were mounted in auto-polymerizing acrylic resin, and incubated for one week .They were then sectioned into 1.5mm thick slices from their coronal surface using a fully automated cutting machine, and subjected to push-out test until failure. The load at debonding was recorded and data were analyzed using one-way ANOVA, post-hoc test and t-test. The coronal margin of the root was at the level of the surface of acrylic resin in the mold

Results: The mean bond strength was 4.45 MPa in the Ca[OH][2], 2.45 MPa in the CHX and 2.48 MPa in the control group. The difference in this regard was statistically significant among groups [p= 0.04]. The Ca[OH][2] group had significant differences with the CHX and control groups [p= 0.03 and p= 0.02, respectively]. The difference between the CHX and control groups was not significant [p= 0.974]

Conclusion: Based on the results, Ca[OH][2] increased the bond strength of fiber post to root dentin but 2% CHX had no effect on bond strength

Effect of health belief model-based education on knowledge and Prostate Cancer screening behaviors: a randomized controlled trial

Background: Prostate cancer has been reported as the second leading cause of cancer death among men in 2013. Prevention and early detection of cancer are considered as critical factors in controlling the disease and increasing the survival of patients. Therefore, we aimed to investigate the effect of Health Belief Model [HBM]-based education on knowledge and prostate cancer screening behaviors in a randomized controlled trial

Methods: This study was a non-blinded randomized controlled trial. We enrolled 210 men aged 50-70. Balanced block randomization method was used to randomize the final participants who had inclusion criteria into intervention [n=93] and control [n=87] groups. The participants of the intervention group attended training workshops based on HBM. Data were collected using three questionnaires, i.e. demographic questionnaire, Prostate Cancer Screening-Health Belief Model Scale [PCS-HBMS], and the Knowledge about Prostate Cancer Screening questionnaire, all given before and immediately one month after the intervention

Results: The mean scores of the perceived susceptibility, severity, barriers and benefits increased significantly after the intervention [P>0.05] in the intervention group. In the control group, such a difference was reported only for perceived susceptibility [P>0.05]. The rate of participation in prostate cancer screening in the intervention group increased from 7.5% to 24% and 43.3% one month and three months after the intervention, respectively

Conclusion: Our findings showed that the health education programs designed based on HBM could positively affect prostate cancer preventive behaviors of individuals by improving their knowledge level and leaving positive effects on perceived susceptibility and severity as well as considering the perceived barriers, benefits and health motivations

Effect of triple antibiotic paste and calcium hydroxide as intracanal medicaments on bond strength of composite to dentin

Objective: Considering the use of triple antibiotic paste [TAP] for root canal treatment of open apex teeth, this study aimed to assess the effect of TAP and calcium hydroxide [CH] on bond strength of composite to dentin

Methods: This in-vitro study was conducted on 32 extracted human premolar teeth. After disinfection with 2% thymol solution, the enamel on the buccal surface of specimens was removed to expose a smooth dentin surface parallel to the long axis of the teeth with approximately 19mm2 surface areas. Specimens were divided into three groups of 11, 10 and 11 specimens. In group one, TAP, in group two CH and in group three, saline solution were applied to dentin surfaces for 14 days. After removal of medicaments, composite cylinders were bonded to the dentin surfaces using a bonding agent. Shear bond strength was measured in an Instron machine at a crosshead speed of 1mm/min. Data were analyzed using one-way ANOVA

Results: The highest mean bond strength belonged to the control group [14.4760 MPa] and the lowest belonged to the TAP group [11.5808 MPa]. The mean bond strength in CH group was less than that of the control and higher than that of the TAP group [11.7834 MPa]. However, the difference among the three groups was not statistically significant [p=0.327]

Conclusion: Use of medicaments such as CH and TAP has no effect on bond strength of composite to dentin

Cytotoxicity of triple antibiotic paste and calcium hydroxide against cultured human dental pulp fibroblasts

Objective: In necrotic immature teeth, intra canal medicaments such as triple antibiotic paste [TAP] and calcium hydroxide [CH] are used for root canal disinfection and regeneration treatment. However, the effect of these medicaments on dental pulp fibroblasts has yet to be known. This study aimed to assess the cytotoxicity of CH and TAP against cultured human dental pulp fibroblasts [HDPFs] obtained from third molars

Methods: In this in vitro study, fibroblasts were obtained from the dental pulp of two third molars. Fibroblasts were exposed to 0.1, 1 and 10 mg/mL concentrations of TAP and CH. Six samples were prepared of each medicament and fibroblast viability was evaluated after 72 hours. Data were analyzed using one-way and two-way ANOVA [p<0.001]. The percentage of cell viability was calculated and the cytotoxicity of the medicament was categorized as severe [30%], moderate [30- 60%], mild [60-90%] and non-toxic [>90%]

Results: In TAP samples, only the 10 mg/mL concentration had a significant difference with the control group in terms of the percentage of cell viability and showed moderate cytotoxicity. In CH samples, the 1 and 10 mg/mL concentrations showed significant differences with the control group and were severely cytotoxic

Conclusion: Reduction in cell viability of fibroblasts by increase in concentration was significantly greater in CH compared to TAP group. Thus, in regeneration treatments, these medicaments must be used in concentrations with adequate therapeutic and insignificant adverse effects on fibroblasts

Self-efficacy in foot-care and effect of training: a single-blinded randomized controlled clinical trial

Diabetes mellitus [DM] is one of the most common metabolic and non-communicable disorders worldwide and the mortality rates caused by the complications associated with the disease, such as diabetic foot ulcer, is increasing dramatically. Patient education is considered as an essential part of controlling DM. Therefore, we aimed to compare the effects of individual and group training methods on self-efficacy in foot care among the patients with DM. In this single-blinded, randomized controlled clinical trial, we enrolled 150 patients with type 1 and 2 DM. The final participants were randomly assigned into two intervention groups [collective and individual training group] and a control group. Data were collected using foot-care self-efficacy questionnaire [Corrbet, 2003]. A research assistant collected the data by interviewing the participants using the questionnaire once before and once one month after the intervention. The participants of the intervention groups attended a training program consisting of three sessions per week for one week. Statistical descriptive tests such as mean and standard deviation [SD] percentage were used to describe the features of the data inferential statistics test such as Chi-square, independent t-test and repeated measures analysis of variance and analysis co-variance [ANOVA, ANCOVA] tests were also used as appropriate. The significance level was set at <0.05. The results indicated that there was no significant difference between the three groups regarding the mean of self-efficacy scores before foot-care training intervention [P=0.39]. But, comparison of the scores before and after the intervention showed that both group and individual training interventions increased the patients' self-efficacy [P

Effects of endodontic tri-antibiotic paste on bond strengths of dentin adhesives to coronal dentin

OBJECTIVES: The aim of this study was to evaluate the effects of tri-antibiotic paste (TAP) on microtensile bond strengths (MTBS) of dental adhesives to dentin. MATERIALS AND METHODS: Sixty extracted molars had their occlusal surfaces flattened to expose dentin. They were divided into two groups, i.e., control group with no dentin treatment and experimental group with dentin treatment with TAP. After 10 days, specimens were bonded using self-etch (Filtek P90 adhesive) or etch-and-rinse (Adper Single Bond Plus) adhesives and restored with composite resin. Teeth were sectioned into beams, and the specimens were subjected to MTBS test. Data were analyzed using two-way ANOVA and post hoc Tukey tests. RESULTS: There was a statistically significant interaction between dentin treatment and adhesive on MTBS to coronal dentin (p = 0.003). Despite a trend towards worse MTBS being noticed in the experimental groups, TAP application showed no significant effect on MTBS (p = 0.064). CONCLUSIONS: The etch-and-rinse adhesive Adper Single Bond Plus presented higher mean bond strengths than the self-etch adhesive Filtek P90, irrespective of the group. The superior bond performance for Adper Single Bond when compared to Filtek P90 adhesive was confirmed by a fewer number of adhesive failures. The influence of TAP in bond strength is insignificant.

Effects of endodontic tri-antibiotic paste on bond strengths of dentin adhesives to coronal dentin

OBJECTIVES: The aim of this study was to evaluate the effects of tri-antibiotic paste (TAP) on microtensile bond strengths (MTBS) of dental adhesives to dentin. MATERIALS AND METHODS: Sixty extracted molars had their occlusal surfaces flattened to expose dentin. They were divided into two groups, i.e., control group with no dentin treatment and experimental group with dentin treatment with TAP. After 10 days, specimens were bonded using self-etch (Filtek P90 adhesive) or etch-and-rinse (Adper Single Bond Plus) adhesives and restored with composite resin. Teeth were sectioned into beams, and the specimens were subjected to MTBS test. Data were analyzed using two-way ANOVA and post hoc Tukey tests. RESULTS: There was a statistically significant interaction between dentin treatment and adhesive on MTBS to coronal dentin (p = 0.003). Despite a trend towards worse MTBS being noticed in the experimental groups, TAP application showed no significant effect on MTBS (p = 0.064). CONCLUSIONS: The etch-and-rinse adhesive Adper Single Bond Plus presented higher mean bond strengths than the self-etch adhesive Filtek P90, irrespective of the group. The superior bond performance for Adper Single Bond when compared to Filtek P90 adhesive was confirmed by a fewer number of adhesive failures. The influence of TAP in bond strength is insignificant.

Microbial Evaluation of Fresh, Minimally-processed Vegetables and Bagged Sprouts from Chain Supermarkets.

The aim of this study was to evaluate the bacterial and fungal quality of minimally-processed vegetables (MPV) and sprouts. A total of 116 samples of fresh-cut vegetables, ready-to-eat salads, and mung bean and wheat sprouts were randomly collected and analyzed. The load of aerobic mesophilic bacteria was minimum and maximum in the fresh-cut vegetables and fresh mung bean sprouts respectively, corresponding to populations of 5.3 and 8.5 log CFU/g. E. coli O157:H7 was found to be absent in all samples; however, other E. coli strains were detected in 21 samples (18.1%), and Salmonella spp. were found in one mung bean (3.1%) and one ready-to-eat salad sample (5%). Yeasts were the predominant organisms and were found in 100% of the samples. Geotrichum, Fusarium, and Penicillium spp. were the most prevalent molds in mung sprouts while Cladosporium and Penicillium spp. were most frequently found in ready-to-eat salad samples. According to results from the present study, effective control measures should be implemented to minimize the microbiological contamination of fresh produce sold in Tehran, Iran.

survey of the knowledge and beliefs of retired men about prostate cancer screening based on health belief model

Prostate cancer has been reported as the second leading cause of cancer death and the most common cancer diagnosed in men. Since Health Belief Model [HBM] has been intensively used for assessing health beliefs associated with cancer screening behaviors, we aimed to investigate the level of knowledge and health beliefs about prostate cancer screening among retired men. In this descriptive study carried out in 2013, we enrolled 180 men aged 50-70 years who were retired from Shiraz Education Department. Data were collected using three questionnaires including demographic questionnaire, HBM and the Knowledge about Prostate Cancer Screening questionnaires by interviewing the participants. Our findings showed that 95.6% and 85.6% of the interviewees had no experience of digital rectal examination [DRE] and prostatic-specific-antigen [PSA] testing for prostate cancer screening, respectively. 86.1% of men had no knowledge about such screening. 12.7% of the respondents reported good knowledge scores. 74.4% and 90.5% of them had good health motivation and perceived benefits scores, respectively. 81.6% of them revealed intermediate scores for perceived barriers. Moreover, 32.7% and 7.2% of the subjects reported good severity and susceptibility scores, respectively. Developing an assessment based on HBM could be effective in designing and implementing educational programs by helping to identify the needs and priorities of the target population

Clinical governance: efficacy of establishment in Mashhad hospital

Clinical governance is a framework in which the organizations providing clinical services are responsible in exchange for the permanent improvement of quality and preserving the service's high standard. It relies on the responsibility to maintain current levels of care and on clinical governance pillars to improve the quality of future care. Also, it is a concept that attempts to integrate the previous methods and tools in measuring and improving quality of care. This descriptive-analytic-interventional study was conducted to evaluate the hospitals of Mashhad before and after the establishment of clinical governance in 2011. Data were collected by both questionnaires and observation. Comparing the range of clinical governance's pillars obtained, from the selected hospitals, showed a significant improvement in all studied axes following the establishment of clinical governance. The highest effectiveness was related to clinical audit, staff management and training axes, whereas the least effective part was the interaction with patients, their relatives and the community. Regarding the significant difference in the obtained results after the establishment of clinical governance in this study, it could be concluded that the establishment of clinical governance and its performance could remarkably improve the quality of health services.

cross-sectional study on food patterns and adiposity among individuals with abnormal glucose homeostasis

Dietary habits play an important role in the prevention of chronic disease; however, few studies have assessed the major dietary patterns in Middle Eastern countries. This study identifies major dietary patterns among Iranian people with abnormal glucose homeostasis. This cross-sectional study was conducted at the Diabetes Research Center, Isfahan, Iran among 425 subjects with abnormal glucose homeostasis. Patients were of ages 35 - 55 years and had family histories of diabetes. We assessed dietary intake by the use of a food frequency questionnaire [FFQ] that contained 39 food items. General obesity was defined as a BMI > 30 kg/m[2] and central obesity was defined as waist circumference [WC] > 88 in women and WC > 102 in men. Five major dietary patterns were revealed by factor analysis: 'western', 'healthy', Vegetarian', 'high-fat dairy', and 'chicken and plants'. Those in the top tertile of the 'western pattern' had greater odds for general [OR = 1.73; 95% Cl = 1.07 - 2.78] and central obesity [OR = 2, 95% Cl = 1.24 - 3.22], however these associations were not significant after adjustment for confounding variables. The 'high-fat dairy pattern' was associated with greater odds of general obesity only after adjusting for confounding variables [OR = 1.73; 95%CI = 1.01 -2.96]. The dietary pattern characterized by high intake of hydrogenated fat and sugar was shown to be positively associated with a risk of general and central obesity, however further prospective studies are required to confirm our findings

Molecular epidemiology of rotavirus strains circulating among children with gastroenteritis in Iran

This study was conducted to evaluate the prevalence of rotavirus disease and to investigate the genotypes of rotavirus strains causing acute gastroenteritis among children aged <5 years old in Marvdasht, Iran. One hundred and forty-one children, aged 1 month to 5 years, afflicted with severe diarrhea were enrolled during January 2007 to December 2008. Their stool samples were studied with enzyme immunoassays [EIA] for group A rotaviruses. Rotavirus-positive specimens were genotyped by the Nested RT-PCR using different types of specific primers. Out of total collected samples rotavirus infection was detected in 40 [28.37%]. Of the rotavirus episodes, 72.91% occurred during the first 2 years of life [P=0.038]. The highest prevalence of infection was identified in summer [52.50%] and the lowest in winter [7.50%]. The most common clinical features included diarrhea [96.25%], vomiting [82.50%] and fever [45.0%]. Mixed genotypes were the predominant G type [60.0%], followed by non-typeable [12.50%], G2 [12.50%], G4 [10.0%] and G1 [5.0%] genotypes. G3/G8 mixed infection is the first of these rotavirus genotypes to be reported in Iran. Regarding high frequency of rotavirus infection, continuous surveillance is needed to inform diarrhea prevention programs as well as to provide information about the occurrence of new rotavirus strains. This will assist policy makers in decision making on rotavirus vaccine introduction

[Reliability, validity and factor analysis of Cohen-Mansfield agitation inventory [CMAI]]

In order to investigate the effectiveness of pharmacological and non-pharmacological treatment methods for decreasing agitation in diseases like dementia, a proper scale like Cohen-Mansfield Agitation Inventory [CMAI] is needed. The aim of the present study was to evaluate the psychometric properties of the CMAI. The sample consisted of 100 caregivers of patients with Alzheimer's disease that responded to the CMAI. The inter-rater reliability of the inventory was investigated by the assessment of other observer. After two weeks, the main observer filled the CMAI for the same patients again. The reliability of the inventory was investigated by test-retest, alpha Cronbach and split-half methods that were 0.99, 0.92 and 0.82 respectively. The validity of the questionnaire was investigated by convergent validity, inter-rater agreement across items and exploratory factor analysis. The results from factor analysis of the CMAI using varimax rotation method yielded 4 factors labeled: 1- Aggressive Behaviors, 2- Non-Aggressive Behaviors, 3- Verbal Aggression, and 4- Hiding Behaviors, which explained 72.77% of the total variance. Convergent validity was confirmed by computing a correlation coefficient between the subscales together and with total scale, which was significant between 0.43 and 0.90 [p<0.01]. Regarding the results, it could be said that this inventory can be a valid and reliable scale to evaluate the agitation in patients with Alzheimer's disease

Fracture strength of mesiobuccal roots following canal preparation with hand and rotary instrumentation: an in vitro study

The aim of this in vitro study was to compare the effect of hand and rotary instruments on fracture strength of tooth roots. Thirty two teeth were randomly divided into two experimental groups of 15 each and one negative control group with two samples. In group 1, step-back technique with conventional stainless steel K-files was used, and in group 2, instrumentation was performed using rotary Ni-Ti Hero642. Samples in control group did not receive cleaning or shaping after access cavity preparation. After obturating each canal, tip of the spreader was locked within canal. The required force for root fracture was measured using Instron testing machine. Recorded data was statistically analyzed using t-test. The mean and standard deviation force required for vertical root fracture were 50.33 +/- 19.1 and 63.1 +/- 25.46 N for hand and rotary groups respectively. However, no significant difference was found between experimental groups. The results indicate that the manual technique did not lower fracture strength of obturated roots in comparison with the rotary preparation technique

Comparing coronal discoloration between AH26 and ZOE sealers

Intrinsic tooth discolorations after endodontic treatment are principally attributed to the composition of necrotic pulp tissue, hemorrhage within the pulp cavity, endodontic medicaments and/or filling materials. Residual sealer left in pulp chamber after obturation can cause discoloration. The objective of this in vitro study was to evaluate coronal discoloration created by AH26 and ZOE sealers after four months. Fifty intact human extracted maxillary central incisors were employed. Access cavities were prepared in all samples and root canals were instrumented; coronal orifices were then sealed using self-cure glass ionomer. The teeth were divided into two experimental groups [n=20] according to utilized sealer in pulp chambers including AH26 and Dorifill [ZOE]. The remaining 10 teeth served as negative and positive controls [n=5]. The access cavities were sealed with self-cure glass ionomer. Teeth were kept in incubator for four month. Preliminary digital images of the teeth were taken and then compared with those related to 4-month follow-up. The images were assessed using Photoshop software. Data was analyzed using paired t-test and independent samples t-test. The teeth which were filled with AH26 sealer showed significantly greater discoloration than those filled with ZOE sealer [Dorifill] [P<0.05]. AH26 sealer causes greater discoloration of the crown compared to ZOE sealer. Despite the other disadvantage of AH26 sealer, it seems that Dorifill is more esthetically considerate

[Source of heavy metal pollutions in the sediments of the Anzali Wetland in Northern Iran]

Anzali wetland in north of Guilan provience is an international important wetland that is recorded in Ramsar convension. Pollution is one of the major problems facing this wetland. In order to investigate the pollution situation, sediment core samples were taken in 7 stations in 4 districts within the wetland, namely Abkenar, Siakishom, Hendekhale and Shijan]. Elements were determined in 0,5 10, 20 and 50 cm depths in each core. Major elements including Al, Ca, Fe, K, Mg, Na, Mn, P, Ti and trace element such as Li, Ba, S, Sr, As, Cd, Cr, Co, Cu, Mo, Ni, Pb, V, Zn, Bi concentrations were determained using ICP-MS. Temporal variability showed that most of the heavy metals decreased in concentartions from surface to depth. The statistical correlations among elemental pairs were performed by Pearson correlation. In Abkenar part of the wetland except Cr, Ni, Zn and Co, other heavy metals have anthropogenic source. Elemets such as Bi, Zn, V, and Pb in Siakishom part, Cu and Ni in Hendekhale, V, Cr and Co In the Shijan part have natural source. When comparing heavy metal concentrations in wetland sediments with Caspian Sea sediments and river sediments, it is apparent that the concentrations of heavy metals in wetland sediments are higher. Furthermore, considering the EF [Enrichment Factor] using Al normalization as the best method, the elements such as Zn, in all parts and Pb, Bi, Cd and Ni in most of wetland have low enrichment

effect of three irrigants on the coronal leakage of the root canals system irrigants

The production of smear layer during canal instrumentation is thought to increase coronal microleakage even after canal obturation. Previous studies have shown that the type of irrigant does not necessarily affect the seal of the obturation. Our study aimed to evaluate the effect of three irrigation solutions [MTAD, citric acid and EDTA/NaOCl] on the coronal microleakage of root canals. Fifty five intact single rooted teeth were instrumented and randomly divided into three experimental groups [15 teeth each] and two control groups [5 teeth each]. Final irrigation was carried out with MTAD in group I, citric acid in group II, and EDTA/NaOCl in group III. EDTA/NaOCl was used for the negative control group and saline irrigation was carried out in the positive control group. After lateral compaction with gutta-percha, the access cavities of the experimental specimens were restored with temporary restorative material. Temporary cement was not used in the positive control group. In the negative control group, access cavities and foramen apices were sealed with glass ionomer. Microleakage of samples was measured using the dye penetration technique. Data were analyzed with ANOVA and Tukey test to determine statistical differences between groups. MTAD, citric acid and EDTA/NaOCl all had less microleakage compared to normal saline. However, no difference was detected between the experimental groups. In this study, all three groups demonstrated effective seal with gutta-percha obturation. This is likely to be due to various factors including their ability to remove smear layer