Antimicrobial and physical properties of alginate impression material incorporated with silver nanoparticles.

BACKGROUND: Self-disinfecting impression materials would reduce time and energy needed for impression disinfecting process in clinic. The aim of this study was to evaluate the antimicrobial effect of alginate mixed with nanosilver solution at a concentration of 500 ppm and 1000 ppm on common oral microorganisms and assess changes in working time, setting time, and surface detail reproduction. MATERIALS AND METHODS: In this in vitro study, three groups were assigned. The first group was alginate, the second group was alginate mixed with 500 ppm nanosilver, and the third group was alginate mixed with 1000 ppm nanosilver. Antimicrobial effect on Escherichia coli, Staphylococcus aureus, and Candida albicans was studied using direct contact test in each group (n = 10). Working time (n = 10), setting time (n = 10), and surface detail reproduction (n = 10) were evaluated separately using the ISO 21563 protocol. Descriptive tables were used to describe the data. Kruskal-Wallis test used to determine significant differences in the number of colonies was counted in antimicrobial test (α = 0.05). RESULTS: No adverse effects observed in working time, setting time, and surface detail reproduction of alginate impressions. Alginate mixed with silver nanoparticles showed no inhibitory effect on S. aureus and C. albicans, but the number of E. coli colonies were counted in the group 1000 ppm was significantly lower than 500 ppm (P = 0.001). CONCLUSION: Antimicrobial effect of alginate mixed with silver nanoparticles is not clinically indicated. Nevertheless, its physical features did not change significantly.

Effect of Propolis mouthwash on plaque and gingival indices over fixed orthodontic patients.

BACKGROUND: In patients with fixed orthodontics, the presence of orthodontic appliances causes dental plaque accumulation and hygiene problems. The purpose of this study was to evaluate the effect of Propolis and chlorhexidine mouthwashes on plaque and gingival indices in patients who are undergoing orthodontic treatment. MATERIAL AND METHODS: In this triple blind study, in total, 37 patients aged from 15 to 35 years those who have been undergoing fixed orthodontic treatment were studied. After that, one of the mouthwashes that containing either Propolis or Chlorhexidine was randomly prescribed to patients. The patients were asked to use mouthwashes twice a day after brushing their teeth for three weeks consecutively. Indicators of plaque, gingival and periodontal status (PI, GI, CPI) were determined on Ramford teeth at the beginning and at the end of three weeks for each patient. Then the results were analyzed statistically. RESULTS: The difference between the values of plaque index (P<0.001), gingival index (P=0.006) and periodontal index (P= 0.005) before and after administration of Propolis were statistically significant. The difference was also statistically significant for all three indexes of plaque (P<0.001), gingival (P=0.001) and periodontal (P=0.003) before and after chlorhexidine mouthwash usage. The indices after using mouthwashes were not statistically significant different between two mouthwash groups. CONCLUSIONS: It seems that Propolis mouthwash can be used as a suitable alternative in patients with fixed orthodontic treatment without the side effects of chlorhexidine mouthwash. Key words:Mouthwash, antimicrobial, Oral hygiene, Propolis, Dental plaque.

Comparison of self-ligating Damon3 and conventional MBT brackets regarding alignment efficiency and pain experience: A randomized clinical trial.

Background. Self-ligating brackets might be more efficient than conventional appliance systems during the initial alignment stage of orthodontic treatment due to reduced frictional resistance. This study aimed to compare the alignment efficiency and pain experience of Damon3 self-ligating and MBT pre-adjusted brackets in the initial alignment stage. Methods. In this randomized clinical trial, 30 patients aged 14‒20 years, who needed non-extraction treatment in both maxillary and mandibular arches, were randomly assigned to two groups; 15 patients were treated with MBT pre-adjusted brackets, and 15 patients received Damon3 self-ligating brackets, both with 0.022-in slots. Alginate impressions were taken at the start of treatment (T0) and four monthly visits (T1, T2, T3, and T4). Little's irregularity index (LII) was used to assess the tooth displacements. The patients rated their pain experience immediately after the insertion of the archwire, 4 hours, 24 hours, 3 days, 7 days, and at each monthly visit using a visual analog scale (VAS). Results. The rate of upper dental alignment between T0 and T4 was significantly higher with the Damon3 compared to MBT brackets (P=0.015). Although significantly more changes in the lower LII scores were observed during the first three months with the Damon3 system, the rate of improvement in the irregularity of lower teeth over the 4-month period was not significantly different between the two groups (P=0.50). The patients' pain experience was not significantly different between the bracket groups (P=0.29). Conclusion. During the four-month alignment stage, significantly more improvement in the upper dental irregularity was observed with self-ligating compared to conventional brackets. The bracket type had no effect on pain experience during the alignment stage.

Piezopuncture-Assisted Canine Distalization in Orthodontic Patients: Two Case Reports.

With the increasing number of young adults seeking orthodontic treatment to improve their smile esthetics or oral function, the time spent wearing brackets is one of the biggest challenges for these patients. Various surgical techniques have been developed over the years to accelerate tooth movement and reduce the total treatment time. A newly introduced, minimally invasive procedure namely piezopuncture, which uses a piezosurgical tool to create multiple cortical punctures through the gingiva, is presented in this report of two extraction cases.

Effectiveness of sodium bicarbonate combined with hydrogen peroxide and CPP-ACPF in whitening and microhardness of enamel.

BACKGROUND: This study investigated the effects of sodium bicarbonate (NaHCO3) combined with 1.5% hydrogen peroxide (H2O2) and casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) on color and microhardness of enamel. MATERIAL AND METHODS: Seventy-five bovine incisors were immersed in a tea solution for 7.5 days. The specimens were randomly divided into five groups according to the whitening agent applied: 1) 94% NaHCO3, 2) a blend of 94% NaHCO3 and CPP-ACPF, 3) a blend of 94% NaHCO3 and 1.5% H2O2, 4) a blend of 94% NaHCO3, 1.5% H2O2 and CPP-ACPF, 5) control. The whitening procedure was performed for 10 times over 10 days. At each day, the buccal surfaces were covered with whitening agents for 5 minutes and then brushed for 30 seconds. After the 10 days, the teeth were again immersed in a tea solution for 10 minutes. Color assessment was performed at baseline (T1), after the first staining process (T2), after the whitening procedure (T3), and after the second staining process (T4). Finally, the specimens were subjected to microhardness test. RESULTS: There was a statistically significant difference in the color change between T2 and T3 stages among the study groups (p<0.05), with the greatest improvement observed in group 4. Microhardness was significantly greater in groups 2 and 4, as compared to the other groups (p<0.05). CONCLUSIONS: The combination of 94% NaHCO3, 1.5% H2O2 and CPP-ACPF was effective in improving color and microhardness of teeth with extrinsic stains and could be recommended in the clinical situation.

Cleft lip and Palate: A 30-year Epidemiologic Study in North-East of Iran.

INTRODUCTION: Cleft lip and palate are among the most common congenital anomalies worldwide. This study was conducted in order to explore the incidence and related factors of cleft lip and/or palate (CL/P) among live births in Mashhad, North-Eastern Iran. MATERIALS AND METHODS: In this cross-sectional study, records of 28,519 infants born between March 1982 and March 2011 at three major hospitals in Mashhad were screened for oral clefts. Clinical and demographic factors relating to diagnosed cases, including birth date, gender, birth weight, maternal age, number of pregnancies, type and side of cleft and presence of other congenital anomalies were recorded for analysis. RESULTS: The overall incidence of CL/P was 1.9 per 1,000 live births. Cleft lip associated with cleft palate (CLP) was the most prevalent type of cleft (50%), followed by isolated cleft lip (35.2%) and isolated cleft palate (14.8%). A total of 92.6% of oral clefts were bilateral and 5.5% were located on the right side. In addition, clefts were found to be more common in male than female births (male/female ratio=2.3). The rate of associated congenital anomalies in CL/P newborns was 37%. No significant differences were observed in the incidence of oral clefts across three decades of study; except for CLP which was significantly more prevalent between 2002-2011 (P=0.027). There were no significant differences with regard to season of birth, associated anomalies or maternal age of affected newborns in the three time periods of the study. Furthermore, maternal age and number of pregnancies were not significantly different among the three types of cleft (P=0.43 and P=0.91, respectively). Although the mean birth weight of patients affected with isolated cleft palate was considerably lower than that of the other two types of cleft, the difference was not statistically significant (P=0.05). CONCLUSION: This study indicates a frequency of CL/P close to the findings in East Asian countries and higher than some previous reports from Iran, European and American countries. Ethnicity-related genetic factors may have a role in the conflicting results obtained from different populations.

The effect of speech therapy on acoustic speech characteristics of cleft lip and palate patients: a preliminary study.

PURPOSE: To assess the effects of speech therapy on the acoustic characteristics of speech in a group of cleft lip and palate patients. MATERIALS AND METHODS: In this experimental pilot study, eight patients with unilateral cleft lip and palate participated in the 13-month period of speech therapy. They had some exercises in the class and at home to reduce the hypernasality of speech. Using an acoustic software named Praat, three formants (F1, F2, F3) of speech sounds /b /, /p /, /f /, /v /, /k /, and /g / were obtained pre and post speech therapy. We used paired samples t-test to compare the acoustic variables of each consonant before and after the therapy. RESULTS: No significant differences were found between the pre- and posttherapy acoustic measures for fricative consonants /f /, /v / and stop consonants /k / and /g/. However, a statistically significant improvement in hypernasality of labial consonants /b / and /p / was observed after the speech therapy. CONCLUSIONS: The present study underlines the role of a speech therapist in a complete cleft care team, in order to take care of the speech improvement of the patient and to motivate the parents to help the speech development of their child.

Coping strategies and psychological distress among mothers of patients with nonsyndromic cleft lip and palate and the family impact of this disorder.

The current study aimed to investigate the coping strategies and level of psychological distress in mothers of patients with cleft lip and palate (CLP) and the family impact of this disorder. Participants were mothers of 55 children or adolescents with nonsyndromic CLP recruited from families attending a CLP clinic and 2 university hospitals in Mashhad, northeast of Iran. Family impact, psychological distress, and coping strategies were assessed using validated psychological questionnaires including Family Impact Scale, General Health Questionnaire, and Coping Response Inventory. Findings revealed that mothers relied more on the use of approach-oriented rather than avoidance-oriented coping strategies. According to General Health Questionnaire scores, 38.2% of mothers showed some evidence of psychological distress, and 23.6% were suspected of having severe psychological problems. Regarding the family impact of CLP, mothers reported the greatest impact to be on the family's financial status and parental emotions. Those mothers who used avoidant coping strategies reported a greater family impact of CLP (P = 0.002). Emotional discharge and acceptance coping were significant predictors of family impact (P = 0.037 and P = 0.035, respectively). Mothers of 13- to 18-year-old patients with CLP reported greater use of problem-solving coping strategy when compared with mothers of younger patients (P = 0.006). Child's age and coping strategies were not significant predictors of the level of mother's psychological distress. Increased knowledge about how parents cope with their child's craniofacial condition may help caregivers develop a more family-oriented care approach, which is sensitive to the psychosocial needs of parents, children, and their families.

Facial soft-tissue morphology of adolescent patients with nonsyndromic bilateral cleft lip and palate.

The purpose of this study was to cephalometrically evaluate the facial soft-tissue characteristics of adolescent patients with bilateral cleft lip and palate (BCLP) and to compare them with a noncleft control group. Lateral cephalometric radiographs obtained from 56 adolescents with nonsyndromic BCLP (29 boys and 27 girls) were analyzed and compared with 67 control subjects (29 boys and 38 girls) who were matched for sex, age, and ethnicity. All patients had been operated on before the age of 2 years for the surgical repair of cleft lip and palate. None had received any orthopedic or orthodontic treatment. Independent-samples t test revealed that patients with BCLP significantly differed from the control group by having a flatter facial profile, thinner and more retruded nasal base, flatter nasal tip (in males), and reduced upper-lip length. Furthermore, thicker lower-lip pit, shallower mentolabial sulcus, and increased inclination angles of the upper and lower lips relative to the horizontal plane were observed in female patients compared with the normal group. The findings of the current study suggested that adolescent patients with BCLP showed several facial soft-tissue deformities when compared with normal individuals with the same age, sex, and ethnic origin. This study provides objective measures that could lead to better treatment planning and prediction of the need for corrective surgeries in patients with BCLP.

Analysis of MTHFR Gene C.677C>T and C.1298A>C Polymorphisms in Iranian Patients with Non-Syndromic Cleft Lip and Palate.

BACKGROUND: Non-syndromic cleft lip with or without cleft palate (nsCL/P) is one of the most common congenital abnormalities of the orofacial region with a multifactorial etiology. The present study aimed to investigate the association of two common polymorphisms of methylenetetrahydrofolate reductase (MTHFR) gene (c.677C>T and c.1298A>C) with the occurrence of nsCL/P in an Iranian population. METHODS: Forty-five nsCL/P patients, 43 mothers of patients, and 101 unrelated controls participated in the present study. Analysis of c.677C>T and c.1298A>C polymorphisms in MTHFR gene was conducted using polymerase chain reaction and restriction enzyme digestions. RESULTS: There was no statistical difference in genotype and allele frequencies for c.677C>T variants between patients or their mothers and the control group. However, differences in the frequencies of alleles and genotypes of c.1298A>C polymorphism were statistically significant between patients and control group (P=0.01 for alleles and P=0.005 for genotypes). The odds ratios (OR) for the CC versus AA homozygotes were 6.1 (95% CI 1.8-20.5) and 4.2 (95% CI 1.1-15.4), in patients and mothers, respectively. CONCLUSIONS: We found no association between genetic polymorphism of MTHFR c.677C>T and the risk of nsCL/P in the population studied. Yet the results suggested that c.1298A>C polymorphism of MTHFR gene may be a risk factor for the occurrence of nsCL/P in the Iranian population.

Prevalence of dental anomalies in patients with cleft lip and palate.

The aim of the present study was to investigate the prevalence of dental anomalies in a group of patients with cleft lip and palate (CL/P) in the northeast of Iran. Ninety-one patients referring to the Cleft Lip and Palate Clinic of Mashhad Dental School were enrolled and classified into right CL/P, left CL/P, and bilateral CL/P groups. Photographs, dental casts, and panoramic and periapical radiographs were retrieved, and dental anomalies were recorded. χ test was used to analyze the frequency of dental anomalies according to type of cleft and sex. Missing maxillary lateral incisors was the most frequent dental anomaly, which was slightly higher in the bilateral group (61.1%). There were significantly more cases of missing lateral incisors outside the cleft area in right CL/P (P = 0.015). Peg lateral incisors were observed in 33.3% of bilateral CL/P compared with 28% of right and 23.3% of left unilateral cases. The sample presented rotations of central incisors in the cleft area in 33.3% of bilateral clefts. In unilateral clefts, it occurred more frequently in the right side (48%). Sexual dimorphism appeared only for maxillary central incisor rotation in the cleft area, which showed significantly greater frequency in females (P = 0.025). Transposition of maxillary canine and first premolars was found in 5.5% of bilateral, 8% of right, and 3.3% of left unilateral clefts. The prevalence of dental anomalies in the studied sample seems to be higher than that reported in the normal population. More anomalies were observed at the cleft side. The frequency of most anomalies was not significantly different between the 2 sexes.

Oral health-related quality of life in children with cleft lip and palate.

Considering the essential need for oral health-related quality-of-life measures for patients with craniofacial malformations, the current study aimed to investigate the oral health-related quality of life of Iranian patients with cleft lip and palate. Fifty children referred to Cleft lip/Palate Research Center of Mashhad Dental School (Iran) were recruited. Participants were asked to complete the Child Oral Health Impact Profile questionnaire. The questionnaire comprised 38 items and was divided over 5 subscales. The scores on all subscales were compared with regard to patients' age, sex, and type of cleft. A significant difference between boys and girls was found on the subscale "emotional well-being" (P = 0.027). There was no significant difference between 8- to 12-year-old patients and those older than 12 years. Also, no significant difference was found between bilateral and unilateral cleft lip and palate patients regarding mean score of Child Oral Health Impact Profile questionnaire and its subscales. Oral health-related quality of life of cleft lip and palate patients did not change with patients' age. Also, the impact of unilateral and bilateral clefts on OHRQoL was similar. Quality of life of girls was more affected by oral health.

Had prevalence of cleft lip and palate differed during the Iran-Iraq war?

Cleft lip and palate are among the most common congenital defects with multifactorial etiology, and maternal stress may have a role in the development of the malformation; thus, the aim of this study was to explore the role of war on cleft lip and palate (CL/P) prevalence.In this study, records of 101,435 newborn infants delivered in the teaching hospitals of Mashhad and Ahwaz during wartime (1982-1987) and recent years (2005-2010) were reviewed. Samples were analyzed for prevalence of anomaly in both cities at 2 time intervals as well as some related factors; χ and t tests were used for data analysis.Results showed the incidences of CL/P in Mashhad during 1982 to 1987 and 2005 to 2010 were 2 and 2.2 per 1000 live births, respectively; however, its incidence in Ahwaz was 1 per 1000 during wartime and 0.7 per 1000 live births for recent years.Despite significant differences that were found in the prevalence of both cities in recent years (P = 0.001), no significant differences were observed during wartime (P = 0.28).The results revealed that CL/P was more prevalent in both cities, but in contrast to Ahwaz, cleft lip was more prevalent than isolated cleft palate in Mashhad, and significant differences were found between both cities (P = 0.007).The study concluded that the prevalence of CL/P in Ahwaz decreased after the war. However, in Mashhad, its prevalence, which was not affected during wartime, gradually increased. Thus, genetic research may be necessary to establish a genetic predisposition in northeast Iran.

The efficacy of gabapentin versus stabilization splint in management of sleep bruxism.

PURPOSE: This study aimed to determine if the use of gabapentin is more efficacious than a stabilization splint with regard to the intensity of masseter muscle contractions and/or sleep quality for patients experiencing sleep bruxism (SB). MATERIALS AND METHODS: Twenty patients with SB participated in this clinical study. They were randomly divided into two treatment groups: stabilization splint group (n = 10) and gabapentin group (n = 10). The first polysomnographic examination was performed before the beginning of the experiment for all the participants. At the end of a 2-month period of stabilization splint therapy or gabapentin usage, a second polysomnographic recording was made. RESULTS: Statistically significant reductions in the number of SB episodes per hour and per night, bruxism time index, total duration of SB episodes per night and number of SB episodes in stages NR I and NR II (p < 0.05) were observed in both groups after treatment. Both treatments significantly reduced the mean intensity of masseter muscle contractions during SB episodes. Moreover, the participants treated with gabapentin showed a significant improvement in total sleep time, slow wave sleep (stage III), and sleep efficiency (p < 0.05). CONCLUSIONS: Gabapentin could be an effective treatment modality in SBs, especially in those with poor sleep quality.

DNA damage in oral mucosa cells of patients with fixed orthodontic appliances.

OBJECTIVE: The release of toxic metal ions from orthodontic alloys has induced concerns regarding the biocompatibility of fixed appliances. This study investigated the genotoxic effect of metal appliances in a sample of patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: The study included twenty-five healthy individuals requiring orthodontic therapy in both jaws. The patients were treated by stainless steel orthodontic brackets and nickel-titanium or stainless steel arch wires. The oral mucosa cells were gathered just before the appliance placement and 9 months later. The cells were centrifuged, fixed and dropped onto slides. After staining, the micronucleus (MN) assay was used to determine genome alteration. The data were analyzed by paired sample t-test. RESULTS: The mean micronuclei frequency in the buccal mucosa was 10.6 ± 5.7 per 1000 cells before the appliance placement and 9.2 ± 6.37 per 1000 cells 9 months later. No significant difference was found in the MN count before and 9 months after therapy (p=0.336). CONCLUSION: Under the conditions used in this study, application of fixed orthodontic appliances did not expose healthy individuals to increased risk of DNA damage in oral mucosa cells.

Effect of sodium fluoride mouth rinse on elastic properties of elastomeric chains.

OBJECTIVE: This study evaluated Sodium Fluoride mouth rinse effects on elastic properties of different elastomeric chains. STUDY DESIGN: In this in vitro experiment, two orthodontic chains were tested. In the first group, they were stored in artificial saliva for the entire duration, and in the second group they were immersed daily in 0.05% NaF mouth rinse for 1 minute, artificial saliva-NaF mixture for 30 minutes, and then in artificial saliva for the rest of the day. Specimens were tested at baseline, 1 hour 24 hours, 1, 2 and 3 weeks and then the displacement of specimens to obtain 150 g and 300 g, also the applied force after stretching them to 100% of their original length were evaluated. RESULTS: In contrast to force degradation, chains of both companies required more displacement to achieve both forces in the saliva-NaF mixture than saliva itself however the difference was only significant for the 300g force (P = 0.020). American Orthodontics chains required more displacement than Dentaurum chains to obtain both forces, also they had more load relaxation (P < 0.001). CONCLUSIONS: Daily use of NaF mouth rinse does not affect force degradation and the displacement of both chains to achieve conventional orthodontic forces, but for higher force levels the displacement increase is statistically significant.