Effect of various irrigation protocols and antioxidant application on bonding performance of two adhesive systems to coronal dentin.

Background: The aim was to evaluate the effect of different irrigation protocols and antioxidants application on the shear bond strength (SBS) of two different adhesive systems to deep coronal dentin at different temperature. Material and Methods: One hundred and twenty human premolar teeth were cut longitudinally in two halves, then the prepared specimens were allocated into four main groups according to the irrigation protocols; Distilled water (control), Sodium hypochlorite (NaOCl) + Ethylenediamine Tetra-acetic Acid (EDTA), and NaOCl + Editronate (HEDP), two subgroups according to irrigation solutions temperature; 4°C and 37°C, two divisions according to grape seed extract (GSE) application (with and without), and two subdivisions according to the applied adhesive systems; OptiBond-All-In-One (OPT) and ScotchBond Universal (SBU). Adhesives were applied in self-etch (SE) mode and resin composite material discs were built. Specimens were kept in distilled water for 24-h at 37°C before SBS testing. Four-way ANOVA and Tukey HSD tests were used for data analysis (α=0.05). Results: 4°C irrigants solution temperature showed the least significant SBS values, distilled water group showed significantly higher SBS values compared to NaOCl + EDTA and NaOCl + HEDP groups respectively. GSE application improved dentin bond strength significantly within each adhesive. Conclusions: Increasing the temperature of the irrigation solutions has significantly enhanced the SBS of coronal dentin. Antioxidants application following different irrigation protocols has improved the SBS. Key words:Irrigation protocols, temperature, bond strength, coronal dentin, antioxidant, adhesive systems.

Arab mothers' viewpoints: Why their children are removed from home.

BACKGROUND: Many studies have explored the impact of child removal on both children and professionals, but there is limited research on the experiences of mothers whose children social services had removed from their homes, particularly within Arab society. OBJECTIVE: This study focused on Arab mothers from East Jerusalem-an ethnic minority in Israel's society, that faces unique challenges-whose children removed from home. The study examines, from the mothers' perspectives (1) reasons for the removal, and (2) relationships with welfare services. METHODS: 15 Arab mothers from East Jerusalem, aged 25 to 49 who had at least one child removed through a court order participated in the study. Nine of the mothers were divorced, separated, or widowed. RESULTS: The mothers described several reasons for their children's removal, including domestic violence and lack of support from their own families after leaving abusive husbands, poverty leading to what social services interpreted as neglect, the child's challenging behavior, and false accusations. The second theme reveals a lack of cooperation between social workers and the mothers, and social workers' negative perceptions of the mothers hindering reunification. CONCLUSIONS: The study sheds light, for the first time as far as we know, on the perspectives of Arab mothers concerning their children's removal. Early support could avert removal, and social workers should make greater efforts to promote child reunification. It is paramount that professionals build trust with these mothers, through culturally sensitive and empowering engagement.

Effect of different root canal irrigants on push-out bond strength of two novel root-end filling materials.

BACKGROUND: The aim of this in vitro study was to evaluate push-out bond strength of different root-end filling materials using various irrigant solutions. METHODS: A push-out bond strength test was performed to evaluate the bond strength of two experimental root-end filling materials: namely, nano-hybrid mineral trioxide aggregate (MTA) and polymethyl methacrylate (PMMA) cement filled with 20% weight nano hydroxyapatite (nHA) fillers compared to conventional MTA. The irrigant solutions employed were sodium hypochlorite (NaOCl) in concentrations 1%, 2.5% and 5.25% and 2% chlorhexidine gluconate (CHX) followed by application of 17% ethylene diamine tetra-acetic acid (EDTA). A freshly extracted sixty single-rooted human maxillary central incisors were used. The crowns were removed, the canal apex was widened to simulate immature teeth. Each type of irrigation protocols was performed. After application and setting of the root-end filling materials, a slice of one mm thickness was cut transversely from the apical end of each root. Specimens were stored for 1 month in artificial saliva and were subjected to a push-out test to evaluate the shear bond strength. Data were analyzed using two-way ANOVA and Tukey test. RESULTS: The experimental nano-hybrid MTA showed the highest significant push-out bond strength values when irrigated by NaOCl at several concentrations (1%, 2.5% and 5.25%) (P< 0.05). Meanwhile, irrigation with 2% CHX resulted in highest bond strength values in nano-hybrid white MTA (18 MPa) and PMMA filled with 20% weight nHA (17.4 MPa) with nonsignificant difference between them (p = 0.25). In each root-end filling material, irrigation with 2% CHX led to the highest significant bond strength, followed by NaOCl 1%, while the least significant bond strength was produced after irrigation with NaOCl 2.5% and 5.25% (P< 0.05). CONCLUSION: Considering the limitations of this study, it may be concluded that the application of 2% CXH and 17% EDTA provides superior push-out bond strength to root canal dentin compared with irrigation with NaOCl irrigants and 17% EDTA, experimental nano-hybrid MTA root-end filling material provides enhanced shear bond strength than conventional micron-sized MTA root-end filling material.

Biomechanical Behavior and Life Span of Maxillary Molar According to the Access Preparation and Pericervical Dentin Preservation: Finite Element Analysis.

INTRODUCTION: This study investigated the significance of pericervical dentin after coronal canal flaring on the biomechanical behavior and life span of a maxillary molar using finite element analysis (FEA). METHODS: In addition to the intact tooth (IT) model, 4 experimental FE models were designed: conservative access cavity model (CON), and 3 models with different radicular preparations for the coronal 4 mL considering 3 instruments: ProTaper SX model (SX), OneFlare model (OF), and Gates-Glidden model (GG). Cyclic loading of 50 N was applied on the occlusal surface and number of cycles until failure (NCF) was compared with the IT model. Mathematical analysis was done to evaluate the stress distribution patterns and calculated maximum von Mises (VM) and maximum principal stresses. RESULTS: Access cavity preparation (CON) decreased NCF significantly when compared with the IT model (93.99%). The coronal preparation of the root canal did not have a significant effect even when the preparation was taken to the extreme (GG: 92.02%). VM analysis confirmed apical dispersion of stresses, with maximum value registered on the occlusal surface in the GG model (7.88 MPa), and minimum on the IT model (7.01 MPa). The furcation area showed higher maximum principal stresses, yet stress values remained minimal and distributed over larger surfaces with the progressive enlargement among models. CONCLUSIONS: Within the limitations of this study, coronal canal flaring affects tooth integrity minimally, and when loading conditions lie within normal functional ranges, tooth structure has the capacity to disperse increasing stresses over a wider surface area.

Influence of Thermomechanical Treatment on the Mechanical Behavior of Protaper Gold versus Protaper Universal (A Finite Element Study).

AIM: To compare and evaluate the influence of thermomechanical treatment of Protaper Gold file versus Protaper Universal file during testing of bending and torsion using finite-element analysis. METHODS: Two nickel-titanium NiTi rotary files (ProTaper Gold and ProTaper Universal) were used in this study. The files were imaged using stereomicroscope to produce 3D models. The behaviour of the instrument during bending and torsion was numerically analysed in CAD/CAM software package. RESULTS: Under bending, ProTaper, Gold showed higher flexibility and flexural resistance than ProTaper Universal. The highest stress was related at the cutting edge of both files. While during testing of torsion, the maximum amount of stresses was related to the base of the flutes in both files. ProTaper Gold showed higher torsional resistance than the ProTaper Universal file. CONCLUSION: Thermomechanical treatment improved the mechanical response (bending and torsional resistance) of NiTi files.

Efficacy of Fiber Post Bonding To Root Dentin after Different Obturation Techniques and Cementation Timings: In Vitro Study.

OBJECTIVE: The aim of this in vitro study was to assess the effect of obturation technique and cementation timings on the bonding of fibre-reinforced posts to the root canal walls. METHODS: Twenty extracted teeth were randomly allocated to two groups according to the obturation technique and cementation timing. Central incisors with single canals were used after being decoronated. Every extracted tooth of the {vertical compaction group} (VC) group (n = 10) had been obturated using the {E & Q plus obturation system} with posts cemented in the same day; The other (CO) conventional group (n = 10) teeth were obturated using the conventional lateral compaction technique and posts cemented after one week. "SF" Fiber posts were used after bonding and cementation using Rely X ARC resin cement with all the endodontically treated teeth. The push-out test was performed in a universal testing machine. Data were analysed by 2 way analysis of variance with Statistical significance was set to 0.05. RESULTS: Heat softened gutta percha group showed more push out the bond strength of the bonded posts than the conventional obturation group (p < 0.05). In the middle region, there was no statistical significance between the two groups while there was significance in the coronal and apical thirds. CONCLUSION: The vertical compaction technique and early cementation improved the bond strength of the resin posts in comparison to the conventional obturation technique with late cementation.

Philtrum length and intercommissural distance measurements at mixed dentition period.

Anthropometric measurements of the lip and mouth are of great importance in clinical dysmorphology as well as reconstructive plastic surgery. In this study, the philtrum length (PhL) and intercommissural distance (ICmD) nomograms for Egyptian children in the mixed dentition period were established. A group of 1,338 Egyptian students in primary schools (735 boys and 603 girls) were included in the study. The students were at mixed dentition period and their ages ranged from 7 to 12 years. Anthropometric norms of PhL and ICmD were developed with significant sex difference in certain groups. A ratio between PhL and ICmD was developed. These data will help facilitate both objective and subjective evaluation of the lip and mouth for proper diagnosis of orofacial anomalies and variations as well as for ideal treatment plans.