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Background: The acidic component of liquid medicinal syrups used by pediatric patients may cause erosion and partial demineralization. This study aimed to evaluate the effect of cheese and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups. Materials and Methods: In this in vitro study, 60 noncarious deciduous molars were used. After measuring the surface microhardness of the samples, they were randomly separated into two groups and immersed in either amoxicillin or ibuprofen for 1 min three times per day. CPP-ACP, cheese, and artificial saliva were then applied to each of the three subgroups (n = 10). After each immersion time, 10 min of therapy was given. Between treatment intervals, the samples were kept in artificial saliva. The microhardness was remeasured after 1 week. Data were analyzed using SPSS software through repeated-measures ANOVA (α = 0.05). Results: All samples’ microhardness reduced considerably after immersion in liquid pharmaceuticals (amoxicillin [84.9 kgf/mm2] and ibuprofen [75.1 kgf/mm2]), but increased significantly following exposure to therapeutic solutions. There was no difference between the amoxicillin-cheese and amoxicillin-CPP-ACP subgroups (P = 0.975). A statistically insignificant difference was found between the ibuprofen group and the ibuprofen-CPP-ACP subgroup (P = 0.499). Conclusion: As a result, cheese and CPP-ACP can be utilized to remineralize erosive lesions caused by amoxicillin or ibuprofen exposure.

Background and Objectives: Periodontal diseases are resulted from gum infections and dental plaques, which are mainly caused by the bacterial agents. Since dental monitoring includes important prognostic roles, the aim of this study was to detect the most common periodontal pathogenic bacteria in children. Materials and Methods: A total of 200 clinical samples were collected from dental plaques and gingival grooves. Target-specific primers were designed for hbpA in Aggregatibacter actinomycetemcomitans, fimA in Porphyromonas gingivalis and 16S rRNA in Prevotella intermedia, Tannerella forsythia and Treponema denticola. Then, a multiplex polymerase chain reaction method was optimized for the highlighted bacterial agents. Results: In general, the highest and the lowest bacterial prevalence rates belonged to Tannerella forsythia (88%) and Porphyromonas gingivalis (13%), respectively. Furthermore, prevalence rates of Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Treponema denticola were 25, 21 and 45% in samples, respectively. Conclusion: There were significant associations between dental/oral health and microbial community. Metabolism of the oral bacteria, including biofilm formation, can affect gums and develop dental plaques and hence dental caries, especially in children. Early diagnosis of dental caries in children via rapid, accurate molecular methods can increase the diagnostic capacity in clinical cases and therefore prevent periodontal infections in adulthood.

Background: Streptococcus mutans is a major component of dental plaque, contributing to cariogenic biofilm formation and inducing dental caries. Attempts have recently been made to use postbiotic mediators (PMs) to prevent dental caries. This research evaluated the antimicrobial/antibiofilm activity of PMs derived from Lactobacillus rhamnosus GG (LGG) and Lactobacillus reuteri (LR) against S. mutans in vitro. Methods: PMs were obtained from the Lactobacilli supernatants. The minimum inhibitory concentration, minimum bactericidal concentration, antibiofilm potential, and metabolic activity of PMs against S. mutans were evaluated using CFU/mL, scanning electron microscopy, and XTT (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) reduction assay. The expression of gtfB gene as one of the most important genes involved in S. mutans biofilm formation was also measured using qRT-PCR. Results: CFU score was reduced by both PMs, but the reduction was only significant in LGG (p = 0.02). Both PMs caused a significant decrease in the metabolic activity of S. mutans compared with the controls (p ≤ 0.002). S. mutans treated with LGG PMs exhibited more destructive effects than LR PMs (p > 0.05). S. mutans gtfB gene expression was significantly downregulated when treated with the PMs obtained from both LGG and LR (p = 0.01 for both). Conclusions: We showed that PMs isolated from two Lactobacillus strains inhibited S. mutans biofilm, metabolic activity, and gtfB gene expression. Therefore, these derivatives may be a suitable biofilm-destruction agent against S. mutants. However, the oral environment is a complex ecosystem that needs further investigation.

Objectives: Dental caries is among the most common chronic diseases of the childhood. This study sought to assess the effect of caries experience in primary molars on caries development in the adjacent permanent first molars. Materials and Methods: This cross-sectional study evaluated 413 students aged 7 and 8 years. Clinical dental examination was performed by two independent examiners using disposable dental instruments and a head light. Dental caries was evaluated using the International Caries Detection and Assessment System (ICDAS) for all four permanent first molars and the decayed, missing, and filled teeth (dmft) index for the primary molars. Data were analyzed using the Pearson’s Chi-squared test and Fisher’s exact test. Results: When primary first molars were sound, 22.9% of the permanent first molars of the same quadrant were sound. When primary second molars were sound, 25.7% of the adjacent permanent first molars were sound. A carious primary second molar had a stronger correlation with development of dentin caries in the adjacent permanent first molar than a carious primary first molar (P

Background and Aims: Most children get a lot of anxiety while they visit a dentist. The most important factor in the child's fear at the beginning of treatment is the syringe and needle. Ways to cope with this anxiety include behavioural control techniques such as mental regeneration, distraction, and induction. The purpose of this study was to compare the pain and anxiety in children when using a syringe and toy- shape syringe needle. This study was the first study that used a toy-shape needle cover. Materials and Methods: This clinical trial study was conducted on 20 children age from 5 to 8 years. More than half of them were anxious with Cfss-Ds (Dental Subscale of the Children's Fear Survey Schedule) and FIS (Facial Image Scale) anxiety diagnostic tests, and the rest of them were not anxious. Patients were randomly divided into two groups. The first group received local anesthesia with conventional syringe and the second group, by syringe with toy shape needle cover. Following, the first group received local anesthesia by syringe with toy shape needle cover, and the second group, by a conventional syringe. Heart rate measuring and pain evaluating test was performed. Analysis of heart rate and anxiety data was performed by non-parametric wilcoxonsianed Ranks T-test (P-value was considered significant at 0.001). Results: The mean amount of pain measured after using a syringe with a toy shape needle cover and using conventional syringe had a significant difference of 5.20% between the two groups. The pain was reduced in children who received local anesthesia by syringe with toy shape needle cover (P

Background: Identifying the best species of medicinal plants and extracting effective substances can be effective in preventing oral and dental illness. The Malva sylvestris L. is among these plants. Malva sylvestris L. belongs to Malvaceae family from which A great deal of (Malvone A: 2-methyl-3-methoxy-5,6-di- hydroxy-1,4-naphthoquinone) anthocyanin and important natural pigments have been extracted. Anthocyanins and other substances of Malva sylvestris own antibacterial properties. Antibacterial properties of Malva sylvestris were investigated on the bacterial species. The purpose of this study was to investigate the antibacterial effects of the Malva sylvestris L. extract on the Streptococcus mutans and compare it with the effect of chlorohexidine (0.12%). Methods: This experimental study was carried out at the Shahed University of Medical Sciences, Tehran, Iran in the field of microbiology in January 2016 to September 2016. Methanolic aqueous extract of Malva sylvestris L. was prepared by decoction extraction method. The presence of polyphenol trepnoid, saponine, anthocyanins compounds in the extract was approved by high performance thin layer chromatography. Chromatographic and spectral fingerprint analysis plays an important role in the quality control of complex herbal medicines. The antimicrobial effect of the Malva sylvestris L. on the growth of Streptococcus mutans was evaluated. Results: Extract at different concentrations (16.8-4.2 mg/ml) had an antibacterial effect and compared with commonly used chlorohexidine in dentistry. The non-growth halo against Streptococcus mutans showed an average of 1.66 mm. The minimum inhibitory concentration against Streptococcus was 2 mg/ml. The presence of polyphenols, troponides of saponin, was characterized by high performance thin-layer chromatography (HPTLC). Conclusion: However, antibiotics play an important role in human health, with the increasing occurrence of bacterial resistance against available antibiotics. The results of this study showed that the aqueous-methanolic extract of the Malva sylvestris L. plant has antimicrobial activity affecting Streptococcus mutans. The flowers extract also showed high antibacterial effects against some human pathogen bacteria strains. This property of polyphenolic compounds of the plant, identified by fingerprint analysis, was less susceptible to chlorohexidine than gold standard.

Background. The aim of this investigation was to compare the sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine combinations on fearful children needing dental treatment. Methods. This crossover double-blind clinical trial was conducted on 30 children aged 2‒6 years, who had at least two similar teeth needing pulp treatment. Standard vital signs were recorded before and after premedication. Wilson sedation scale was used to judge the level of sedation. Cases were divided into two groups based on the sequence of medication received. This was to overcome the sequence effect. Group I received oral midazolam (0.4 mg/kg/chloral hydrate (50 mg/kg) at the first visit while they received midazolam (0.4 mg/kg)/promethazine (5 mg/kg) in their second visit. Group II received the premedication in the opposite sequence. The operator and child were blinded to the medication administered. Sedative efficacy of the two combinations were assessed and judged by two independent pediatric dentists based on the Wilson scale. Data were analyzed with ANOVA and paired t-test. Results. Only 10% of children who received chloral hydrate with midazolam exhibited high improvement in their behavior while 53% showed reasonable positive changes and 12% had no change or even deterioration of behavior. The difference between the effect of the two combination drugs was statistically significant (P

Background: Mineral trioxide aggregate (MTA) is known as a common biomaterial for pulpotomy of primary molars, with limitation including high cost, difficult handling, and long setting time. This study was conducted to compare the clinical and radiographic success rate of Allium sativum oil and MTA in pulpotomy of primary molar teeth. Materials and Methods: This randomized, controlled, clinical trial was performed on a group of children with at least two symptom-free primary molars requiring pulpotomy. A total of 90 teeth were randomly assigned into two groups: After pulp amputation and hemostasis, Group I received MTA as medication in the pulp chamber and Group II received Allium sativum oil over the pulp stumps. Pulp chamber was then filled with reinforced ZOE paste (zinc oxide eugenol) and teeth were restored using stainless steel crowns. The follow-up scheme of 6, 12, and 18 months was set, and teeth evaluation was conducted by a calibrated pediatric dentist based on the modified criteria proposed by Zurn and Seale. The results were analyzed using the generalized estimating equation analysis with the P = 0.05 as the level of significance. Results: The clinical success rate was 100% in both groups after all follow-ups. The radiographic success rate was, however, 91.1% after 6.75. 6% after 12 and 18 months in Group II while it was 95.6% after 6, 91.1% after 12 and 18 months in Group I in those follow-up points. The difference between the two groups was not statistically significant. Conclusion: According to the results, Allium sativum oil has a high clinical and radiographic success rate comparable to those of MTA.

Objectives: The aim of the present study was to compare the effects of intranasal ketamine and midazolam on behavior of 3-6 year-old children during dental treatments. Materials and Methods: In this randomized cross-over clinical trial, 17 uncooperative children requiring at least two dental treatments were selected and randomly received ketamine (0.5mg/kg) or midazolam (0.2mg/kg) prior to treatment. The other medication was used in the next visit. The children’s behavioral pattern was determined according to the Houpt's scale regarding sleep, movement, crying and overall behavior. Physiological parameters were also measured at different time intervals. The data were subjected to Wilcoxon Signed Rank test and two-way repeated measures ANOVA. Results: The frequency of crying decreased significantly following ketamine administration compared to midazolam (P=0.002); movement of children decreased with fewer incidence of treatment interruption (P=0.001) while their sleepiness increased (P=0.003). Despite higher success of sedation with ketamine compared to midazolam, no significant differences were found between the two regarding patients’ overall behavior (P>0.05). The patients had higher heart rate and blood pressure with ketamine; however, no significant difference was found regarding respiratory rate and oxygen saturation (P>0.05). Conclusions: Ketamine (0.5mg/kg) led to fewer movements, less crying and more sleepiness compared to midazolam (0.2mg/kg). No significant differences were found between the two drugs regarding children’s overall behavior and sedation efficiency. Both drugs demonstrated positive efficacy for sedation of children during dental treatments.

Background and Aim: Application of self-etching bonding systems to primary and permanent teeth has increased due to the simplicity of work and fewer steps. This experimental study aimed to compare the effect of conventional acid etching and single-bottle and self-etching bonding systems on shear bond strength (SBS) of light-cured fissure sealant to primary and permanent enamel . Materials and Methods: In this experimental study, the smoothest unprepared proximal enamel surfaces of 30 primary molars (groups 2, 4 and 6) and 30 permanent premolar teeth (groups 1, 3 and 5) were divided into 6 groups of 10. Groups 1 and 2 (control) were acid-etched and received light-cured fissure sealant (Concise 3M-ESPE). Groups 3 and 4 (SB) were subjected to acid etching + Single Bondadhesive + fissure sealant. Groups 5 and 6 (PLP) received self-etching bonding system (Prompt L-Pop, 3M, ESPE) + fissure sealant. Specimens were then subjected to 500 thermal cycles with the dwell time of 30 seconds. Shear bond strength was determined using Universal Testing Machine (Zwick, Germany). Mode of fracture was determined under stereomicroscope and data were analyzed using ANOVA, (between-subjects effect) and LSD . Results: SBS was not significantly different between the control and PLP or SB and PLP groups (P>0.05). However, the difference in SBS between the control and SB groups was statistically significant (P=0.022). The SBS in primary teeth was less than in permanent teeth in all groups (P

Background and Aim : High consumption of carbonated diet soda is the most common etiologic factor for dental erosion. This study aimed to assess the efficacy of addition of Xylitol to carbonated diet soda to prevent enamel microhardness reduction in permanent teeth . Materials and Methods : This in-vitro experimental study was conducted on 40 human impacted third molars that had been surgically extracted and were free from caries, erosion, cracks or hypocalcification. For correct measurement of microhardness, surface of samples was polished with 5000 grit abrasive paper and microhardness was measured usingVickers microhardness testing machine. The teeth were then divided into 4 groups and immersed in 40 ml of 4 different solutions for 5 minutes (regular coke as the first control, coke zero, coke zero plus 10 g Xylitol and tap water as the second control). Understudy surface was a 5x5 mm square on the distal surface of teeth. At the end of experiment, microhardness of teeth was measured again. Changes in microhardness were compared in each group with paired t-test and between groups with ANOVA . Results : Based on the obtained results, microhardness decreased after immersion of specimens in regular coke, coke zero and coke zero plus 25% Xylitol by -38.66 ± 24.87, -26.1 ± 16.65 and -19.5 ± 23.52, respectively and these reductions were statistically significant (P1=0.001)(P2=0.001)(P3=0.005). Change in microhardness was -7.4 ± 9.17 in specimens immersed in tap water and was not statistically significant (P4=0.5). The reduction in microhardness of enamel exposed to Xylitol was significantly less than the other two test groups . Conclusion: Addition of Xylitol to carbonated diet soda reduced the amount of tooth erosion but could not prevent it .

Background and Aim : Fluoride has an important role in the prevention of caries. This study assessed the efficacy of three types of topical fluoride: fluoride varnish, APF gel (sultan), APF gel (Kimia) in protecting the enamel from demineralization in an in vitro environment . Materials and Methods : Sixty human caries-free premolars where randomly assigned into four groups of 15 specimens. The control group was washed with deionized/distilled water. Weekly gel (Kimia) was treated with APF gel (1/23%) for 2 minutes weekly, weekly gel (Sultan) was treated with APF gel (1/23%) for 60 seconds weekly, weekly varnish fluoride was treated with Durashield (2/26%). Specimens were then placed in a cycle of demineralization (pH= 4.3) for 6 hours and remineralization (pH= 7) for 17 hours. This pH- cycle was repeated for 3 weeks (21days). The teeth were sectioned buccolingually and evaluated under polarized light microscope. Then the depth of each lesion was measured from the deepest demineralization point of the lesion. The data were analyzed using Kruskal-Wallis and Dunn test for pairwise comparison . Results : The control group had the deepest lesions (mean depth, 140±37micrometer). The varnish group had the shallowest lesions (mean depth, 60±37 micrometer) with a 75.3% reduction percent. However, there was no significant difference in the depth of demineralization between all fluoride treated groups. The difference between fluoride groups and the control group were significant. Conclusion : Treatment of the enamel of permanent teeth with various topical fluorides significantly inhibited demineralization, but there was no significant difference between varnish or gel application .