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Blood extracts containing platelet products are gaining popularity in promoting healing and pulp regeneration. This study was designed to evaluate the effect of platelet-rich plasma (PRP) and gallium–aluminum–arsenide (GaAlAs) laser on proliferation and differentiation of human dental pulp stem cells (hDPSCs). In this ex vivo study, hDPSCs isolated from impacted mandibular third molars were cultured in Dulbecco’s Modified Eagle’s medium )DMEM(with 10% fetal bovine serum (FBS). After reaching the desired confluence, the cells were distributed into 4 groups, namely, control, PRP, laser, and PRP+laser for MTT assay and alkaline phosphatase (ALP) test. In the PRP and PRP+laser groups, 10% PRP was added to each well on the plate. In the laser and PRP+laser groups, as for the proliferation test, laser irradiation was carried out for 45 s, while 135 s was designated for ALP test. After 1, 3, and 5 days, cell proliferation and ALP activity were assessed using MTT and ALP colorimetric assay, respectively. Two-way ANOVA was utilized to analyze data. In PRP and PRP+laser groups, cell proliferation and viability increased until day 3 but began to decline afterwards until the 5th day. In the laser group, the increase in proliferation and viability was observed till day 5 which was less than the control group. Laser and control groups exhibited significantly higher cell viability and proliferation than both PRP and PRP+laser groups. ALP activity was more pronounced in PRP+laser, PRP, and laser in descending order; however, all were less than that of the control group. Only in the control group did the ALP activity augment during the 5-day period. Laser irradiation could induce pulp cell proliferation and demonstrated a better performance than PRP in this regard.

The aim of this prospective study was to investigate the predictors of choosing mode of delivery (MOD) among Iranian urban women applying the socio-ecological model. In 2015, a convenient sample of 530 pregnant women in urban regions of Urmia, Iran, was recruited to complete a socio-ecological approach–based questionnaire. Then, 1 week after childbirth, the women were followed up by telephone to be asked about their MOD (response rate = 81.88%). Logistic regression analysis showed that the odds of cesarean section (CS) among the women with university education, whose husbands were an employee in a governmental organization, who preferred a private hospital for delivery, and who selected the CS as the preferred MOD during pregnancy were significantly higher than their counterparts. Among all the factors, the socioeconomic status of the families was more influential in predicting the MOD among women. The cognitive factors like fear of childbirth may not be determinants for MOD if women are from privileged families.

The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of preoperative oral administration of ibuprofen or dexamethasone on the success rate of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Seventy-eight patients with irreversible pulpitis were randomly divided into 3 groups (26 per group) and given one of the following at 1 hr prior to performing local anesthesia: a placebo; 400 mg ibuprofen; or 4 mg dexamethasone. Each patient recorded their pain level on a visual analog scale before taking the medication or placebo, at 15 min after completion of IANB, and during treatment if pain occurred. The success of the anesthesia was defined as no or mild pain at any stage during the endodontic procedure. The success rate of the IANB was 38.5, 73.1, and 80.8% with the placebo, ibuprofen, and dexamethasone, respectively. Both ibuprofen and dexamethasone were significantly more effective than the placebo. No significant difference was observed, however, between the two experimental medications in terms of effectiveness. The results of the present study suggest that premedication with ibuprofen or dexamethasone increases the success rate of an IANB in patients with symptomatic irreversible pulpitis in the mandibular molars.

Background: The aim of this study was to compare the apical sealing ability of cold lateral condensation and Obtura II by using fluid filtrationmethod. Methods: Thirty four single-canal mandibular premolars with mature apices and apical curvature less than 20 degrees were se- lected. For obtaining complete similarity among samples, all teeth were shortened to 15 mm by cutting the remained crown. For canal preparation, themanual step-back technique by K-files was used. The teeth were divided into two experimental groups (each group included 15 teeth), positive controls (n = 2), and negative controls (n = 2). Teeth in group 1 and 2 were obturated with cold lateral condensation and Obtura II, respectively. To allow the sealer to set, all teeth were stored at 100% humidity and 37°C for the next seven days. For measurement of apical leakage, fluid filtration method was used. The amount of leakage in each canal was recorded as L/min/cmH2O. Independent T-test was used for statistical analysis. Results: Teeth obturated with cold lateral condensation showed significantlymore leakage than those obturated with Obtura II (P value = 0.022). Conclusions: Obtura IImay obtain better apical seal than cold lateral condensation.

Background and aims. Substituting chlorhexidine (CHX) for water has been shown to enhance antimicrobial activity of mineral trioxide aggregate (MTA). The purpose of this study was to compare the compressive strength of MTA mixed with distilled water, 0.12% and 0.2% chlorhexidine. Materials and methods. MTA was mixed according to manufacturer’s instructions in group I (n = 20). In groups II & III, 0.12% and 0.2% CHX liquid was substituted for water, respectively. Samples were condensed with moderate force into 20 tubes with 1.5 × 5 mm dimensions and were allowed to set for 72 hours at 37°C in 100% humidity. After being removed from the molds, their compressive strength was determined using Instron testing machine. Each group was divided into two subgroups according to the time of testing (at 72 hours, and one week). Fractured surfaces of 4 specimens in each group were then evaluated under Scanning Electron Microscope (SEM) to determine their microstructure. One-way ANOVA, Tu-key, and paired sample t-test was used for statistical analysis. P < 0.05 was set as significant. Results. There was no significant difference between three groups in terms of their compressive strength after 72 hours. However, the compressive strength of group II was significantly higher than group I (P = 0.034) and group III (P = 0.021) after one week. Crystalline microstructure was similar in all groups. Conclusion. Substitution of 0.012% chlorhexidine for water significantly increased the compressive strength of MTA at 1 week without significant change in crystalline structure.

Introduction: The aim of this study was to determine the histologic effect of low level laser therapy (LLLT) with or without the use of mineral trioxide aggregate (MTA) on exposed pulp tissues of dogs. Methods: Twenty-five premolar teeth in three healthy mature dogs were randomly divided into five groups. In group 1, the pulp tissue was capped with MTA. In groups 2 and 3, before capping with MTA, the exposure site was irradiated by low power lasers at 630 nm (20 mW, 150 seconds, 7.5 J/cm2) and 810 nm (peak power 80 W, average power 50 mW, 1500 Hz, 50 seconds, 6.25 J/cm2) wavelengths, respectively. In groups 4 and 5, the exposure site was irradiated similar to that described in groups 2 and 3, but the pulp tissue was covered by gold foil instead of MTA. After 2 months, the animals were sacrificed and the samples were prepared for histologic evaluation. Results: There were differences in pulpal response and dentinal barrier formation among the study groups. The morphology of pulpal tissue and the integrity of dentinal barrier and formation of odontoblastic layer were more favorable in the first three groups. The occurrence of extensive and intense inflammation and necrosis was more frequent in groups 4 and 5. Conclusion: Under the conditions used in this study, the presence of MTA as a pulp capping material was more important than laser therapy in the success of direct pulp capping (DPC) treatment. MTA proved to be an effective material either alone or in combination with laser irradiation in vital pulp therapy.

The aim of the present study was to compare two methods used in inferior alveolar nerve (IAN) repositioning to evaluate their effect on the vitality of intact teeth anterior to the mental foramen. Nerve lateralization (NL) is defined as the lateral reflection of the IAN without incisive nerve transection; nerve transposition (NT) involves sacrifice of the incisive nerve. Twenty-one patients were included in this study. Vitality tests for the teeth anterior to the mental foramen, including pulse oximetry and electric pulp testing, were evaluated at 1 week prior to surgery and at 1 week, 1, 3, 6, and 12 months after surgery. Lower lip and chin neurosensory changes were also recorded at the same time intervals by static light touch test with a cotton-tipped applicator and two-point discrimination test with sharp callipers. Vitality tests were negative after the operation in the NT group, while all had normal values at 1 week prior to the operation. In the NL group, only two patients (20%) had negative test results at 1 week after surgery. Lip and chin neurosensory changes in the total transpositions (28 operations) were seen in 7.1% at 1 year after the operation. It appears that NL is a more physiological procedure than NT.

Objectives: Using the fluid filtration method, an in vitro study was conducted to evaluate the effects of medication with calcium hydroxide on the sealing ability of the New Endodontic Cement (NEC) apical barrier in the short and long terms. Methods: Fifty extracted single rooted teeth were prepared and apical resorption produced using acid sulfuric for four days. The teeth were randomly divided into two experimental groups (n=20) and two control groups. In group 1, calcium hydroxide was placed into all canals for one week and in group 2, no medication was used. In both groups, a 4 mm NEC apical plug was placed in the canals and the remaining portion of the canals was filled with gutta-percha. The amount of microleakage of all samples was evaluated after one week and three months. The data were statistically analyzed using two-way ANOVA. Results: There was no significant difference between the two groups in either time period (P>.05). In both group 1 and group 2, microleakage increased after three months but this increase was not statistically significant (P>.05). Conclusions: According to the result of this study, medication with calcium hydroxide had no adverse effect on the short- and long-term sealing properties of an NEC apical plug. (Eur J Dent 2011;5:260-264)

Introduction The purpose of this study was to evaluate the effect of calcium hydroxide premedication on the marginal adaptation of the mineral trioxide aggregate (MTA) apical barrier. Methods Forty single-rooted teeth were prepared and apically resorbed using sulfuric acid for 4 days. Teeth were allocated into two groups according to whether calcium hydroxide was placed in the canals for 1 week (medicated group) or not (nonmedicated group) before placing a 4-mm MTA apical plug in the canals. The roots were mounted on aluminum stubs, the root apex was viewed from the top under scanning electron microscopy, and the maximum distance between MTA and the surrounding dentin was measured. Results The mean gap widths in the medicated and nonmedicated groups were 70.2 μm and 130.0 μm, respectively ( p Conclusions Calcium hydroxide treatment improves marginal adaptation of the MTA apical plug.

Evaluation of the pulpal response to a resin-modified glass ionomer, a conventional glass ionomer and calcium hydroxide.Fifty-five deep Class V cavities were lined with Vivaglass Liner, Chembond Superior and Dycal. After seven, 30, and 60 days the teeth were extracted and a histological assessment was performed.There was no statistically significant difference in pulpal response among the three groups for the same time interval (P0.05).Light-cured glass ionomers have similar advantages to conventional glass ionomers.

This report describes non-surgical treatment of an invaginated maxillary lateral incisor with three roots. The mesial root had a C-shaped canal, while the distal one had a type III dens invagination. Cone beam computed tomography (CBCT) was used as an adjunctive resource in the diagnosis and making decision about the required treatment. Clinical and radiographic follow up after 15 months revealed satisfactory periapical healing and absence of symptoms after 15 months.

Recently, vital bleaching by carbamide peroxide has become more popular; therefore, it is necessary to study the effect of this agent on enamel and dentin.The purpose of this study was to evaluate the effect of a 16 percent carbamide peroxide bleaching gel, Vivastyle, on enamel staining susceptibility.Thirty bovine specimens were selected and randomly divided into two groups of 15. The experimental group was subjected to Vivastyle gel and then was immersed in coffee for half an hour daily for three weeks. The control group was only immersed in coffee. The teeth were evaluated using a colorimeter to measure L*, a*, b* of each tooth. Value (black to white) is denoted as L*, wheres chroma (a* b*) is denoted as red (+a*), green (_a*), yellow (+b*), and blue (_b*). Total color differences between two colors (deltaE) were calculated using the following formula: deltaE = [(deltaL*)2 + (deltaa*)2+(deltab*)2]: deltaE1.Bleached, AE2: bleached and immersed in coffee, deltaE3: immersed in coffee.Mean differences were: deltaE1 = 9.478, deltaE2 = 13.808 and deltaE3 = 7.230. Paired comparison by use of Duncan test showed there was a significant difference between deltaE1 and deltaE2 (P0.000); and t test showed there was no significant difference between deltaE3 and deltaE1. (P0.080.05), but deltaE3 showed a significant difference with deltaE2(P0.000).After vital bleaching, the enamel staining susceptibility significantly increased.

Canal preparation is one of the most important stages of endodontic therapy, and various techniques have been applied for it. The present study was conducted to compare the quantity of debris extruded from the apical foramen during canal preparation during the manual technique and with the use of three rotary systems (Profile, Race, FlexMaster). One hundred single-rooted premolars were divided into four groups of 25 teeth each. For collection of debris, vials containing distilled water and weighed before canal preparation were used. Groups H, P, R and F were prepared by the manual step-back technique, and with the use of the Profile system, Race system and FlexMaster system, respectively. After canal preparation, the vials were dried thoroughly and reweighed. The difference between the weights of the vials at the two stages was taken as the debris weight. The mean debris weights were compared by one-way ANOVA. Group H had the highest mean debris weight, which was significantly different from those of the rotary groups (P < 0.001). The lowest mean debris weight was related to group R, which was significantly different from that of group F but not significantly different from that of group P. It was concluded that the Race system induces less extruded debris than the manual technique and the FlexMaster system. (J. Oral Sci. 48, 85-88, 2006)

Aim To compare the antimicrobial effect of 2% chlorhexidine, 2.5% sodium hypochlorite and MUMS containing 2% chlorhexidine. Materials and methods All of the above irrigants were examined on Enterococcus faecalis, Streptococcus mutans, Candida albicans, Lactobacillus casei and E.coli. A total of 0.5 CC of each solution and 0.5 CC of McFarland solution bacterium were added to each examination tube. After 15, 30 and 45 minutes, colony count was performed for each tube. The difference in the number of bacteria indicated the effect taken by disinfectant material. Results MUMS containing chlorhexidine showed the antimicrobial properties just like chlorhexidine's effect against E.coli, Streptococcus mutans, Candida albicans, Enterococcus faecalis and Lactobacillus casei in preventing these entire microorganisms to incubate. Sodium hypochlorite was not effective against Enterococcus faecalis and Candida albicans incubated in 15, 30 and 45 minutes and Enterococcus faecalis in 15 minutes. Conclusion MUMS has antimicrobial properties similar to chlorhexidine. Clinical significance As MUMS containing chlorhexidine can transfer chlorhexidine through its own surfactant around apical area and it can open the dentinal tubules by its own chelator for more penetration of chlorhexidine, it may be a choice for canal irrigation. How to cite this article Bidar M, Hooshiar S, Naderinasab M, Moazzami M, Orafaee H, Naghavi N, Jafarzadeh H. Comparative Study of the Antimicrobial Effect of Three Irrigant Solutions (Chlorhexidine, Sodium Hypochlorite and Chlorhexidinated MUMS). J Contemp Dent Pract 2012;13(4): 436-439.

INTRODUCTION: Open-apex teeth with irreversible pulpitis require complex and difficult treatment. Providing the right environment for apexogenesis and pulp protection is vital for their long term prognosis. The young pulp of open apex tooth, however, is better equipped against irritation and assault. The aim of this study was to evaluate pulp inflammation in open apex canine teeth of cats. MATERIALS AND METHODS: In this in vivo study, twelve cats with open apex canines were used. Pulps were iatrogenically exposed and the animals were sacrificed at one, seven, thirty and ninety days after pulp exposure. Samples were prepared for histological evaluations. RESULTS: During the first and seventh day, changes were limited to acute inflammation in the coronal pulp. During the first month pulp changes in 45.5% of samples were similar to the seventh day. In the other samples necrosis and abscess spread to the end of the root, and internal resorption and periapical abscess were observed. In 45.5% of samples in the apical region vital tissue was barely observed (during 90 days); in 54.5% of samples however, complete pulp necrosis, internal resorption and a large periapical lesion was observed. CONCLUSION: In one and seven-day periods pulp tissue was vital, however, in the thirty and ninety-day periods, minority of the pulp samples were vital.

The use of a suitable substance that prevents egress of potential contaminants into the periapical tissues is important in endodontic surgery. The aim of the present study was to compare the marginal adaptation of three root-end filling materials (white mineral trioxide aggregate (MTA), grey MTA and Portland cement), using scanning electron microscopy. Seventy-five single-rooted extracted human teeth were used. The canals were instrumented and filled with gutta-percha. Following root-end resection and cavity preparation, root-end cavities were filled with white MTA, grey MTA or Portland cement. Using a diamond saw, roots were longitudinally sectioned into two halves. Under scanning electron microscopy, the gaps between the material and dentinal wall were measured. The data were analysed using Kruskal-Wallis test. The mean of the gap in grey MTA, white MTA and Portland cement was 211.6, 349 and 326.3 microm, respectively. The results indicate that the gap between grey MTA and the dentinal wall is less than other materials, but there was no significant difference between the materials tested in this study (P > 0.05).

The aim of this study was to compare the efficacy of NiTi flex K-file instruments and rotary FlexMaster and Race instruments (short for reamers with Alternating Cutting Edges) in root canal preparation. A total of 75 single rooted teeth with minimum curvature (< 5°) were selected and divided into three groups, each containing 25 teeth. Canals were prepared with NiTi flex K-file, FlexMaster and Race instruments using crown down preparation technique, up to size #40. After each instrument, the root canals were flushed with 5 ml of 0.5% NaOCl solution. The amount of debris and smear layer was quantified on the basis of Hulsmann method using a scanning electron microscope. Completely cleaned root canals were not found after instrumentation with any of the three instruments. In general, FlexMaster instruments left significantly less debris and smear layer than Race and NiTi flex K-file instruments (P < 0.05). NiTi flex K-files resulted in significantly more smear layer (P < 0.05) compared to Race and FlexMaster instruments only in the apical third of the canal. (J. Oral Sci. 49, 47-52, 2007)

INTRODUCTION: The aim of this study was to compare the efficacy of two irrigants on decreasing the pain and swelling at different times after treatment of necrotic pulp. MATERIALS AND METHODS: Fifty patients with single canal tooth and necrotic pulp were selected and divided into two groups, twenty-five in each. Rotary files were used for preparing the canals and 0.2% chlorhexidine gluconate and 2.5% sodium hypochlorite were used for irrigation of canals. Then canals were filled by lateral condensation technique. A questionnaire was given to patients asking for the level of their pain and swelling. The patients were followed for 48h. Visual Analogue Scale (VAS) was used for determination of pain degree. The scale with 4 levels was used for measurement of the intensity of swelling. The data were statistically analyzed using Mann-Witney and Kruskal-Wallis tests. RESULTS: The research showed no significant difference between irrigant solutions in decreasing the amount of pain and swelling after endodontic treatments. No significant relationship was detected between the incidence of pain with swelling, age, and sex. Flare-up in maxilla was more than mandible. CONCLUSION: According to results of this in vivo study it was concluded that efficacies of 0.2% chlorhexidine gluconate and 2.5% NaOCl are the same.

INTRODUCTION: Osteoblasts and periodontal ligament cells are major cells for wound healing after root end resection. The interaction of osteoblasts with filling materials could play a critical role in healing of surgical lesion. Adhesion and spreading of cells on material surface are the initial phase for cellular function. The purpose of the present study was the evaluation of morphology and attachment of human osteoblasts in present of white MTA, Portland cement (PC) and IRM as root end filling and perforation repair materials. MATERIALS AND METHODS: The human osteoblasts (MG-63 cell line) were prepared from Iranian Pasteur Institute; Cellular Bank, were grown in RPMI 1640 medium. The testing materials were mixed according to the manufacture's instruction, inserted in to the wells of 24-well flat-bottomed plate, and condensed to disk of 1mm thickness and 1×1mm diameter. Cells were added to the materials after two weeks. During 1,3,7 days intervals, the disk of materials along with cells were grown on their surface, examined by a scanning electron microscope (SEM). We used of IRM as negative group. RESULTS: Results showed that after 7 days many of osteoblasts were attached on the surface of white MTA and PC and appeared partially round or flat. The cells appeared round with no attachment and spreading in conjunction with IRM. CONCLUSION: The results indicate that human osteoblasts have a favorable response to white MTA and Portland cement compared with IRM.

INTRODUCTION: The ideal endodontic treatment for the teeth with in complete root-ends and necrotic pulps may involve the use of material which forms an immediate apical barrier instead of long term calcium hydroxide therapy. Such procedure may lead us to a single appointment endodontic treatment. The purpose of the present study was to evaluate clinical and radiographic success rate in necrotic teeth with open apices treated with MTA as an apical plug. MATERIALS AND METHODS: Thirty five patients between the ages of 8-16 with total number of 41 necrotic anterior teeth containing open apices were selected. In the first visit, root canals were debrided and filled with calcium hydroxide. After one week, calcium hydroxide was removed and MTA with the thickness of 3 to 4 mm was put in the apical region of the canals. After 24 hours, the remaining part of the canals was filled with guttapercha and sealer and the teeth were restored with composite. All the cases were evaluated clinically and radiographically after 3 and 6 months and data were analyzed by McNemar test. RESULTS: No clinical symptoms were observed in 97.6% of the teeth after 3 months and in none after 6 months. The study showed a significant difference from pretreatment status. After 3 months radiographic evaluation showed that in 17 cases (41.5%), lesions were reduced and in 14 cases (34.1 %), lesions remained the same, and in 10 cases (24.4%) lesions disappeared. After 6 months in 21 cases (51.2%), lesions were reduced, in 3 cases (7.3%) lesions remained the same and in 17 cases (41.5%) lesions disappeared. These finding were statistically different from pretreatment data. CONCLUSION: The results indicate that MTA can be used as an apical plug in the teeth with open apices following root canal debridement and disinfection with calcium hydroxide. Further investigations with longer follow-ups are recommended in order to evaluate the effect of this material.

The purpose of this in vitro study was to compare two common techniques, conventional and rotary instrumentation, in debris extrusion.Two hundred mature human teeth with mature apices and less than 15 degrees of root curvature as determined by Schneider's method were selected for use. Teeth were randomly divided into four groups of 50 teeth each and prepared using step-back instrumentation and profile 4 percent Taper Series 29 rotary system at three different speeds: 1,000 rpm, 8,000 rpm and 24,000 rpm. All of the speeds were reduced by contra angle to 1/6 rpm. Extruded debris were collected on pre-weighed vials containing distilled water through the apical foramen during instrumentation. The vials were then dried in a microwave oven at 150 degrees Celsius and weighed again. The difference was recorded as "the weight of the extruded debris." Eight control vials, two for each group, were weighed and filled with distilled water, dried, and reweighed. The mean weight of extruded debris for each group was statistically analyzed. T-student, unilateral variance analysis and Pearson tests were used in this study.Step-back instrumentation (Group 1) produced significantly more debris than other groups. The difference in the amount of debris produced among rotary groups was not significant.Rotary technique could reduce the amount of debris extrusion.

Background Recently, the clinical use of low power lasers has increased, and it is said that wound healing is accelerated by their irradiation. The aim of this study was evaluation of the effect of platelet-rich plasma on proliferation and differentiation of human dental pulp stem cells with or without Ga-Al-As laser. Methods: In this experimental study, human lower third molar dental pulp cells prepared from torabinejad research center located in isfahan. When cells reached to adequate extent, divided in 4 groups including PRP, PRP+Laser, Laser, and control for implementation of MTT test and alkaline phosphatase activity test. In Laser and PRP+Laser groups, each well irradiated 45 seconds for MTT test and 135 seconds for alkaline phosphatase activity test. Results: Results demonstrated that PRP and PRP+Laser increased cell proliferation and viability up to 3 days but decreased cell proliferation and viability up to 5 days. Alkaline phosphatase activity was more in PRP+Laser, PRP and Laser, respectively, which all of them were less than control group. Alkaline phosphatase activity up-regulated in control group whereas in other groups down regulated. Conclusion: Laser irradiation can induce cell proliferation and in this field better acted than PRP. However, for assessment of stimulatory effect of Laser and PRP more studies are warranted. Keywords:Dental pulp stem cells, Ga-Al-As laser, Platelet-rich plasma.