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Introduction: Bone tissue engineering proposes a suitable way to regenerate lost bones. Different materials have been considered for use in bone tissue engineering. Hydroxyapatite (HA) is a significant success of bioceramics as a bone tissue repairing biomaterial. Among different bioceramic materials, recent interest has been risen on fluorinated hydroxyapatites, (FHA, Ca ₁₀ (PO ₄ ) ₆ F _x (OH) _2−x ). Fluorine ions can promote apatite formation and improve the stability of HA in the biological environments. Therefore, they have been developed for bone tissue engineering. The aim of this study was to synthesize and characterize the FHA nanopowder via mechanochemical (MC) methods. Materials and Methods: Natural hydroxyapatite (NHA) 95.7 wt.% and calcium fluoride (CaF ₂ ) powder 4.3 wt.% were used for synthesis of FHA. MC reaction was performed in the planetary milling balls using a porcelain cup and alumina balls. Ratio of balls to reactant materials was 15:1 at 400 rpm rotation speed. The structures of the powdered particles formed at different milling times were evaluated by X-ray diffraction (XRD), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Results: Fabrication of FHA from natural sources like bovine bone achieved after 8 h ball milling with pure nanopowder. Conclusion: F⁻ ion enhances the crystallization and mechanical properties of HA in formation of bone. The produced FHA was in nano-scale, and its crystal size was about 80-90 nm with sphere distribution in shape and size. FHA powder is a suitable biomaterial for bone tissue engineering.

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Aims: The purpose of this study was to introduce a nanosilver particle based endodontic irrigation solution and to evaluate its antimicrobial efficacy in comparison to 5.25% NaOCl. Materials and Methods: In an in vitro experiment the effect of the new irrigant against Enterococcus faecalis (ATCC: 29212) and Staphylococcus aureus (ATCC 25923), two most commonly isolated species of root canal space, was studied in different time intervals of 3, 5 and 15 minutes. Results: No growth of E. faecalis and S. aureus was observed in any of irrigant groups and any of different time intervals. Conclusion: These results indicate that the new irrigant is as effective as NaOCl in preventing the bacterial growth of common root canal bacteria.

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Introduction: This study aimed to investigate the indications for an epidemiological survey on the oral health of young males, and the possibility of conducting it during their military service. Settings and Design: Despite the excellent oral health of young Finnish people in the past, there is concern about its degradation today. About 80% of young Finnish males enter the mandatory military service annually. The draftees have obligatory health inspection, with oral health screening, in the first two weeks of their service. Subjects and Methods: Self-reports on oral health were analyzed. Dental screening of conscripts performed by military dentists was timed and evaluated in two garrisons in 2010 (n = 256). Results: Over 40% of the conscripts reported having either dental symptoms or sensitivity after eating or drinking sour food or due to changes in temperature. Toothache was reported as having been the reason for the latest dental visit by 17% of the respondents. Clinical inspection took on an average almost three minutes and answering the questionnaire, almost 11 minutes. For evaluation of the process, the need for randomization of the study sample was emphasized as well as for specific guidelines, radiological education, and calibration of the dentists performing future survey to increase inter/intra examiner reliability. Moreover, the need for three computers per dentist for the questionnaires was pointed out. Discussion: The need for an epidemiological survey was indicated by a high number of respondents reporting dental symptoms and the need for treatment. An epidemiological survey is possible to be conducted by the existing military dental personnel, but they must be educated radiologically and calibrated. A specific protocol is essential.

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Background: The risk to dentists, dental assistants, and patients of infectious diseases through aerosols has long been recognized. The aim of this study was to evaluate and compare the efficacy of commercially available preprocedural mouthrinses containing 0.2% chlorhexidine (CHX) gluconate, chlorine dioxide (ClO ₂ ) mouthwash, and water in reducing the levels of viable bacteria in aerosols. Materials and Methods: This single-center, double-blind, placebo-controlled, three-group parallel-designed study was conducted over a period of 4 months. One hundred twenty patients with chronic periodontitis were divided randomly into three groups (A, B, and C) of 40 patients each to receive the ClO ₂ mouthwash, water, and 0.2% CHX gluconate respectively as preprocedural rinse. The aerosol produced by the ultrasonic unit was collected at five standardized locations with respect to the reference point, i.e., the mouth of the patient. The blood agar plates were incubated at 37°C for 48 h, and the total number of colony-forming units (CFUs) was counted and statistically analyzed. Results: The results showed that CFUs in groups A and C were significantly reduced compared to group B, and P < 0.001 [analysis of variance (ANOVA)]. CFUs in group C underwent the highest reduction, but statistically there was no significant difference between the mean values of postprocedural CFUs in groups C and A (i.e., P > 0.05). The numbers of CFUs were the highest at the patient's chest area and lowest at the patient's front i.e., the 6 o'clock position. Conclusion: This study proves that a regular preprocedural mouthrinse could significantly eliminate the majority of aerosols generated by the use of an ultrasonic unit, and that ClO ₂ mouthrinse was found to be statistically equally effective in reducing the aerosol contamination to 0.2% CHX gluconate.

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The aim of this study was to elucidate the diagnosis, etiology, and therapeutic options for the treatment of gummy smile. The smile level is an imaginary line after the lower superior lip and used seems to be convex. The presence of 3 mm or grater continuous gingival band exposures to natural smile or speech performs the gummy smile. Original articles studying the diagnosis, etiology, and therapeutic alternatives for the treatment of gummy smile were searched in the Medline, Scopus, Science direct, and EBSCO host databases. Together with some example and diagnosis method was purposed. The authors conclude that the etiology is multifactorial and can be showed excessive vertical maxillary grow up, excessive labial contraction, shorter upper lip, gingival excess, and extrusion of the anterior teeth. The therapeutics alternative are often multidisciplinary, besides can be used orthognathic, plastic and periodontal surgery, and orthodontic.

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Introduction: The aim of the present in vitro study was to evaluate and compare the antibacterial effect of pomegranate and aloe vera extracts on Streptococcus mutans. Materials and Methods: Hydroalcoholic extracts of pulp from both Punica granatum (pomegranate) and Aloe barbadensis miller (aloe vera) were prepared to concentrations of 5, 25, 50 and 100%. Pure sorbitol powder dissolved in distilled water was taken as the negative control. Streptococcus mutans (S mutans) was isolated from saliva by inoculation on to Mitus Salivarius Bacitracin (MSB) agar, which was then streaked onto agar plates containing Brain Heart Infusion. In each petridish, wells were prepared and using a sterile micropipette, 125μl of the specific concentration of the extract (pomegranate/ aloe vera/ sorbitol) was deposited in each well. This was done in triplicate for each concentration of the extracts. The effect of different concentrations of the extracts on S mutans was observed and the data was subjected to statistical analysis. Results: Pomegranate extract showed significantly higher inhibitory effect on S mutans at all concentrations (P≤0.05). On comparison of all three extracts at different concentrations, a significant difference (P≤0.05) was observed only at 50 and 100% concentrations. The inhibitory effect of pomegranate extract was significantly different when compared to aloe vera and sorbitol extracts. (P≤0.01). Discussion: Pomegranate extract has a significant antibacterial effect on S mutans at all concentrations.

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Salvia officinalis is a medicinal herb used as an cosmetic, flavoring agent, It has antibacterial, antifungal, anticaries, antiplaque, antiviral, astringent, and other useful properties, it is also used in dental practice for the management of periodontal disease and to prevent halitosis. The objective of this article is to highlight various uses of S. officinalis in the dental field along with its use in medical problems.

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Introduction: Calcium hydroxide (CaH) is customarily used for permanent teeth but not for deciduous dentition because it is known to cause internal resorption in the latter. Though this has been attributed to chronic inflammation and odontoclasts, the exact mechanism has not been elucidated. The Hypothesis: The authors propose an explanation that CaH-induced odontoclastogenesis could be multifactorial. Odontoclasts may result from fusion of cells of monocyte/macrophage series either due to inflammatory mediators or through stimulation by stromal odontoblasts /fibroblasts. Pre-existing progenitor cells of primary tooth pulp because of their inherent propensity may transform into odontoclasts. Evaluation of the Hypothesis: The hypothesis discusses the role of various inflammatory cytokines that may be responsible for CaH-induced transformation of pre-odontoclasts to odontoclasts. Alternatively, pre-existing progenitor cells with proclivity to change into odontoclasts may cause internal resorption. The loss of protective layer of predentin over mineralized dentin may also make the primary tooth more susceptible to resorption.

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Introduction: Recently, a number of studies have investigated the impact of fluoride concentration of drinking water on dental fluorosis. These Studies should be reviewed to provide a new outlook on the analysis of the causes and effects of dental fluorosis in specific regions. The objective of this study was to systematically review the fluoride concentration of drinking water and investigate its relation to the frequency of dental fluorosis in Iran. Materials and Methods: Dean's index was used to classify data, and a meta-analysis was conducted to obtain summary measure with 95% confidence interval (CI). In this regard, Stata/SE 11.1 was employed for data analysis based on random effect models for reporting the results. In this systematic review, Scientific Information Database (SID) and IranMedex databases were searched and studies were included based on specific criteria. Data validity was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist adapted for cross-sectional study designs. Furthermore, a series of predefined keywords were used, and the combination of these keywords were considered using operators. The inconsistency was examined using the χ² test at a significance level of 10%. In addition, heterogeneity was quantified across studies using the І² statistic. The difference between study variance was analyzed based on τ² statistic. Results: In the age group of 6-18 years old based on the fluoride level in drinking water and exposure time, there was significant heterogeneity among the studies in all subgroups for determining the frequency of dental fluorosis and assessing the effect of other variables. Conclusions: The variables, water fluoride exposure time, and any exposure to fluoride are considered as confounding factors. Analyzing the subgroups and examining the heterogeneity showed that the results of the studies in all subgroups cannot be pooled.

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Introduction: This paper summarizes different conditions, which have a well-known influence on the resorption of tooth roots. It also highlights factors important for individual susceptibility to root resorption. Furthermore, the paper focuses on idiopathic root resorption where the provoking factor is not known. The Hypothesis: The several different disturbances causing root resorption can be either orthodontically provoked or acquired by trauma, virus or congenital diseases. It is presumed that all these conditions lead to inflammatory processes in the three main tissue layers, comprising the peri-root sheet. Evaluation of the Hypothesis: This paper explains how different etiologies behind root resorption and how different phenotypic traits in root resorption can be understood from immunohistochemical studies of the human periodontal membrane close to the root and thus, gain a new understanding of the phenomenon of root resorption.

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Introduction: The relationship of oral health (OH) with the quality of life (QL) is multidimensional; the extent to which oral disorders disrupt an individual's normal function may affect health-related QL, particularly among children. The current study aimed to examine the relationship between clinical OH variables, psychological, social, and demographic factors with regard to OH-related QL (OHRQL) in the children of Isfahan province, Iran. Materials and Methods: Data relevant to the characteristics, psychological, dental, and demographic factors of 336 children aged 11-15 were assessed. These characteristics included sociodemographic data, sense of coherence (SOC), self-esteem, and children's health locus of control (HLC). The clinical variables that were implicated to be effective on the QL were assessed via an oral examination. The parameters assessed included caries, periodontal disease, malocclusion, and traumatic dental injuries. Finally, the data was analyzed using Statistical Package for the Social Sciences (SPSS) software and P-value was set at 0.05. Results: The results indicate that oral disease, the extent of treatment-need, self-reported symptoms, and degree of dysfunction were influential in QL. Bivariate (Spearman and Pearson) analysis showed that there was a relationship between decayed, missing, and filled teeth (DMFT) and QL score (r = 0.4, P-value = 0.03) and gender and total self-esteem (r = 0.8, P-value = 0.009). Self-esteem and index of orthodontic treatment need (IOTN) (P-value = 0.01), education level of the parents (P-value = 0.03), and overall health (P-value = 0.001) significantly influenced OHRQL. Conclusions: The findings of our study indicate that oral disease, the extent of treatment-need, self-reported symptoms, and degree of dysfunction were influential in the QL.

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Introduction: The aim of this ex vivo study was to check the antimicrobial efficacy of silver nanoparticles with and without different antimicrobials against Enterococcus faecalis and Candida albicans. Materials and Methods: Two-hundred and fifty two freshly extracted single-rooted human teeth were contaminated with E. faecalis and C. albicans. The teeth were randomly divided into five experimental (n = 21) and one control group (n = 21). Each subgroup was then exposed to different antimicrobials, namely calcium hydroxide (Ca(OH)₂) (Group 1), 2% chlorhexidine (CHX) (Group 2), silver nanoparticles (SNP) (Group 3), SNP with Ca(OH)₂ (Group 4), SNP with 2% CHX (Group 5), and saline as control group (Group 6). Cultures were made from each group after 24 h, 7 days, and 14 days, and colony forming units were counted. The Kruskal–Wallis test was used to compare the study parameters among the groups at 24 h, 7 days, and 14 days. Results: Significant difference was found in the antimicrobial efficacy of different intracanal medicaments against E. faecalis and C. albicans after 24 h, 7 days, and 14 days. 2% CHX was found to be the most effective medicament at 24 h, 7 days, and 14 days against E. faecalis and C. albicans. Combination of SNP with 2% CHX and Ca(OH)₂ and SNP alone ranked second in their antimicrobial efficacy against E. faecalis and C. albicans at 24 h, 7 days, and 14 days, respectively. Conclusion: 2% CHX was more effective as intracanal medicament against E. faecalis and C. albicans biofilm in both short as well as long-term duration, i.e., at 24 h, 7 days, and 14 days.

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Introduction: Periodontitis is a local chronic inflammation with systemic consequences. Many disorders are associated with periodontitis such as diabetes, high-serum low-density lipoprotein (LDL), and premature birth. Cardiovascular disease does not correspond to a classic risk factor for periodontitis but evidence suggests that endothelial dysfunction due to systemic inflammation may be the link between both pathologies. The aim of this study was to review the literature regarding endothelial dysfunction and periodontitis and to establish a possible link through systemic inflammatory biomarkers. Methods: We searched the terms "periodontitis and endothelial dysfunction" and "periodontal disease and endothelial dysfunction" in the following four databases: PubMed, Cochrane, Bibliografia Brasileira de Odontologia-Brazilian Bibliography in Dentistry (BBO), and Embase. Results: Both diseases share same systemic biomarkers. Conclusion: Endothelial dysfunction may be the link between periodontitis and other diseases such as cardiovascular ones.

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Introduction: Stem cells (SCs), known as cells with characteristics such as self-renewal and multilineage differentiation, are generally obtained from two sources: Embryonic stem cells (ESCs) and adult stem cells (ASCs). SC research is expected to play a pivotal role in future medicine. The aim of the present review was to introduce dental and nondental SCs, examining the general characteristics, in vivo and in vitro differentiation capacities, immunosuppressive properties as well as the application of SCs in dentistry and regenerative medicine. Methods: In October 2015, PubMed, Scopus were searched by experienced researchers with the query "stem cells and dentistry "and a focus on SC and dental journals. Results: In the field of dentistry, ASCs, isolated from different structures, are divided into different subpopulations: Dental SCs, population of SCs isolated from different components of immature and mature teeth and nondental SCs, and those isolated from oromaxillofacial tissues. Conclusions: It appears that dental and nondental SCs are popular resources of SCs because of easier accessibility and fewer ethical problems. In addition, they have a high differentiation capacity into different cell lineages. Different studies have introduced dental and nondental SCs as suitable SC sources for SC therapy in dentistry and regenerative medicine.

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Introduction: Talon cusp is an uncommon odontogenic anomaly which most frequently affects maxillary permanent incisors. Its presence causes the problem in esthetics, prevention of caries, and occlusal accommodation for the patient and problems in the diagnosis and clinical management for the dentist. Case Report: This article reports a case of talon cusp on the palatal surface of the permanent maxillary central incisor. Discussion: Since, the presence of talon cusp usually demands that definitive treatment be instituted; it represents a problem of clinical significance. The dentist should be able to diagnose it as the maxillary incisor is also the principal site for supernumerary tooth.

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Introduction: Trauma, altered tooth germ position and delayed tooth eruption have been hypothesized as possible causes of tooth root dilacerations and flexion, however these anatomical variations appear more commonly associated with posterior teeth and absence of traumatic history. The Hypothesis: Postulated is that tooth root dilaceration or flexion may be a result of tooth root sheath displacement due to gradients of bone remodeling present within alveolar bone. Evaluation of the Hypothesis: Alveolar bone displays bone remodeling gradients between coronal, apical and basal sections which affect bone plasticity. As a tooth is erupting or experiences delayed eruption, there are other relative dento-skeletal alterations occurring, such as the mesial drift of the dentition and transverse growth of the maxilla. It is plausible that during the physiologic and growth related alteration of the alveolar and basal bones, portions of developing tooth could be found within one or more of the plasticity zones, contributing to alteration of the root sheath and tooth root dilaceration.

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Introduction: Bromelain, a mixture of proteases derived from different parts of pineapple, has been described to have therapeutic benefits in a diversity of inflammatory diseases. Such effects are associated to its proteolytic activity. As one of the most common and multifactorial diseases, periodontitis is a bacterial infection that results from the damage to the integrity of the tissues around the tooth, which includes gingiva, periodontal ligament, and alveolar bone. In periodontitis, the recruitment of defense cells occurs, which releases several pro-inflammatory cytokines. At elevated levels, they can potentiate the alveolar bone loss. Studies have been conducted trying to alleviate the damage to the periodontium, however, the regeneration of the periodontal tissues is still limited. The Hypotheses: Based on previous studies showing that bromelain can act by decreasing the periodontal microorganism growth by proteolytically cleaving important cell surface molecules in leucocytes, by reducing neutrophils migration to periodontal sites, by downregulating the inflammation mediator levels, and by decreasing alveolar bone loss in the periodontitis. Evaluation of the Hypothesis: In a first moment, to evaluate this hypothesis, could be used two animal models: the ligature or bacteria inoculation induced periodontitis. If studies using animal models show encouraging results, appropriate clinical trials should be designed to evaluate the effect of bromelain as a complementary treatment for periodontal disease in humans, during the active phase or after the healing phase of mechanical therapy could be tested; to conduct a placebo-controlled study where health and periodontitis patients could be used.

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Oil pulling has its origin in Ayurvedic medicine, is a natural remedy to improve oral health. Its antibacterial properties help to eradicate the bacteria and other debris from adhering to the oral cavity. It reduces the accumulation of plaque, prevents halitosis, cavities, gingivitis. It is used to heal the bleeding gums and mouth ulcers. Oil pulling with sesame oil improves overall health. Other than oral health, oil pulling also helps in reducing asthma, allergies, chronic fatigue, diabetes, migraine headaches and chronic skin problems. It works by detoxifying or cleansing the body. The aim of this article is to highlight the benefits of oil pulling in management of oral health.

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Dental anxiety and fear can be a significant barrier to dental care, with symptoms ranging from feelings of unease to avoidance of care. The management of anxious patients is essential to improve their oral health. Triggers include sights, sounds, sensations, and smells of the equipment used in restorative procedures, and management should focus on controlling these factors. Recommendations for controlling these triggers include distraction and pharmacological interventions. In medicine, distractions include animal-assisted therapy, which proves an effective means of reducing anxiety levels. Studies have shown that interactions with live animals reduce self-reported anxiety more than distractions by either humans or magazines. The media also addresses the valuable role of emotional support by animals in boosting health and enhancing lives. In the past year, numerous news stories have reported regarding the use of certified therapy by dogs to comfort anxious patients in dental practices across the United States. Dogs serve to distract patients, drawing their focus away from dentistry, and generate a positive energy that enliven both the staff and the patients. The positive impact that therapy dogs have had on patients' dental experiences cannot be overstated. The incorporation of pet anti-anxiety therapy is a safe, effective, and inexpensive approach to easing dental anxiety and has profound potential for improving oral health.

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Introduction: Most studies about caries detection methods have been performed using permanent teeth. Primary teeth, however, present significant differences from permanent teeth; hence findings of these studies with permanent teeth cannot be extrapolated. The Hypothesis: Our hypothesis is that the caries diagnosis process in primary teeth is less challenging than in permanent teeth. This assertion is based on the fact that primary enamel is thinner and the caries process progresses faster in this type of teeth when compared to permanent teeth. For these reasons, the majority of caries lesions in primary teeth would be more evident and therefore, easily detected through visual inspection. Only a few number of caries lesions would be missed by visual inspection. Thus, adjunct diagnostic methods, such as radiographs, would be unnecessary for primary teeth. Evaluation of the Hypothesis: To evaluate this hypothesis, researchers should conduct studies about the performance of the caries detection methods avoiding selection bias and defining appropriate settings. Clinical trials randomizing the diagnostic strategies would be worthwhile. The evidence supporting the benefits of adjunct methods in detecting caries lesions in primary lesions is limited. However, clinical guidelines have recommended the use of the radiographic method to detect caries in primary teeth in all symptomless children. The confirmation of our hypothesis would lead to the need to re-evaluate such guidelines.

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Introduction: Tooth wear - attrition, abrasion, or erosion - are modern day problems for dentistry. It usually leads to discomfort and sensitivity especially during eating, drinking, or tooth brushing. If left untreated for a long time, it may lead to loss of vitality of tooth. Various qualitative and quantitative methods have been used in the past to describe tooth wear. However, each method has certain shortfalls. There is no ideal index that is simple and clear in its scoring criteria. The Hypothesis: The classifications described in the literature are very descriptive and hence, it takes a long time to grade for a complete dentition. Some are based on the morphologic appearance and others on severity. A classification system has to facilitate standardized identification of a condition and help in diagnosis and treatment planning. The present manuscript is an attempt to emphasize the need to develop a classification system that is easy to score and describes the condition in details without utilizing much time. Evaluation of the Hypothesis: The hypothesis highlights some drawbacks of the classification systems available today and puts forth a new and easy to use classification system.

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Researchers and scientific communities have encountered a horrible event named journal hijacking. In this paper, we present the unethical and criminal practices of journal hijacking. A hijacked journal is a legitimate scientific journal that offers print-only version, for which a bogus website has been created by a malicious third party fake publisher for the purpose of fraudulently offering research scientists the chance to rapidly publish their paper online with publication fee. Journal hijackers are dominant in analyzing the behaviors of researchers and journalism worldwide. They find the email addresses of authors from the websites of commercial and non-peer-reviewed journals. During last few years, more than one hundred of hijacked journals have been observed unbelievably. Whoever they are, it is apparent that they have the knowledge required to design a website, manage an open access e-journal, and they are skilled to hide their characteristics on the World Wide Web. They are aware that many of authors are in urgent need to publish their work in well-known prestigious journals. The goal of an anti-journal hijacking strategy should be to disseminate knowledge about such scams and to train authors so they will have the basic skills required to avoid fake publishers and hijacked journals.

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