Introduction: Pain control is important during dental treatments since the lack of sense of pain causes less emergency events, less extra injections, and increased patient’s trust. Infiltration injection in the anterior maxilla was considering one of the most painful injections. The aim of this study was to investigate the effect of local massage on the success of anesthesia and infiltration injection pain in maxillary central incisors. Materials and Methods: This double-blind, crossover trial was conducted among 30 participants by injection with and without “massage before the injection” over two sessions with an interval of 2 weeks. The injection pain in both methods was measured immediately after injection by Visual Analogue Scale (VAS) at three times of needle insertion, 5 seconds after injection, and needle withdrawal. The success rate of anesthesia was determined 5, 15, and 30 minutes after injection by electrical pulp tester. Results: The mean scores of VAS at three times with and without the massage at three times were not statistically significant (Wilcoxon, P > 0.05). However, the mean score of VAS in injection with the massage were lower. The success of anesthesia in injection with and without the massage at intervals 5, 15, and 30 minutes after injection was not found to be significant (McNamara, P > 0.05). Conclusion: Massage before injection had no effect on the success of anesthesia and injection pain.

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Introduction: Color change of composite restorations in different color media over time is a common problem in esthetic dentistry, creating the need to replace the restoration and spending a great deal of cost and time by patients. The aim of this study is in vitro comparison of color stability of resin composites in blood area. Materials and Methods: Fifteen disk-shaped specimens of each resin composite (valux plus and filtek supreme) were prepared. The samples were kept in distinct water containers for 24 h in order for the primary water absorption to happen by restorative materials. Then, for 1 month, they were immersed in blood every day for 20 min. The color values (L*, a*, and b*) were measured using the CIE L*a*b* system. The color change values were calculated before and after 1, 7, and 30 days of immersion. The amounts of ΔE₁, ΔE₇, ΔE₃₀ for each group were calculated with ΔE = [(ΔL*)² + (Δa*)² +(Δb*)²]^½. Repeated measures and paired t-tests and one-way analysis of variance (ANOVA) were applied for the statistical analysis. Results: The discoloration in two groups was not significant and visually perceptible. However, microhybrid samples at primary time (less than 7 days), under the significant level, showed more discoloration, but nanofilled’s samples discoloration increased till the 30th day. Conclusion: Blood as a biological agent that contains globulin as a large molecule, did not have a significant impact on changing the color of the resin composite.

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Introduction: Oil pulling is an ancient, traditional folk remedy that has been practiced for centuries in India and southern Asia as a holistic Ayurvedic technique. The practice of oil pulling involves placing a tablespoon of an edible oil (e.g. sesame, olive, sunflower, coconut) inside the mouth, and swishing or “pulling” the oil through the teeth and oral cavity for anywhere from 1–5 minutes to up to 20 minutes or longer. Materials and Methods: Articles related to oil pulling were collected by using oil pulling as Keyword in Google and Medline. Out of the 21 related articles published till 2016, 6 articles with the proper study designs were used for analysis. Results: The studies were unreliable for many reasons, including the misinterpretation of results due to small sample size and improper study design. Conclusion: Though the promoters claim it as one of the best method to be as adjuvant to mechanical control methods, scientific evidences are lacking.

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Introduction: The treatment of Class I malocclusion aims to arrange teeth position in a good arch form. The arch form consists of tooth size and arch dimension (intercanine width, canine depth, intermolar width, molar depth). Numerous methods have been used to describe the arch form quantitatively. The aim of this study was to develop a mathematical ratio for identifying arch form (square, oval, tapered) using arch dimension variables (intercanine width, canine depth, intermolar width, molar depth). Materials and Methods: Dental cast pre and post-orthodontic treatments from 190 Indonesian patients were scanned to obtain digital data. All data were measured using “Image Tool.” The measured data (tooth size, intercanine width, intercanine depth, intermolar width, intermolar depth, and arch perimeter) were analyzed statistically using ordered logistic to find out determining variables to the arch form. Results: The validity, reliability, and normality of all the data were analyzed using Stata. From analyzing the data using ordered logistic, intercanine width and intermolar depth showed a reverse relation to the arch form. The shape of the arch form (square, oval, and tapered) can be described quantitatively by using ratio (CD/CW)/(MD/MW); a ratio less than 45.30% indicates square, 45.30–53.37% indicates oval, and more than 53.37% indicates tapered. Conclusions: (CD/CW)/(MD/MW) ratio can be used to describe arch form quantitatively.

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Introduction: Ewings sarcoma (ES) is an unusual, aggressive malignant neoplasm occurring primarily in the long bones of the lower and upper extremities followed by pelvis, ribs, vertebrae, skull, and jaws-bones. Patients with ES tumor need long-term complete oral reconstruction. The location of the primary tumor in the face is predominantly in the mandible, and usually in the posterior mandible. Case Report: Here, both surgical procedures and prosthetic reconstruction in three stages of a 10-year-old childs life presented. Definitive prosthetic reconstruction is extremely challenging in such patients after previous excessive surgical resection, especially when the patient has complex dental abnormality. Fixed dental prostheses and implant-supported fixed restorations have been selected as the preferred treatment option in this case after increasing occlusal vertical dimension (OVD) to create sufficient interocclusal space (IOS). Discussion: In this case, ES patient treated in three phases. In the first-stage, only surgical resection of tumor and bone graft reconstruction with titanium plate fixation was performed. In the second-stage, Lefort I surgery for maxilla with dental implants insertion in mandible was done simultaneously. For definitive restorations fabrication, it was mandatory to increase occlusal vertical dimension (OVD) to create sufficient inter-occlusal space (IOS) for the restorations. OVD has been altered to achieve more stable relationship of mandibular teeth with maxillary teeth, and to obtain an optimum esthetic and functional result. Several factors should be considered as determinants for increasing the OVD such as remaining tooth structure, the space available for the restorations such as the current situation, occlusal variables, and esthetics.

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Introduction: Progressive loading protocol is a high-demanding procedure suggested to increase the quality of bone when the implant is inserted in D3 or D4-typed bone. The purpose of this study was to present a case report regarding simultaneously progressive and immediately loading implants in the anterior position of the maxilla. Case report: One patient whose implants in the anterior maxilla (in site of teeth #7, #9, #11) had questionable to poor prognosis who was treated immediate and delayed progressive loading protocol and was followed up for 2 years. Discussion: Although the number of studies in this field is limited, it can be concluded that the progressive loading protocol can predictably enhance the treatment success in immediate-loaded implants with poor prognosis and when inserted in low quality bone such as the present case.

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