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Marginal penetration in zirconia inlay-retained fixed partial dentures: An in-vitro study.

Mohamed T. El Halawani, Yehia S. Aboushady, Sally M. Abdel Kader, Stefano Benedicenti

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Introduction: Inlay-retained fixed partial dentures (IRFPDs) have been proposed as a more conservative method for replacing missing dentition instead of the more destructive full crown preparation. Various studies have been conducted on the flexural strength of such restorations; however, there is a lack of evidence on their marginal integrity. Aim of the study: Evaluating the marginal integrity of three IRFPD designs fabricated using monolithic translucent zirconia. Materials and methods: Thirty IRFPDs were fabricated using a translucent monolithic zirconia (Katana STML) and divided randomly into 3 groups according to the cavity design. Group 1 received an inlay cavity preparation including a proximal box and a 2 mm deep occlusal extension, Group 2 received an inlay cavity preparation including a proximal box and a 1.5 mm deep occlusal extension, and Group 3 received only a proximal box cavity preparation without an occlusal extension. The restorations were fabricated and cemented using a dual cure resin cement (Panavia V5 system) and subjected to an equivalent of 5 years of ageing. A dye penetration test was performed on the specimens, and the values of marginal penetration were analyzed under a stereomicroscope. Results: During the whole 5-year ageing process, no specimens showed signs of cracking, fracture or loss of retention in any or the restorations. There was a significant difference between the marginal leakages values obtained in the 3 groups of the study (H=10.208, p<0.05). Comparing the groups of the study showed significant difference in marginal leakage between Group 1 and Group 3 (p<0.05). Conclusion: The margins of inlay-retained fixed partial dentures performed well after ageing with recommended bonding protocols for zirconia. Inlay cavity design including a proximal box and an occlusal extension exhibited better marginal stability than proximal box without any occlusal extension. Keywords: Inlay-retained, FPD, dye penetration, marginal leakage


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ASSESSMENT OF ORAL HEALTH RELATED QUALITY OF LIFE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AFTER ORAL REHABILITATION UNDER GENERAL ANAESTHESIA (CROSS SECTIONAL STUDY)

Mohammed M. Metwally, Aly A. Sharaf, Niveen S. Bakry

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Introduction: Children with Special Health Care Needs (CSHCN) can be at increased risk of unmet dental services. Dental treatment under General Anesthesia (GA) may be a safe and effective treatment for CSHCN. Assessing Oral Health Related Quality of Life (OHRQoL) of CSHCN could enable the evaluation of the oral health state and treatment efficiency after oral rehabilitation under GA. Objectives: To assess change in oral health related quality of life among children with special health care needs before and after oral rehabilitation under general anesthesia. Materials and Methods: A cross-sectional study with a sample of 47 parents/caregivers of CSHCN who were scheduled for oral rehabilitation under GA at the Faculty of Dentistry, Alexandria University. Parents/caregivers responded to a self-completed Child Oral Health-Related Quality of Life questionnaire (COHQoL). It consists of Parental- Caregiver Perceptions Questionnaire (P-CPQ) and Family Impact Scale (FIS) which completed before and at 1 month after the oral rehabilitation. Results: The impact on OHRQoL was reportedly negative before oral rehabilitation under GA but it improved significantly (p=0.001)in all aspects postoperatively with overall scores for P-CPQ section ranged from 12.0 to 45.0 and a mean of 30.2± 7.7 preoperative and it declined post-operatively to range from 0.0 to 39.0 and a mean of 15.9± 11.4. Also for FIS section scores ranged from 3.0 to 23.0 and a mean of 13.9± 4.5 preoperative and declined post-operatively to range from 0.0 to 21.0 and a mean of 7.3± 6.0. Conclusions: Oral rehabilitation of CSHCNs under GA markedly improved their OHRQoL as well as their families. Keywords: Oral health related quality of life, children with special health care needs, general anesthesia.


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EFFECT OF EXTRAORAL AGING CONDITIONS ON MECHANICAL PROPERTIES OF FACIALSILICONE ELASTOMER REINFORCED WITH TITANIUM-OXIDE NANOPARTICLES (IN VITRO STUDY)

Nayera S. Radey, Ahmed M. Al Shimy, Dawlat M. Ahmed

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Introduction: Investigators have been searching for an ideal maxillofacial prosthetic materials in order to gain patient acceptance and can be fabricated easily in the dental setting. Objectives: To evaluate the influence of adding different concentrations of titanium oxide nanoparticles (TiO2 NPs) on the mechanical properties of facial silicone elastomer (SE) after different extra-oral aging methods. Methodology: TiO2 nanoparticles were mixed with MED-4210 maxillofacial silicone elastomer at 1.5 %, 2% and 2.5 % weight percentage (w/w). Unmodified silicone was served as control group. Each of the above groups were evaluated to mechanical properties before aging conditions. Control & 2.5% nano-TiO2 silicone elastomers groups were subjected to six equal aging conditions groups as follow. Dry storage in dark for 6 months, storage in simulated sebum solution for 6 months, storage in simulated acidic perspiration for 6 months, accelerated artificial daylight weathering for 360 hours, storage in antimicrobial silicone-cleaning solution for 30 hours and mixed aging of sebum under UV light for 360 hours. After aging exposures, they were evaluated to the mechanical properties. Data were analyzed using the Kolmogorov-Smirnov test, F-test (ANOVA) and Post-hoc pair-wise test. Results: TiO2 nanoparticles addition improved the mechanical properties in terms of tensile strength and percentage elongation, tear strength and shore A hardness of MED-4210 maxillofacial silicon elastomer before and after extra-oral aging conditions (P < 0.05). Pair-wise comparison between control group and 2.5% nano-TiO2 silicone elastomers composite exhibited significant differences according to the mechanical properties after aging. Conclusions: Reinforcement of MED-4210 maxillofacial silicon elastomer with TiO2 nanoparticles introduces a favorable material with physical and anti-ageing properties in our in vitro study. Keywords: Nano-TiO2, Silicone elastomer, mechanical properties, artificial ageing.


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CONSERVATIVE APPROACH FOR MANAGEMENT OF POSTERIOR ATROPHIC MAXILLA USING IMPLANT ASSISTED OVERDENTURE (CLINCAL TRIAL)

Nayrouz A. Metwally, Ahmed M. Abdel-Hamid, Ahmed M. Hommos, Nermeen A. Rady

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Introduction: Implant assisted  prostheses provide a higher degree of patient satisfaction than traditional prostheses. However, severe atrophy of the edentulous maxilla and maxillary sinus pneumatization may reduce the available bone in the posterior region for a safe and reliable implant‑supported dental rehabilitation. Tilted implants in the anterior region of the maxilla were suggested to be useful in the treatment of posterior atrophic edentulous maxilla that allows the use of longer implants to gain more stability. This may preclude the use of conventional Implant overdenture abutments, requiring the use of divergence correcting attachments. Aim of the study: The aim of the present study was to clinically evaluate the effect of the use of Smart Box accompanied with OT Equator attachment in retaining the inclined implant assisted overdenture for atrophic maxilla. Material and methods:  Ten patients with posterior atrophic maxilla and partially dentate mandible with posterior occlusal stops were allocated for this study. For each patient, an implant assisted maxillary overdenture was fabricated using minimally invasive flapless surgical technique. Four implants were placed while the most anterior implants were axial and the most posterior implants divergent to 25 degrees using CAD/CAM surgical guide. The implants were loaded immediately by OT EQUATOR and smart box attachment retained maxillary overdenture. Each patient was evaluated clinically at the final prosthesis insertion (baseline), three, six and nine months post insertion. Modified gingival index (MGI), Clinical attachment Level (CAL) and Peri-implant probing depth (PIPD) are the clinical parameters that were evaluated. Results: MGI, CAL and PIPD revealed significant increase in both tilted and axial groups throughout the evaluation period intervals. Tilted implants group showed significantly greater increase in all parameters when compared with the axial group.  


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KNOWLEDGE, ATTITUDES AND REPORTED PRACTICES REGARDING MANAGEMENT OF PATIENTS WITH BLEEDING DISORDERS AMONG ALEXANDRIA MINISTRY OF HEALTH DENTISTS A cross sectional analytical study

Noha A. Elshafaei, Mona K. El Kashlan, Wafaa E. Abdelaziz

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INTRODUCTION: Bleeding disorders and their complications are considered a significant health hazard worldwide. Research reports on the awareness of dental professionals regarding bleeding disorders were few and the researcher could not obtain any from Egypt. OBJECTIVES: The objective of this study was to assess the knowledge, attitudes and reported practices of Ministry of Health (MOH) dentists regarding bleeding disorders and their management. MATERIALS AND METHODS: This was an analytical, cross sectional study that was carried out in Alexandria during a period of 6 months from August 2018 to January 2019. The participants were asked to complete a comprehensive, close-ended self- administered questionnaire regarding patients with bleeding disorder. The questionnaire was previously pilot tested and validated by 4 professors at the Department of Pediatric Dentistry and Dental Public Health and 6 professors in the Department of Hematology, Faculty of Medicine-Alexandria University before releasing the final version of the questionnaire. It consisted of 33 items arranged in four sections. The first section was concerned with the demographic variables of the participating dentists. The second and third sections enquired about the participants’ knowledge and attitudes regarding bleeding disorders symptoms and management, while the forth section of the questionnaire assessed the respondents’ reported practices concerning bleeding disorders patients and actions taken to manage patients with the disease. RESULTS: Dentists participating in the study (n= 340 from 400 with a response rate of 85%) showed that Ministry of Health dentists had a fair knowledge, good attitudes and excellent reported practices toward bleeding disorders patients visiting the Ministry of Health clinics. CONCLUSIONS: The present study showed a need to increase awareness of dental practitioners regarding bleeding disorders. Therefore, designing appropriate training programs for oral health care providers in order to enhance their practices towards the diagnosis and management of patients with bleeding disorders is mandatory.  


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EFFECT OF DIFFERENT DENTIN TREATMENT PROTOCOLS ON SURFACE ROUGHNESS AND COMPOSITE BONDING

Raghda A. Okda, Ahmed S. El kadi, Fayza H. AlAbbassy

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Introduction: With advances in technology, other options besides the traditional cavity preparation with diamond and carbide burs have emerged; among them are laser and sono-abrasive systems. Objectives: The aim of this study was to compare in vitro the effect of (Er:YAG) laser with different radiation distances, sono-abrasion and rotary cutting on  the surface roughness of dentin and the shear bond strength of resin composite to dentin using self-etching adhesive system. Materials and Methods: 50 extracted human molars were randomly divided into 5 groups (n=10) received the following treatments. Group 1: carbide bur, Group 2: diamond bur, Group 3: sono-abrasion, Group 4: contact Er:YAG laser, Group 5: non-contact Er:YAG laser. Average surface roughness (Ra) was determined with a profilometer. Specimens in all groups were treated with self-etching adhesive system and composite build ups were done with Filtek Z-250. Bonding of resin composites to the dentine specimens was tested in shear mode. For morphological analysis; two extra teeth from each group were examined using a scanning electron microscope (SEM).   Results: The shear bond strength of composite to the laser irradiated dentine (contact and non-contact) ranged from 6.64 ± 5.24 MPa and 6.29 ± 2.08 MPa respectively, and were significantly lower than the bond strength seen in other groups. However, the surface roughness of the laser irradiated dentine was significantly higher than that of the sono-abraded dentine and bur-cut dentine. SEM revealed that, the dentine surfaces irradiated by laser showed a scaly and rugged appearance and open dentinal tubules without smear layer production. Conclusion: It was concluded that Er:YAG laser treatment reduced shear bond strength of resin composite to dentin in comparison with conventional treatment with high speed rotary and treatment with sono-abrasion. Different Er:YAG laser distance irradiations did not influence the shear bond strength of composite to dentin.  


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COMPARISON BETWEEN NANO-HYBRID COMPOSITE AND RESIN REINFORCED GLASS IONOMER IN FLUORIDE RELEASE AND RECHARGE CAPACITY (IN VITRO STUDY)

Sabreen A. Ibrahim, Ahmed A. Mohamed, Adel A. Kamar, Niveen S. Bakry

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Introduction: Caries prevention and eradication has been the greatest dentists’ challenge world wide. As fluoride has been identified as one of the protective factors that tilt the caries balance towards the positive side. Therefore, fluoride releasing materials were elaborated with the purpose of reducing the incidence of caries. Objectives: to compare between the amount of fluoride releasing and recharging capacity of fluoride releasing nano-hybrid composite and resin reinforced glass ionomer. Materials and Methods: Two hundred and seventy two round specimens (n=136 for each material) were used to prepare the required samples. Each 4 specimens immersed in 5 ml of artificial saliva were considered as one sample of total number sixty eight samples (n=34 for each group).The samples were divided randomly into two groups according to the materials used: Group І (experimental): reliaFIL light cure nano-hybrid composite and Group Π (control): Riva light cure resin reinforced glass ionomer. The amount of fluoride released in each sample was recorded on day 1, 7 and day 15 by using fluoride ion selective electrode. After 15 days each group was divided into 2 subgroups (n=17): Subgroup A: experimental subgroup (treated with ClinproTM white varnish) and Subgroup B: control subgroup (no fluoride varnish treatment). The amount of fluoride re-release was recorded at the same time intervals. Then, the recharge capacity was calculated as the difference in the fluoride release between experimental and the control subgroups. Results: As for the fluoride release there was a statistical significant difference between two groups (P=0.05). However, there was no significant difference between the two groups in the fluoride re-release and recharge capacity (P=0.05). Conclusion: Fluoride releasing nano-hybrid composite had demonstrated a capacity of fluoride release and a recharge capacity comparable to resin reinforced glass ionomer. Keywords: fluoride release, fluoride recharge, fluoride releasing nano-hybrid composite, resin reinforced glass ionomer, fluoride varnish


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