Periodontal disease affects the supporting tissues of the tooth. The clinical manifestation varies from gingivitis to periodontitis. Periodontal disease is triggered by bacterial infection that releases toxins. The imbalance between oxidants and antioxidants determines the progression of periodontal disease. Melatonin (MEL) (N-acetyl-5-methoxytryptamine) is a hormone in the human body. Its production takes place in various organs including the retina, gastrointestinal tract, bone marrow, leukocytes, lymphocytes, skin, and principally pineal gland. Its main function is the regulation of circadian and seasonal rhythm, body weight, reproduction, bone metabolism, and tumor growth. An important function of melatonin is the ability to reduce oxidative stress. The aim of this work is to explain if there are differences in salivary melatonin concentration between periodontal and healthy individuals. The study was conducted utilizing the main scientific databases (PubMed, MEDLINE, and Web of Science). The time window considered for the electronic search was from March 1, 2007, to March 1, 2020. The work takes into account 6 works on the disease. Other studies were excluded as they did not meet the inclusion criteria. Studies revealed a concentration of salivary melatonin compared to patients with periodontal disease. Studies agree that the concentration of melatonin is lower in people with periodontal disease. Only one study showed no difference in concentration. Melatonin, therefore, has a protective effect on the periodontium thanks to its antioxidant properties. The salivary measurement of melatonin could be a useful tool for early detection. It can also be used as a therapy to improve the symptoms of periodontal disease.

Purpose: Periodontal diseases (PDs) are considered a risk factor for some systemic conditions such as cardiovascular diseases, diabetes, and adverse pregnancy outcomes. Hyperemesis gravidarum (HG) is a common health problem, and inflammation is claimed to play a vital role in its etiopathogenesis. Here, we aimed for the first time to demonstrate the relationship between PD and HG. Materials and Methods: A total of 30 pregnant with HG and 30 healthy pregnant between the age group of 18 and 40 years were enrolled in the study. HG was diagnosed if the followings were present: at least one-positive ketonuria, >5% weight loss, and severe vomiting, which is >2 times a day. Periodontal status was evaluated by the plaque index (PI), gingival index (GI), probing pocket depth (PPD), and bleeding on probing index (BOPI), and these parameters were recorded. All measurements were performed at 6 points of each tooth (mesiobuccal, midbuccal, distobuccal, mesiolingual, midlingual, and distolingual) and compared between the groups. Results: Mean age was 29 ± 3 in HG and 28 ± 4 in the control group. There was no difference between two groups according to the age (P = 0.421), gravida (0.524), and parity, (P = 0.54). PI, GI, PPD, and BOPI were significantly higher in HG group as compared to controls. Conclusions: Gingival inflammation is more common in patients with HG, and it is possibly associated with insufficient tooth brushing because it may stimulate the gagging reflex and vomiting. Since there could be a vicious cycle between PD and HG, periodontal preventive programs are crucial for pregnant women with HG.

Background/Aims: Nuclear factor kappa beta (NF-κB) is a member of the transcription factor family, and it plays a key role in coordinating the expression of genes in many chronic inflammatory diseases. The main etiology of endodontic treatment failure is caused by bacteria in root canal, including Enterococcus faecalis. The aim of this study to determine NF-κβ and osteocalcin expressions during the periapical tissue damage due to induction of E. faecalis. Materials and Methods: Fifty-four male rats were randomly divided into two main groups, each of which had three subgroups. In Group C (control), every tooth was induced only by sterile brain–heart infusion broth (BHIb). Group C had three subgroups, namely Group C3 with 3 days inductionprocess, Group C10 with 10 days induction process, and Group C21 with 21 days induction process. In Group T, every tooth was induced by 10 μl of BHI-b E. faecalis ATCC212 (10⁶ CFU). Similarly, Group T also had three subgroups, namely Group T3 with 3 days induction process, Group T10 with 10 days induction process, and Group T21 with 21 days induction process. The animals were sacrificed based on their group schedule and then prepared for histological and immunohistochemical examinations of periapical tissue. Afterward, the expressions of NF-κβ and osteocalcin were calculated on the light microscope. Results: The results revealed that the number of cells expressed of NF-κβ and osteocalcin increased significantly in all sub-groups of Group B induced by E. faecalis compared to the control group. Conclusion: It can be concluded that the number of cells expressed NF-κβ and osteocalcin increase during the periapical tissue damage induced by E. faecalis.

Aim: The aim of this study was to compare the effect of different surface coating agents on water sorption and solubility of a high-viscous glass ionomer cement (GIC). Materials and Methods: A high-viscous GIC (EQUIA Forte, GC, Tokyo, Japan) was used for this study. Sixty disc-shaped specimens (8 mm × 2 mm) were prepared from material. Specimens were divided six subgroups and five different coating systems were applied on specimen surfaces. Other groups were used as the control group (n = 10) (Group 1: Control, Group 2: Scotchbond Universal Adhesive (3M ESPE, St. Paul, MN, USA), Group 3: Petroleum jelly (Vaseline, India, Lever Ltd.), Group 4: BisCover LV (Bisco, Schaumburg, IL, USA), Group 5: EQUIA Forte Coat (GC, Tokyo, Japan), Group 6: Final Varnish LC (VOCO, Cuxhaven, Germany). All specimens were prepared according to the manufacturer's instructions and subjected to water sorption and solubility tests based on the ISO 4049 requirements. Data were analyzed by paired samples t-test, one way analysis of variance, post hoc Tukey HSD, and Tamhane's T2 tests (α = 0.05). Results: Equia Forte Coat and Final Varnish LC were more successful in terms of water sorption, but Final Varnish LC was more successful in terms of solubility. Conclusion: Within the limitation of this study, it can be concluded that light-cured surface coatings, especially Final Varnish LC were more successful than other groups in terms of water sorption and solubility.

Purpose: The purpose of this study is to evaluate four different methods used to examine preparation taper and relative parallelism of the prepared abutment teeth. Materials and Methods: A total of 12 artificial teeth were prepared simulating six sets of prepared abutments. Proximal walls of the premolars in all sets were prepared parallel and 90° to the occlusal plane, whereas walls of the second molars were prepared either 0°, 20°, or 45° to the long axis of the premolar preparation. A total number of 210 participants were involved in the study. All data of the taper evaluation and responses to the questionnaire were coded and entered into an Excel Spreadsheet file. Statistical analyses of the participants' responses were performed using the Chi-square test with P < 0.05 was considered statistically significant. Results: No significant difference was found between the educational levels relative to their responses to level of difficulty, sensitivity, skills, and technical demands for the four techniques. The intraoral mirror technique in the mandibular arch was found to be statistically significantly (P < 0.05) better. The surveyor technique in the maxillary arch was found to be statistically significantly (P < 0.05) better. The highest percentage of faculty members (50%) chose dental surveyor (DS) as the most preferred technique to be included into the academic curriculum. Conclusions: The DS was more favored among the respondents across all educational levels. This technique presented high potential in accurately evaluating tooth preparation in comparison to the intraoral techniques.

Background and Aim: There is a shortage of empirical studies that combine the problem of malocclusion to the importance of the self-perception of the mouth/smile in the mental representation of the self-image of the face, which is the aim of the present qualitative and exploratory study. Subjects and Methods: The convenience sample consisted of 151 children and youngsters of both genders, aged 8–24 years, who used an orthodontic appliance for 6 months to 1 year, and were invited to draw two portraits of their mouth/smile before (M1) and after (M2) the use of an orthodontic appliance. Results: The main reasons that underpin the use of an orthodontic appliance are defined by the crooked teeth correction, malocclusion correction, and interdental spaces categories, in which having the perfect smile was only relevant to preteens. Discussion and Conclusions: In the present study, we have identified the orthodontic smile as a new categorization of a perfect smile associated with the social display of a look with perfect teeth.

Aim: This study is aimed to evaluate the impact of three irrigating solutions on the apical sealing ability of three endodontic sealers. Materials and Methods: One hundred maxillary central incisors were decoronated, and their roots were assigned into three experimental groups (n = 30 each) according to the nature of the irrigating solution and two control groups (n = 5 each). Each experimental group was divided equally into three subgroups (n = 10 each) according to the type of root canal sealer. All root canals were instrumented using ProTaper Universal rotary system and irrigated with 3% sodium hypochlorite (NaOCl/Group 1), 3% hydrogen peroxide (H₂O₂/Group 2), and 2% chlorhexidine gluconate (CHX/Group 3). The final irrigating solutions for all groups were 17% ethylenediaminetetraacetic acid (EDTA) and distilled water. The continuous-wave technique was used to fill the prepared canals with the following materials: MTA-Fillapex/Gutta-percha (Subgroup A), AH Plus/Gutta-percha (Subgroup B), and Realseal SE/Realseal (Subgroup C). The microleakage was assessed after 72 hours using the linear dye penetration method. The results were statistically analyzed with one-way analysis of variance. Results: Significant differences were found only between the experimental groups (P < 0.05). All root canal sealers after irrigation with 3% H₂O₂ showed the lowest amount of leakage. The highest apical leakage was observed when 3% NaOCl and 2% CHX were used. Conclusions: The type of irrigating solution could affect the apical sealing ability of experimental sealers used with the continuous-wave obturation technique. Root canal irrigation with 3% H₂O₂+17% EDTA increased the apical sealing ability of all root canal sealers. Root canal irrigation with 3% NaOCl or 2% CHX +17% EDTA decreased the apical sealing ability of all root canal sealers.

Objective: To evaluate the surface characteristics of restorations performed after simulated toothbrushing and to compare the results between the composites. Materials and Methods: In total, 80 samples were made (7 mm × 4 mm) from the composites: Bulk Fill One, Bulk Fill Flow, Z350 XT, and Z350 XT flow (3M/ESPE, St. Paul, MN, USA). Half of the specimens was submitted to 60,000 cycles of simulated toothbrushing, while the other half was the control group (n = 10). The surface was evaluated through Scanning electronic microscopy (SEM), surface roughness (Ra), and weight loss, before and after the simulated toothbrushing. To evaluate the statistical analysis, a two-factors variance test and the Tukey's posttest were performed. Results: In the analysis performed by SEM, it was observed the presence of both small and medium protruding particles in all groups after simulated toothbrushing, with the exception of the group which used Z350 flow composite. All materials presented increasing on Ra after simulated toothbrushing. Regarding weight variation, there was not any significant statistical difference in all materials. Conclusions: The abrasive process occasioned by toothbrushing leads to changes on the particles' disposition, which causes changes on the surface and increase on the Ra. On the other hand, there was not any difference regarding to weight variation.

Aim: This study is aimed to evaluate the effect of exogenous matrix metalloproteinases (MMPs) inhibitors on immediate shear bond strength (SBS) of resin composite attached to primary teeth dentin. Methods: Sixty extracted anterior primary teeth were selected. A dentin block (6.0 mm × 6.0 mm × 2.0 mm) was obtained from each tooth. All dentin blocks (n = 60) were pretreated for 60 s with either 0.01 M phosphate-buffered saline (pH 7.2) in the control group (Group I), chlorhexidine (CHX) 2% (Group II), doxycycline (DOX) solution 2% (Group III), and ethylenediaminetetraacetic acid (EDTA) 17% (Group IV) before applying etch-and-rinse adhesive system (Adper Single Bond 2). After adhesive application, composite resin (Filtek 3M, USA) was applied, and then, SBS values were determined with a universal testing machine. Results: There were no significant differences between SBS values of DOX, EDTA, and the control group (P < 0.05). SBS values reduced when CHX was applied, although the reduction was not statistically significant (P = 0.961). The DOX group showed the highest bond strength values (8.82 ± 3.29), which was significantly greater than the CHX (P = 0.026). Conclusion: Based on the results, pretreatment with MMPs inhibitors was not advantageous with regard to improving the immediate SBS of composite attached to primary teeth dentin.

Aim: The study aimed to compare the in vitro antibacterial activity of an ethanol extract of Rosmarinus officinalis “romero” (EERO) at different concentrations with Streptococcus mutans ATCC 25175. Materials and Methods: We worked with three concentrations of 25%, 50%, and 75% of the EERO and compared these with the positive control chlorhexidine 0.12% and distilled water as a negative control. Seeding was performed in Müller–Hinton agar medium. The inhibitory effectiveness of EERO was determined using the disc diffusion method with the experimental solutions. The seeded and inoculated plates were incubated at 37°C, for 24 and 48 h. The reading was carried out according to the Kirby–Bauer method by measuring the diameter (mm) of the inhibition halo formed by the bacteria using a Vernier caliper and recorded on a data collection sheet. Results: In the 24-h group, chlorhexidine 0.12% showed the highest inhibition halos with a mean of 12.8 ± 0.8 mm, followed by EERO 75% with a similar mean of 12.1 ± 0.6 mm. Similarly, at 48 h, chlorhexidine 0.12% had the highest antibacterial activity of 13.0 ± 0.7 mm followed by EERO 75% with 12.2 ± 0.5 mm. Conclusions: The EERO showed inhibitory effectiveness against S. mutans, with the concentration of 75 mg/ml showing similar results, albeit not statistically significantly different, to those of chlorhexidine.

Aim: The aim of this study to evaluate the effects of 10% alpha-tocopherol (10AT) or 20% alpha-tocopherol (20AT) incorporation on biological compatibility, pH, and calcium release of calcium hydroxide (CH) paste associated with 2% chlorhexidine digluconate (CHX). Materials and Methods: Four groups were evaluated: CH, CH-CHX, CH-CHX-10AT, and CH-CHX-20AT. For biological compatibility test, polyethylene tubes containing several pastes were implanted in Wistar rats' subcutaneous tissue (n = 28). After 48 h and 7, 14, and 21 days postimplantation, the specimens were removed and subjected to histologic and histomorphometric analysis. The number of inflammatory cells was evaluated. For pH and calcium release analysis, the pastes were placed individually (n = 10) in plastic tubes and immersed in deionized water. The calcium release and pH changes were evaluated in 24 and 48 h and 7, 14, and 21 days. All data were submitted to Kruskal–Wallis test (α = 0.05). Results: Concerning biological compatibility, all materials shown a similar decidual response (P > 0.05). In the first hours, there was as increase in the number of inflammatory cells, inducing an expressive inflammatory response. After 14 days, inflammation reaction decreased and collagen fiber was organized for the tested pastes (P = 0.05). The pH analysis of the groups maintained the same relationship during the different periods evaluated: the CH and CH-CHX groups showed higher values and were similar to each other (P > 0.05), followed by the CH-CHX-10AT and CH-CHX-20 AT groups. Regarding the amount of calcium ions, in the initial (24 hours) and final (21 days) periods, the groups did not present differences between them (P > 0.05). Conclusion: The 10AT or 20AT, as an antioxidant agent, incorporation to CH and 2% CHX paste negatively affected biological and physicochemical properties.

Introduction: Nicotiana tabacum, a South American herb, is the main source of tobacco. The use of tobacco for medicinal purposes emerged in the 1400s, and later in 1800–1900, the presence of nicotine in tobacco was discovered, leading to tobacco abuse. Apart from tobacco use, manufacturing tobacco, packaging, and even disposal of cigarette butts and packages have an environmental effect. Tobacco is available in different types from manufactured cigarettes, hookahs, bidis, cigars, cheroots, and chewing tobacco. The main aim of the study was to assess the knowledge of health risks associated with tobacco habit in tobacco users. Materials and Methods: A descriptive cross-sectional survey was conducted among tobacco users visiting a private dental institution. A total of 100 participants were involved, and a questionnaire containing 21 closed-ended questions was prepared and distributed online using Google Survey Forms. The responses were collected, tabulated in excel, and statistically analyzed using SPSS. Chi-square test was done to assess the knowledge of the participants regarding the health risks of tobacco.Results: The majority of the participants smoked everyday for the past 3–10 years. Manufactured cigarettes were predominantly used among the 100 participants. The majority of the participants were aware that smoking causes lung and heart diseases in adults. Most of the participants were also aware of passive smoking. Conclusion: Immense programs regarding disposal of cigarette butts and awareness in young adults should be practiced to reduce the consumption of tobacco.

Background and Purpose: Gingival phenotype (GP) can be measured in patient's clinical evaluations to predict the Schneiderian membrane thickness (SMT). Materials and Methods: In this analytic observational cross-sectional study, cone-beam computed tomography (CBCT) images of 310 patients requiring implant surgery in the first or second molar area of maxilla were selected. The GP was determined by inserting a periodontal probe into gingival sulcus. If the outline of the underlying periodontal probe could be seen through the gingival, it was categorized as thin; if not, it was recorded as thick. The examiner measured SMT by calculating the average thickness of the Schneiderian membrane in three sequent cuts of CBCT images. All analyses were performed using SPSS Version 24 software. To analyze the data, independent samples test, Pearson correlation, and linear regression were performed. The level of significance was set at P = 0.05. Results: Age had no statistically significant relation with SMT and GP (P = 0.666 and P = 0.842, respectively). The difference of SMT among males and females was not statistically significant (P = 0.196). In terms of GP, males and females were statistically significantly different such that females had thin GP more frequently compared to males (P = 0.003). SMT was statistically significantly thinner in patients with thin GP compared to those with thick GP (P ≤ 0.001). Conclusion: It may be suggested that GP is an important clinical predictor for SMT, particularly if CBCT evaluations or histological examinations are not possible.

Digital technology is improving dentistry by manufacturing restorations faster and easier. Veneers can be handcrafted fabricated by the dental technician or designed by software and fabricated by a milling machine. Currently, there are many scanners available in the market that are clinically acceptable for the fabrication of restorations. However, there have been no clinical reports comparing the clinical protocols of the two most frequently used software programs in the market. The aim of this article is to show the digital workflow of the two most common systems for the fabrication of CAD/CAM veneers.

This case report describes the orthodontic and surgical treatment of an adult patient aged 25 years 10 months, who had a skeletal Class I and Angle Class III subdivision malocclusion, with mild mandibular crowding and facial asymmetry. The chief complaint was a deviated chin to the left. Treatment was performed using a surgery- first approach that included maxillo-mandibular advancement, followed by orthodontic fixed appliances. After 12 months, the treatment has addressed the chief complaint of facial asymmetry and resulted in an attractive smile, functional occlusion, passive lip seal, balanced facial profile, and esthetic improvement. After 2 years 5 months of follow-up, the patient showed a stable surgical-orthodontic outcome with increased airway space.