Objectives The purpose of this study was to evaluate the dental, skeletal, and soft-tissue change in crowding cases treated with nonextraction approach using the Damon system. Materials and methods The sample included 20 patients, with an average age of 17.8 ± 3.7 years, selected on the basis of pretreatment class I skeletal and molar relationships with an acceptable soft tissue facial profile, and a moderate crowding range between 4.0 and 9.0 mm for the maxilla and 2.0 and 6.0 mm for the mandible. None of them had received any orthodontic treatment before, or had extraction or any congenital anomalies such as supernumerary teeth. Results The evaluation of the study was performed by detecting the dental, skeletal, and soft tissue changes between pretreatment and post-treatment study models and lateral cephalometric radiographs. The paired t-test was used for statistical analysis. The treatment required 20.7 ± 2.2 months to be finished, with an average of 13.8 ± 1.5 appointments. Conclusion The results of this study revealed that the correction of crowding was achieved through expansion of the dental arches and mandibular incisors proclination.

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Aim The aim was to access Roods and Shehab criteria if one or more radiological signs are present in orthopantomogram and position of the mandibular canal in relation to the third molar apices using cone beam computed tomography (CBCT). Materials and methods A total of 25 orthopantomogram radiographs exhibiting close relationship between mandibular third molar apices and mandibular canal according to Roods and Shehab criteria were accessed for cortical integrity along with position of the canal using CBCT. Results CBCT images showed that about 63.8% of the teeth were in contact (loss of cortical integrity) with mandibular canal. All Teeth with two or more radiological signs showed contact. The position of the canal was buccal in 61.7% of cases followed by inferior placement in 23.4% of the cases. Conclusion Risk of injury to inferior alveolar nerve increases if two or more radiological signs are present. In our study buccally placed inferior alveolar nerve was seen in more often therefore operator should not gutter the bone below the middle third of the root and mesial point of application for elevation should be used in cases with radiological signs of close association between the nerve and the root apex.

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The issue of osseointegration serving as the endpoint of implant therapy is no longer relevant. The long-term health and stability of the implant, prosthesis, and peri-implant tissues are the most desirable outcomes for implant therapy however recent advances have been developed to support the fabrication of a fixed provisional prosthesis that provides implant patients with improved esthetics and function during the osseointegration period. However with the advent of new technologies and materials the success and failures of these materials still remains in question and have to be evaluated. This paper presents an overview of the recent trends in implant dentistry.

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Periodontal diseases are infectious diseases, but the specific mechanism by which the tooth-supportive tissue is destroyed is not clearly understood. Viral infection impairs periodontal defenses, thereby permitting subgingival overgrowth of periodontopathic bacteria. The role of viruses is significant, as they may induce abnormalities in the adhesion, chemotaxis, phagocytosis, and bactericidal activities of polymorphonuclear leukocytes. When associated with one another, viruses and bacteria have stronger periodontopathogenic potential than individually. Therefore, it is significant to know all etiologic factors and such an insight would lead to the better treatment of the disease.

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Purpose: The article reviewed the various studies on semiadjustable articulators (SAA) to determine their uses, accuracy and limitations in orienting the cast. Materials and methods: An electronic and manual search of PubMed and Medline databases and other published articles was performed. The article concomitant to question in focus on accuracy of cast orientation on to the SAA with the help of facebow when compared to the lateral cephalogram was included. Other question in focus was whether interocclusal records used for programming the articulator are more accurate than the computerized jaw-tracking devices. Article on reliability, repeatability and interchangeability of SAA were also included. The study also focused on the use of SAA in various specialties of dentistry with the help of available literatures. Only articles in English were considered for the study. Results: The initial search resulted in 450 papers. The reviewers independently screened the abstracts for those articles related to the focus question. Of the resulted 72 studies, 16 were excluded for not being in English, resulting in 56 entries. Hand-searching yielded 2 additional papers. Conclusion: SAA seems reliable in interchangeability and promising to be used in various fields of dentistry. The condylar guidance obtained by SAA proves to be more accurate than other radiographic methods. Jaw motion analyzer is more accurate in adjusting the SAA rather than protrusive records.

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Aim To evaluate sealing ability and quality of obturation when canal filled with gutta-percha and either mineral trioxide aggregate (MTA), or AH Plus sealer with detection of any possible correlation between microleakage and voids. Materials and methods Human freshly extracted 30 maxillary one-rooted teeth were prepared and assigned to experimental groups (n = 10), designated as group I: gutta-percha/AH Plus, group II: gutta-percha/MTA sealer, group III positive control group (n = 5) teeth unobturated, group IV: negative control group (n = 5) teeth obturated with gutta-percha, AH Plus sealer. After obturation, each tooth was prepared for fluid filtration assessment. Voids detection was performed through cross-sectional analysis at three root levels. Data were analyzed using one-way analysis of variance at a level of confidence of 95%. Results None of the tested obturation systems was able to provide leak proof filling. The sealing ability of MTA FillApex sealer showed higher parameters than AH Plus sealer even if it was not significant. The lowest percent of voids was recorded at the apical third for both tested sealers. The correlation between leakage and voids percentage was nonsignificant. Conclusion Calcium silicate root canal sealer (MTA FillApex) and AH Plus sealer can provide adequate seal with low voids percent. None of the root canal filled teeth were gap-free. Voids percentage cannot be used as an indicator for sealing ability.

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Purpose The objective of this in vitro study was to evaluate the retentive strength of 3 clasp materials Acetal resin (Ac), Cobalt- Chrome (Co-Cr) alloy and Nickel-Chrome (Ni-Cr) alloy before and after cyclic loading. Materials and methods A total of 72 clasps (24 clasps for each material) were fabricated on standardized metallic molar models. The clasps of each material were divided into 3 groups 8 clasps each according to degree of undercuts (0.01, 0.02 & 0.03 inch). Each clasp assembly was subjected to 730, 1460, 2190 and 2920 cycles of insertion and removal of a removable partial denture. Retentive strength was measured before and after each cyclic period. Retentive strength values were analyzed using ANOVA and Fisher's PLSD multiple comparison test at the 0.05 level of significance. Results Ac clasps had significantly lower retentive strength than Co-Cr and Ni-Cr clasps. Clasps with 0.01 inch undercut showed significantly less retention than clasps with 0.02 inch undercut and the latter showed significantly less retention than clasps with 0.03 inch undercut. All clasps exhibited continuous significant decrease in retentive strength from the first period of cyclic loading till the end of the cycling except for Acetal resin at 0.01 inch undercut which show no significant difference after 730 cyclic loading. Conclusion There was significant decrease in retentive strength of the 3 clasp materials.

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Objective The objective of this study was to evaluate the Young's modulus (E) and nanohardness (H) of recently developed high viscosity bulk-fill and self-adhering resin composites by using nanoindentation technique. The effect of water aging on these properties was also studied. Materials and methods Four resin composites that fall into the categories of conventional (Filtek Z250 XT; FZ), high viscosity bulk-fill (Filtek Bulk-Fill Restorative Posterior), flowable (Filtek Supreme Ultra Flowable), and self-adhering flowable (Vertise Flow) were evaluated in this study. Ten disc specimens (5 mm × 2 mm) were prepared from each material. After polishing, half the specimens of each material (n = 5) were dry stored and the other half stored in distilled water for 30 days at 37°C. The E and H were determined by nanoindentation test using Bruker CETR-Apex nanoindenter. Ten indentations were made on top surface of each specimen. Statistical analysis was performed using one-way analysis of variance and paired t-test. Results All materials were significantly different from each other regarding both E and H in both testing circumstances. A 30-day water storage caused a significant decrease in E and H of all tested composites except for Filtek Bulk-Fill Restorative Posterior, where its E increased and its H not affected. There was a positive correlation between E and H. Conclusion Generally, both E and H were significantly increased when the filler content increased and they were significantly affected by 30-day water aging. E and H were affected not only by the filler content but also by the quality of resin matrix particularly after water storage.

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Background Clear cell carcinoma (CCC), or hyalinizing CCC, and clear cell odontogenic carcinoma (CCOC) are rare and typically indolent malignancies that can be diagnostically challenging. Aim The aim of this study was to determine the diagnostic utility of p63, carcinoembryonic antigen (CEA), CD10, pan-cytokeratin (pan-CK), and cytokeratin 19 (CK19) in the diagnosis of CCOC and hyalinizing CCC. Material and Methods The study groups comprised patients with CCOC (n = 15) and CCC (n = 10). The blocks of CCOC and CCCs were prepared for immunohistochemical staining for p63, CEA, CD10, pan-CK, and CK19. Results The results of this study revealed significant differences between the expression of pan-CK, CK19, and CEA between CCOC and hyalinizing CCC, with no significant value of p63 and CD10 expression. In conclusion, CCOC and hyalinizing CCC are malignant, locally aggressive tumors with the capacity to metastasize. Conclusion Based on the current observations and immunostains, it can be concluded that they are difficult, and, in some cases, impossible to distinguish morphologically and immunohistochemically despite a different cell of origin. Pan-CK, CK19, and CEA may have slight significant difference between CCOC and hyalinizing CCC but the diagnosis of these tumors mainly depends on the exclusion of other tumors. In addition, histological and immunohistochemical analyses of neoplasm features have limited value.

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Purpose To determine the dentin bonding ability of three new universal adhesive systems under different etching modes using microshear bond strength (μSBS). Materials and methods Futurabond U, Single Bond Universal, and Tetric N-Bond Universal were used in this study. Sixty noncarious human molars were assigned to three groups based on the type of the universal adhesives. Two etching modes (total-etch and self-etch) were employed for each adhesive group. The adhesives were applied on dentin surfaces according to the manufacturer's instructions then composite resin (Z350 XT, nanocomposite) was condensed through a polyethylene tube with a 1 mm internal diameter and 2 mm height attached firmly to dentin surfaces and light cured. All samples were thermocycled for 500 cycles from 5 to 55°C. The μSBS was measured by using universal testing machine at cross-head speed of 0.5 mm/min. The bonded surfaces were examined under a stereomicroscope at magnification ×50 to determine the mode of failure. Dentin slices were prepared for each group to evaluate the resin–dentin interface a resin composite with each adhesive were placed 2 mm thick to form composite core. The segments were sectioned longitudinally and prepared to be examined under scanning electron microscope. Results Among the universal adhesives, Futurabond U and Tetric N-Bond Universal in total-etch mode showed significantly higher μSBS values than in self-etch mode. Single Bond Universal did not show any significant difference in μSBS between the total-etch mode and self-etch mode. Conclusion Performance of universal adhesives was shown to be material-dependent. The results indicate that universal adhesives used on dentine performed better in total-etch mode than self-etch mode.

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Introduction Primary teeth are considered natural space maintainers and should be maintained till their exfoliation is chronologically appropriate. The success of endodontic treatment is directly related to the microbial reduction in the root canal system as a result of chemomechanical preparation. Objective This study was carried out to evaluate and compare cleaning efficacy of rotary and manual systems for root canal preparation in primary teeth. Materials and methods Thirty extracted single-rooted human primary teeth were selected. In group I the root canals were instrumented manually with Ni-Ti Flex K-file. Revo-S rotary instruments were used for canal preparation in group II. Irrigation with 1% sodium hypochlorite was done at each file change. Roots were split longitudinally and processed for scanning electron microscope examination. For evaluation of cleaning efficiency two separate scores were used for evaluation of debris and smear layer at three root canal thirds. Results However, both techniques did not achieve complete clean walls, Revo-S rotary system achieved better cleanliness than that obtained by manual instrumentation at all root canal levels. Conclusion Revo-S rotary system might be an alternative method for preparing root canal in primary teeth with better cleaning efficiency.

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Introduction The aim of this study is to compare the debridement efficacy of the EndoVac irrigation system versus needle irrigation with different irrigant solutions using scanning electron microscope. Materials and methods Eighty human freshly extracted single rooted teeth with fully developed, single root canals were collected. The teeth were divided randomly into two equal main groups according to the method of irrigation system used: group A, EndoVac system; and group B, needle irrigation. Each group was further subdivided into four equal subgroups according to the type of irrigant solution used: subgroup 1; sodium hypochlorite (NaOCl), subgroup 2; EDTA, subgroup 3; mixture of tetracycline, acid and detergent (MTAD), subgroup 4; saline. The canals were instrumented to a master apical file size #40/0.02 taper. Roots were split longitudinally in a buccolingual direction and examined under scanning electron microscope. Result At all tested root canal levels, group A recorded lower mean rank of score percentage compared to group B with statistical significant difference between them (P = 0.001 and 0.039 at the middle and the apical root level, respectively), while there was no statistical significant difference between both groups (P = 0.053) at the coronal root level. Conclusion The debridement efficacy of NaOCl only, NaOCl+EDTA, NaOCl+MTAD or even saline increased when using EndoVac system rather than conventional needles especially in the apical third.

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Objectives The purpose of this study was to determine the effect of fluoride gel, Remin Pro, and GC tooth mousse plus in changing surface roughness of enamel after bleaching procedures. Materials and methods Dental enamel blocks measuring 2 × 3 × 4 mm were prepared from nonerupted human third molars. The 38% hydrogen peroxide in-office bleaching protocols were performed. The specimens were randomly divided into three groups (n = 10 samples per group) according to the remineralizing agent used: group 1: using fluoride gel, group 2: using Remin Pro, and group 3: using GC tooth mousse plus. Measurements of surface roughness were carried out using a contact stylus profilometer before bleaching, after bleaching, and after remineralization. Results Data were analyzed using analysis of variance and Tukey's test. There was a highly significant difference of enamel surface roughness measurements among initial, after bleaching, and final regarding the three tested groups (P < 0.001). There was no significant difference among the three tested groups in relation to enamel surface roughness before and after bleaching (P = 0.739 and 0.341, respectively). There was a highly significant difference in relation to final measurements (P < 0.001) among the three tested groups. The difference in Ra value of enamel between the group used fluoride gel and that used Remin Pro and GC tooth mousse plus was highly significant and that between groups 2 and 3 was not significant. Conclusion GC tooth mousse plus and Remin Pro are more effective in reducing enamel surface roughness after bleaching than fluoride product.

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Bone destruction due to periodontal disease is one of the factors responsible for loss of teeth. The ultimate goal of periodontal therapy is predictable regeneration of lost periodontal tissue including bone defects. Various bone graft materials have been used for periodontal regeneration, which include autogenous grafts, allografts, xenografts, and synthetically produced ones. Amongst allogenic bone grafts, demineralized freeze-dried bone allograft (DFDBA) is most commonly used. All the bone allografts are osteoconductive, but DFDBA also provide an osteoinductive effect. DFDBA has been successfully used to reconstruct intraosseous periodontal defects and furcation defects. This case report describes the management of an intrabony defect in a maxillary left canine where the osseous defect included loss of buccal wall extending up to the periapical region. This localized periodontitis was successfully treated with periodontal regenerative technique using DFDBAs. DFDBA was used because it contains BMP, which induces new bone formation during the healing process. After 1-year follow-up of treatment, the tooth was functional without any signs and symptoms. Clinical and radiographic changes revealed healthy periodontal support.

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Ultrasound has been used for many years in periodontics to remove tartar, debride root surfaces, and to degranulate periodontal defects. In the last two decades, dental surgical techniques have developed rapidly. Piezosurgery is a novel surgical approach which was originally developed for the atraumatic cutting of bone by way of ultrasonic vibrations and as an alternative to the mechanical and electrical instruments that are used in conventional surgery. It is based on the basic principles of 'piezoelectricity' discovered by Pierre Curie and Jacquesin 19^th century. Over the past two decades, piezoelectric devices have emerged as an innovative tool in the field of dentistry. There has been extensive research on indications of piezosurgery in the field of periodontology and implantology.

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Bone grafts are necessary to provide support, fill voids, and enhance biologic repair of skeletal defects. They are desired to be bioresorbable in nature and also to present no antigen-antibody reaction. Despite of the tremendous number of bone-graft substitutes that can be used in, there is no ideal bone graft that has the function capabilities and the potentiality to reduce the need for autograft. This paper reviews the role of the combination therapy for periodontal regeneration.

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Introduction: Oral lichen planus (OLP) is a chronic mucocutaneous disease with an immunological etiology. This study was conducted to evaluate the effect of coenzyme Q10 (CoQ10) as an adjunctive to topical corticosteroids in the treatment of erosive–ulcerative lichen planus. Materials and methods: A total of 30 patients with a confirmed clinical diagnosis of OLP participated in this clinical trial. Patients were randomly allocated into one of two groups and treated as follows: group I received topical corticosteroids and group II received CoQ10 combined with topical corticosteroids. Assessment of outcome measures including clinical score and pain was carried out at the time of initial visit (baseline) and at 2, 4, 8, and 12 weeks following treatment protocol. All recorded data were analyzed using paired t-test and independent t-test. The level of significance was established at a P value of 0.05 or less. Results: The two studied groups showed a marked reduction in pain sensation and size of lesions, particularly in the final follow-up period. However, healing and decrease in the size of the lesions were effective in group II, and a significant difference was found between the two groups favoring group II over group I. Conclusion: CoQ10 in combination with topical corticosteroids was found to be effective in managing ulcerative lesions of OLP; however, more studies with a larger sample sizes and longer duration with evaluation of the adjunctive effect of CoQ10 on inflammatory markers expressed in OLP are recommended.

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Purpose: To evaluate the remaining filling material (gutta-percha/EndoSequence bioceramic sealer) on root canal walls after retreatment using ProTaper universal retreatment (PTUR) system with and without chloroform solvent. Materials and methods: Thirty extracted human premolars with type I root canal system were used. After crown removal and working length determination, all root canals were prepared using nickel–titanium rotary ProTaper system and obturated using gutta-percha as a core filling material with EndoSequence bioceramic sealer. All roots were randomly divided into two equal main groups (n = 15) according to retreatment technique. Group I: filling materials was removed using PTUR system and chloroform as a solvent; while group II: filling materials was removed using PTUR system without solvent. Both groups were cleaved longitudinally and examined under scanning electron microscope to evaluate root canal filling remnants. Results: PTUR system with the aid of chloroform recorded highest values of score percentage of remaining filling material at all tested root canal levels. The values of score percentage of remaining filling materials were significantly lower at coronal level compared to other tested levels. Conclusion: Using chloroform during removal of root canal filling material using rotary instruments was associated with larger amount of residual root canal filling material compared to using rotary instruments only.

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Objective The aim of this study was to evaluate the effect of different desensitizing agents, oxalate desensitizer and I-Bond, on the shear bond strength of composite resin to dentin surface. Materials and methods Occlusal surfaces of 80 sound human molars extracted were trimmed to expose a flat dentin surface. Each prepared sample was inserted in a metallic mold, which was designed with a Teflon mold having a hole (4 mm diameter ×3 mm height) for filling the restorative material. The samples were divided into four groups (20 each): group I (the control group), in which Adper Single Bond 2 and composite were applied; group II, in which oxalate desensitizer (D/Sense Crystal) was applied followed by Adper Single Bond 2 and composite; group III, in which oxalate desensitizer was applied, followed by re-etching and application of Adper Single Bond 2 and composite; and group IV, in which I-Bond and composite were used. All samples were thermocycled for 500 cycles (5–55°C). The samples in each group were subdivided into two subgroups (10 each) (A and B) according to storage time (24 h or 6 months, respectively). Shear bond strength of eight samples from each subgroup was measured. Debonded surfaces were examined under a stereomicroscope at magnification ×40 to determine the mode of failure. The remaining two samples were prepared to be examined under scanning electron microscope to reveal the resin penetration. Results Group I (the control group) recorded the highest shear bond strength values (11.838 ± 3.141 and 6.842 ± 3.912, respectively) in the two subgroups, followed by group IV (6.695 ± 3.164 and 6.217 ± 3.276, respectively) and group III (7.707 ± 3.845 and 3.681 ± 1.743, respectively), whereas the lowest values were found in group II (6.347 ± 3.208 and 3.240 ± 1.804, respectively). The incidence of adhesive mode of failure was higher in all tested groups, followed by mixed mode. Scanning electron microscope results confirmed the obtained statistical analysis of collected data. Clinical significance Both desensitizing agents and storage time had a negative significant effect on the shear bond strength of composite restoration to dentin surface.

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Objective: The objective of the present study was to compare between two different clasp materials for the treatment of maxillary class II Kennedy classification clinically, radiographically. Materials and methods: Twenty male patients were selected for this study. The patients were divided into two groups. Each group consists of 10 patients. For group I each patient have maxillary removable partial denture that was constructed and retained by cobalt–chromium RPI clasp on the maxillary first premolar with cross arch stabilization (using double Aker clasp) on the other side. For group II each patient has the same except that the retentive I bar of RPI clasp was made of acetal resin. Patient satisfaction, clinical, and radiographic evaluations were carried out for every patient at insertion, 3, 6, and 9 months, the data were collected, tabulated, and statistically analyzed using t-test. Results: Satisfaction for the treatment. Group II patients were more satisfied of the treatment regarding aspects of the patients' comfort and esthetics. No significant difference in the aspects of phonetics, the ability to eat, prosthesis loosening, the gingival health, general satisfaction and food impaction between the two groups were found, also there were insignificant increase in the gingival recession, pocket depth, and plaque index around the abutments tooth in both groups. Radiographically, there was significant decrease in the bone height around the abutments in both groups. Conclusion: Removable partial denture with acetal resin clasp is better for esthetic and patient comfort. Good periodontal condition of the abutment tooth of both groups is maintained. Acetal resin clasp is the clasp of choice when esthetic is of primary concern to the patient.

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Aim Biocompatibility of materials used in regenerative endodontics is of prime importance. Thus, this study was conducted to evaluate and compare cytotoxicity and apoptotic changes of propolis, chitosan, and their nano counterparts on dental pulp stem cells. Materials and methods Aqueous and ethanolic extract of propolis, chitosan, propolis nanoparticles, and chitosan nanoparticles were prepared. Dental pulp stem cells were isolated from human third molars and characterized. Cultured cells were incubated with each extract of each material used for 24 and 72 h. Thereafter, cellular viability was assessed using MTT assay and DNA fragmentation using DNA fragmentation laddering assay. Control samples containing only medium were treated similarly. Differences in mean values of cell viability and DNA fragmentation between materials were assessed by using the one-way analysis of variance and Tukey's test. Results Nanoparticles of both materials expressed higher cell viability and lower DNA fragmentation in comparison to their original particles counterpart. Chitosan nanoparticles recorded a lower cytotoxicity and DNA fragmentation after 24 h, which increased by time, meanwhile that of propolis nanoparticles were decreased by time. Type of vehicle was a factor affecting the results of chitosan nanoparticles, while time was the factor affecting propolis nanoparticles. Conclusion Both propolis and chitosan nanoparticles displayed an acceptable biocompatibility and can be used in endodontic regeneration purposes.

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Purpose To evaluate clinically and radiographically the rehabilitated compromised upper permanent central incisors with the everStick post. Patients and methods Thirty-six children patients aged from 10 to 16 years were divided into three equal groups (12 patients each). Group I, flared root canals of the patients were rehabilitated with the everStick post. Group II, flared root canals were rehabilitated with EasyPost/composite, and group III (control), unflared root canals were rehabilitated with EasyPost/core. The clinical parameters included the reinforced tooth, mucosa, temporary crown, and reinforcing system. The radiographical parameters were the periapical status, periodontal ligament condition, root fracture or resorption, and changes at the interfaces of the reinforcing system. All patients were followed up clinically and radiographically at 3, 6, 12 and 18 months. Results Both everStick and control group showed 100% clinical success, while EasyPost/composite group showed debonding of the reinforcing system in one patient with a clinical success rate of 91.7%, and the difference was not statistically significant (P > 0.05). Radiographic assessment showed no evidence of root fracture or external root resorption and no periodontal or periapical pathology that require crown removal for clinical interference. The radiographic findings showed 100% success rate for all studied groups. Conclusion The use of direct anatomical everStick posts in the rehabilitation of flared canals functioned well for 18 months with favorable clinical, radiographical, and aesthetic results.

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Objectives The present study was performed to evaluate and compare the effect of ozonized water lavage followed by ozone injection with that of lactated Ringer lavage followed by either corticosteroid or sodium hyaluronate injection. Materials and methods A total of 27 patients suffering from internal derangement of the temporomandibular joint and not responding to conservative therapy were randomly classified into three groups. In group A joint lavage was performed using ozonized water followed by injection of ozone. In group B joint lavage was performed using lactated Ringer solution followed by corticosteroid injection. In group C joint lavage was performed using lactated Ringer solution followed by sodium hyaluronate injection. The treatment outcome was evaluated biochemically by measuring the change in tumor necrosis factor-α (TNF-α) level in the synovial fluid preoperatively and 1 week postoperatively. Clinical measurements of maximal mouth opening and lateral and protrusive excursions were taken preoperatively and at 1 week, 1, and 3 months postoperatively. Pain was measured using the Visual Analogue Scale at the study intervals. These data were statistically analyzed. Results The three groups showed significant improvement (P ≤ 0.05) in all biochemical and clinical measurements. However, joint lavage using ozonized water followed by ozone injection provided more favorable results compared with treatment with sodium hyaluronate, which in turn was more superior to corticosteroid treatment with respect to maximal mouth opening. All of the study groups showed significant reduction (P ≤ 0.05) in TNF-α level in the synovial fluid. Group A had the highest reduction of TNF-α level with significant difference (P ≤ 0.05) between its results and those of groups B and C, whereas groups B and C showed nonsignificant difference between their results (P ≥ 0.05). Conclusion Data from our study suggested more favorable outcomes from ozonized water lavage followed by ozone injection with regard to the clinical and biochemical parameters.

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Aim/purpose Comparative evaluation of surface roughness of stainless steel (SS), nitinol (NiTi), titanium molybdenum alloy (TMA) and copper nitinol (Cu NiTi) orthodontic arch wires before and after clinical use to find the smoothest wire surface best used in orthodontic sliding mechanics. Materials and methods Surface roughness of 40 arch wires divided into four groups (group 1: 10 SS arch wires, group 2: 10 NiTi arch wires, group 3: 10 TMA arch wires and group 4: 10 Cu NiTi arch wires) were measured at five different points for each wire before and after its clinical use in oral cavity for 4 weeks using atomic force microscope and optical digital microscope. All obtained data was statistically tested. Results SS arch wires had the smoothest surface (average roughness: 17.38 μm for new wires and 104.1 μm for used wires) and Cu NiTi arch wires had the roughest surface (average roughness: 221.12 μm for new wires and 499 μm for used wires) with high significant differences between both groups either new or used arch wires (P < 0.001). High significant difference was found between new and used wires for all groups. NiTi wires had greater surface roughness (average roughness: 211.8 μm for new wires and 313.8 for used wires) than TMA wires (average roughness: 138.5 μm for new wires and 221.2 μm for used wires). Conclusion SS orthodontic arch wires exhibited the least amount of surface roughness and advocated to be used in sliding mechanics to minimize the friction during orthodontic tooth movements.

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Aim: The aim of this study was to evaluate surface and mechanical properties of bulk fill composite compared to conventional incremental composites. Materials and methods: The bulk fill composites were Filtek Bulk Fill, Sonic Fill, SDR Smart Dentin Replacement and Tetric-N-Ceram Bulk Fill while the incremental ones were Filtek Z350 × T and Herculite XRV Ultra. Surface roughness and wettability was measured using profilometer (Bruker) and drop shape analyzer (Kruss), respectively. Surface hardness of the top and bottom surface was measured using Micromet 6040 (Buehler). For mechanical test, the universal testing machine was used under the three-point bending test. Results: There was no statistical significant difference in wettability and surface roughness between bulk fill and incremental composites, except the SDR that showed statistically significance higher roughness than incremental composites. All composites showed significantly lower hardness than Filtek Z350; the lowest hardness was recorded for SDR. There was no significant difference between bulk fill and incremental composites in flexure strength and modulus. SDR showed the lowest flexure strength and modulus but the highest strain% (P < 0.05) compared to all tested materials. Sonic fill system showed significantly higher flexure strength and modulus when compared to other bulk fill materials (P < 0.05). Conclusion: The difference between bulk fill and incremental composite is mainly material dependent.

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