Mustansiria Dental Journal is published by the Mustansiriyah University, which publish full-length papers, oringinal research reports, literature reviews, special reports, clinical cases, current topics and short communications, dealing with dentistry or related disciplines.
College of Dentistry / Mustansiriyah University
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Plasma Surface Treatment of Heat-Cured Acrylic Resin Material A Narrative Review
Aim: This narrative review was an attempt to assess the impact of plasma surface treatment on Polymethyl methacrylate (PMMA) heat-cured acrylic resin with special attention on surface properties and antimicrobial activity. Methods: The PRISMA method was used to identify literature in PubMed, Google Scholar, and Research Gate databases. Articles published from January 2016 to March 2025 that explored the topic of plasma surface treatment of heat-cured acrylic resin were taken into consideration. Out of the 183 studies found, 32 studies were found to meet the inclusion criteria. Results: The analyzed literature proved that Atmospheric Pressure Cold Plasma treatment and Dielectric Barrier Discharge treatment substantially enhanced wettability and surface energy of PMMA based on functional groups polarization incorporation. These changes on the surfaces continuously decreased adhesion of microbes, especially Candida albicans, and prevented the formation of biofilms. Moreover, the bond strength between PMMA and soft liners, coatings and adhesives, was improved through plasma treatment. These effects differed in their magnitude with parameters of plasma (gas type, exposure time, etc.) Conclusion: Plasma surface treatment can be a promising technique of enhancing biofunctionality and longevity of heat-curing PMMA dentures. Nonetheless, it requires standardized treatment regimens and long-term clinical trials that can establish its clinical reliability.
Copyright (c) 2026 Jinan Abdulrazzaq Aljbory, Nihad Hasan Mohammed Alfuraiji, Syed Saad B Qasim https://creativecommons.org/licenses/by/4.0
Evaluate the effect of probiotics on Oral Health Status and Its Influence on Salivary Biomarkers in Iraq: Clinical Trial
Aim of the study: To verify the effect of probiotic tablets on oral health status and to compare their effects on gingival health and potential salivary biomarkers by monitoring the levels of Interleukin-1β (IL-1β) and Matrix metalloproteinases-8 (MMP-8) in saliva of individuals with moderate gingivitis. Materials and methods: A randomized interventional trial was conducted over 28 days, which included 88 healthy male college students aged 18 to 25 years old from Al-Anbar University. The participants have randomly assigned to two groups: study group (A) and control group (B). The gingival health parameter GI has evaluated clinically, and the concentrations of IL-1β and MMP-8 have been quantified in both groups at baseline (0 days), 14 days, and 28 days. Results: GI significantly decreased in study group when compared to the control group. Fuethermore, IL-1β and MMP-8 showed significant reductions only at day 28. Conclusion: Probiotics may improve gingival health by positively affecting the oral flora and regulating the immune system.
Pedodontics, Orthodontics & Prevention Dentistry
Copyright (c) 2026 BAYDAA YOUNUS, Dr. MOHAMMED I ALZUBIDI https://creativecommons.org/licenses/by/4.0
Enhancement Of 3D Printed Resin by Incorporating Nanofillers: A Literature Review
Background: Recent developments in manufacturing technology have brought three-dimensional (3D) printing as an efficient method for directly fabricating products from computer-aided design (CAD) data. This technology has attracted much attention in dentistry and is now employed in numerous fields, such as prosthodontics, orthodontics, and implant dentistry. Although there are several studies on the reinforcement of 3D-printed dental resins using nanoparticles, there are still few narrative reviews that provide detailed discussion on the reinforcement tactics and the related manufacturing issues. Purpose: The present study covers the existing information on 3D-printed dental resins, highlighting the use of nanoparticles as a reinforcing method, the possible constraints of incorporating nanoparticles, and the manufacturing processes involved in the production of the materials. Furthermore, the influence of these alterations on the mechanical and physical behavior of printed dental materials is also examined to provide a better understanding of recent advances and possible future avenues of research. Methods: The relevant studies were obtained by studying the articles published in 2010-2025 in the databases of Scopus, Pubmed, and Google Scholar. The inclusion criteria focused on research that evaluated the introduction of nanoparticles in 3D-printed dental resins to enhance mechanical, surface or functional qualities. Inclusion of studies having a defined experimental procedure and quantitative results. Results: The nanoparticles tested were ZrO2, YSZ, SiO2, ZnO, TiO2, Al2O3, and Ag and several mechanical, surface, and antibacterial properties of 3D printed dental resins were improved with minimal, or no change in certain properties.The effect was also found to rely on the type and concentration of the nanoparticles and the preparation and printing processes utilized. But these developments have sometimes led to problems with resin formulation, printing accuracy and post-processing, which have to be carefully calibrated for clinical use.
Copyright (c) 2026 Israa Fathil Abass, Abdalbseet A Fatalla, Matheel AL-Rawas, Johari Yap Abdullah https://creativecommons.org/licenses/by/4.0
Comparative Evaluation of Splenda sweetener and sucrose on Salivary Ph and Streptococcus mutans Growth: An In Vivo Study
Background: Dental caries is a common chronic disease that is intricately associated with dietary sugars and oral microbial activity, especially Streptococcus mutans (S. mutans). The purpose of this study was to compare the impact of Splenda (sucralose) and sucrose on both salivary pH and S. mutans. The aim of the study: The current study sought to comparatively assess the impacts of sucralose (Splenda) and monk fruit, on salivary pH and salivary Streptococcus mutans counts, relative to sucrose, after a standardised mouth-rinse protocol. Methods: Ninety healthy dental students from Mustansiriyah university aged from 20-24 they were randomly grouped into two groups (n=45 each): Splenda, and sucrose.se. Each participant rinsed with 10g of the assigned sweetener dissolved in 90ml of distilled water. Then the unstimulated saliva samples were taken at the start, right after rinsing, and again 15 and 30 minutes after rinsing (the rinsing took one minute). We used a digital pH meter to measure the pH of saliva and serial dilution and culture on selective media to count the number of S. mutans. Results: the findings indicated that sucrose markedly reduced salivary pH over time (p<0.001), whereas Splenda maintained near-neutral pH levels. Additionally, Splenda significantly reduced S. mutans counts (p<0.001), while sucrose increased bacterial growth (p=0.004). Statistically significant differences between the groups were observed at 30 minutes (p<0.001). Conclusion: Splenda have a cariostatic effect by preserving salivary pH and reducing S. mutans, supporting their use as sugar substitutes in caries prevention.
Copyright (c) 2026 Kawthar Alharan, Dunia Ahmed Aldulaimi https://creativecommons.org/licenses/by/4.0
The relationship between Peppermint oil immersion and the hardness of resin
Aim of the study: This study aimed to evaluate the effect of peppermint oil immersion on the surface hardness of polymethyl methacrylate (PMMA) acrylic resin after different immersion periods (1 day, 1 week, and 3 weeks). Materials and methods: Twenty rectangular samples were set up and split up into two groups, each group had 10 samples, first group was immersed in distilled water and second group was immersed in peppermint oil solution. They included three different periods: one day, one week, and three weeks. A daily immersion routine was adhered during these immersion times. This included immersing for eight hours in the immersion solution and then for sixteen hours in artificial saliva, all specimens were tested by hardness tester. The statistical analysis was used for the data and the comparison among all groups was obtained using analysis of variance test (two-way ANOVA-test) among all groups regarding the different immersion solutions in three different immersions periods. Further analysis was used post hoc comparisons Tukey-test to determine where the differences exist among groups at different times. In addition, Student’s t-test was used for comparisons between the two-immersion media at each time interval. Results: The descriptive statistic revealed that there is an increase in surface hardness after immersion in distilled water and peppermint oil for three weeks, as the results of immersion in distilled water after three weeks (74.70) and the results of immersion in peppermint oil after three weeks was (75.10), but the two-way ANOVA indicated there was no significant interaction regarding immersion time of acrylic resin and both solutions, but there was a significant variation was detected regarding to immersion groups across time points. As well as, the Student’s t-test revealed a significant difference was found between distilled water and peppermint oil after 1 day of immersion but there were no statistically significant differences were observed between the two-immersion media after 1 week or after 3 weeks of immersion. Conclusion: Immersion in peppermint oil and distilled water increased the surface hardness of acrylic resin. Hardness increased significantly from 1 day to later immersion times, while a difference between the two media were observed only after 1 day.
Copyright (c) 2026 Prof. Hawraa Khalid Aziz, Asist.Lec.Rafal kareem Rasheed https://creativecommons.org/licenses/by/4.0
Comparative Analysis of Fracture resistance and Fracture mode in Zirconia Restorations Supported by Different Abutment Designs: An In Vitro Study
Background: The effectiveness of implant-supported restorations largely relies on their capacity to resist functional forces. To enhance the mechanical performance of zirconia restorations, different abutment designs have been developed and are currently in use. Aim: This study aimed to evaluate the fracture resistance and fracture modes of implant-supported zirconia crowns fabricated with different abutment configurations after artificial aging. Materials and Methods: 36 implant analogs were arbitrarily assigned to three groups (n = 12). Group A: one-piece hybrid abutment crowns (HAC). Group B: Two-piece restorations hybrid abutment with a separate crown. Group C: stock titanium abutments with crown. Artificial aging was applied to all specimens (500 thermo-cycle and 120,000 mechanical cyclic). The fracture resistance was assessed by a universal testing machine, the fracture modes were evaluated under (SEM) at ×30, ×300, and ×5000 magnifications. Results: Group A showed the highest fracture resistance mean (2243.2 ± 234.2N), Group B recorded the lowest value (1819.6 ±173.2 N). The difference among the groups was statistically significant (P < 0.05). SEM analysis revealed different fracture morphologies in the three different groups. Conclusion: The one-piece restoration revealed highest fracture resistance. However, the fracture resistance values in the different designs were higher than the average masticatory forces in the premolar teeth, supporting their potential for clinical use.
Endodontics, Fixed Prosthesis & Operative Dentistry
Copyright (c) 2026 Zainab Ahmed Abbas, Haider Hasan Jasim , Sami Bissasu https://creativecommons.org/licenses/by/4.0
Role of Kefir Mouthwash in Halitosis Reduction. A Triple-Blind Randomized Clinical Trial
Aim: This research aimed to investigate the efficacy of kefir mouthwash, a probiotic-based natural alternative, compared to chlorhexidine (CHX) in reducing halitosis Materials: A triple-blind, randomized, controlled clinical study involved 60 systemically healthy adults whose ages ranged 18-28 years diagnosed with moderate gingivitis, recruited from dentistry students at Bilad Al-Rafidain University and training dentists from a specialized dental center in Diyala, Iraq. Subjects were randomly assigned to either control group (30 subjects) using 0.12% chlorhexidine mouthwash or study group (30 subjects) using kefir mouthwash twice daily for 28 days. Halitosis was assessed objectively via volatile sulfur compound (VSC) levels, concentration, and odor detection distance using a Halimeter, and subjectively using a Visual Analog Scale (VAS) at baseline, day 14, and day 28. Results: Both groups exhibited significant reductions in halitosis parameters over 28 day time (p < 0.001). The kefir group showed slightly greater improvements in VSC concentration, odor detection distance, and VAS scores at follow-up points, although these differences compared to the control group were small. Conclusion: The findings of this study indicate that both kefir and chlorhexidine mouthwashes are effective options for reducing halitosis over the 28-day period. Although the kefir mouthwash led to slightly better improvements, which may be due to its effects on the oral microbiota, these differences compared to the control group were small. Additionally, kefir's good safety and biocompatibility profile imply that it might be an effective natural substitute for people looking for long-term halitosis treatment without the negative side effects of chlorhexidine. Further research with longer follow-up and larger sample sizes is recommended to confirm its efficacy and mechanisms.
Copyright (c) 2026 Zahraa Hussein, Dr. Rand Al-Obaidi https://creativecommons.org/licenses/by/4.0
The Diagnostic Aids of Salivary Trace Metals in Dental Caries among Systemically Healthy Individuals
Abstract Objectives of study: This research aimed to assess levels of salivary trace elements, iron and copper as potential biomarkers for dental caries in Iraqi patients. Methods: Stimulated salivary samples were collected from (60) participants aged (20-27) years to determine iron and copper concentrations. Results: There had been a significant elevation of salivary iron and copper among caries group (p>0.001). There was a positive relationship among iron and DMFT scores (r=0.3, p=0.03). ROC analysis revealed that iron had a strong diagnostic performance (AUC=0.9), while copper showed a moderate accuracy (AUC=0.7). Conclusion: Salivary iron demonstrated high sensitivity and specificity for detecting dental caries and may save as a reliable biomarker. Copper may also be supportive but less specific. This findings suggest the diagnostic accuracy of salivary trace elements, though further standardized collection methods of saliva are recommended.
Copyright (c) 2026 Reyam Fawzy Hameed, Professor, PhD. Maha Jamal Abbass, Professor, PhD. Hayder Hamed Abed https://creativecommons.org/licenses/by/4.0
Impact of Different Fiber Reinforcement Techniques on Stress Distribution of Cervical Composite Restorations: Finite Element Analysis.
Abstract Aim: To compare the stress distributions in the cervical cavities of four different restorations using Von Mises stress under varying loading directions. Methods: Virtual restored lower first premolar models (n=4) with class V cavities were created from a sound premolar CAD model. Single restorative materials of a resin-modified GIC (model A), a conventional filler composite (CFC) (model B), a combination of short-fiber-reinforced composite-CFC (model C), and a ribbond fiber-CFC (model D) in a bilayered fasion were considered in this study. The FEA models received a 150 N occlusal load in the axial and oblique directions. The stress distribution in the enamel and dentin components of the model and restorative sections was analyzed. The maximum von Mises criterion was determined and compared between the tested models. Results: The FEA model indicated that the highest mvM was detected in the enamel structure of the premolar. Notably, greater stresses were observed in the GIC (Model A) and CFC (Model B) restorations than in the combined EverX-CFC restoration (Model C), which resulted in less stress in the enamel and dentin. Finally, the bilayered ribbond-CFC restoration (Model D) had the lowest stress values among the different components of the model. In the oblique loading scenario, all the models with various components presented higher stress values than did those with axial loading, with slightly lower stress values in the fiber-reinforced composite restorations. Conclusion: The incorporation of either glass or polyethylene fibers within the cervical composite restoration apparently enhances stress distributions on the surrounding tooth structure, thus probably improve the retention rate of the restoration.
Copyright (c) 2025 Ali Nahidh, Abdallah Ahmed Elsherbiny, Ahmed Sleibi https://creativecommons.org/licenses/by/4.0
Simvastatin's Application in dentistry. A narrative review.
Simvastatin a pharmaceutical drug, belongs to the statin’s family, that shares the same properties of their mechanism of action which is summarized by the lowering of hypercholesteremia, by averting the production of mevalonate from HMG-CoA which is a compulsory product in the cholesterol synthesis pathway. Th proved effect of oral administration of Simvastatin on increasing of bone formation and reduction of bone resorption by over expression of BMP-2 and lowering the bone resorption markers abetted by its safe use and feasibility made it an interest point of many researchers. Various dental studies have shown a positive response to both oral and local administration of statins concerning periodontal health, including a notable decrease in tooth mobility, improved clinical attachment levels, and enhanced bone fill in cases of type II diabetes having chronic periodontitis. Researchers propose that simvastatin may partially mitigate the frequency and severity of relapse, while others indicate that exosome-based drug delivery holds considerable promise for therapeutic applications in orthodontics. Furthermore, simvastatin exhibits diverse effects and applications across various fields of dentistry. The aim of this review is to entails the benefits and applications of statins in many domains of dentistry including original manuscripts for the last five years.
Copyright (c) 2025 Muna Alaa Alsaeed, Nada MH Al-Ghaban, Enas Fadhil Kadhim, Zaid A. Abdulhussein, Mohammed A. Abdalqader https://creativecommons.org/licenses/by/4.0
Halitosis-related Knowledge, Attitude and Practice (KAP) among Mustansiriyah dentistry students: A cross-sectional study
Aim: To determine the knowledge, attitude and practice of dental students regarding oral halitosis and associated gender differences at Mustansiriyah university-college of dentistry. Methods: A cross-sectional study design was used in Baghdad, Mustansiriyah University- college of dentistry and a total of 136 students participated in the study. A standardized questionnaire that was self-administered was used to collect data on socio-demographics, oral halitosis knowledge, attitudes, and practices. After being examined and cleaned, the data was imported into SPSS version 25.0. The data was described using descriptive statistics, and the results were shown in tables and texts. Results: A total of 136 undergraduate dental students were assessed on the perception of halitosis. In terms of knowledge, the overall participants had satisfactory knowledge toward halitosis (62.8%). The participants demonstrated a favorable attitude toward halitosis, with an overall attitude score of 87.3%. The overall level of practice toward halitosis was low (23.3%). The students’ gender demonstrated a statistically significant association with selected items only; specifically in one knowledge question and two practice questions, whereas no significant gender-related differences were detected across any of the attitude items. The overall association between knowledge and practice was weak to moderate. Conclusion: The study concludes that the overall knowledge about halitosis was satisfactory with generally positive attitudes. However, the overall practice was low. This highlights the need for focused educational and behavioral interventions and to enhance the practices of oral hygiene. Students' gender did not have an impact on the KAP domain.
Copyright (c) 2026 NOOR ABED TAHER, Dr.Athraa A.Mahmood https://creativecommons.org/licenses/by/4.0
the effect of psychological stress on salivary alpha- amylase in pediatric patient
Background: This study aimed to investigate the relationship between psychological stress and salivary alpha -amylase levels in pediatric dental patients visit specialist versus non specialist dental clinics. Materials and Methods :Eighty male children aged 4–6 years with first dental visit were recruited from specialist and non-specialist dental clinics in Iraq. Salivary samples were collected at three time points and alpha amylase levels were analyzed using ELISA assays. Results In the non-specialized clinic, mean values rose from 2.66 ± 0.68 prior to therapy to 4.06 ± 0.70 during diagnosis, ultimately reaching 5.37 ± 1.14 post-treatment (F = 243.383, p < 0.001). At the specialized clinic, levels increased from 2.27 ± 0.75 to 2.00 ± 0.74, and subsequently to 3.34 ± 1.02 following therapy (F = 37.958, p < 0.001). Comparisons between groups revealed statistically significant variations in α-amylase levels at all time intervals (p < 0.05), with continuously elevated values noted in the non-specialist clinic.Conclusion: Children attending pediatric dental clinics are less prone to stress than those treated at regular dental clinics, salivary alpha-amylase is a reliable physiological biomarker of dental stress, Environmental and emotional stresses exert a greater influence on SAA secretion than self-perceived stress.
Copyright (c) 2025 Donya Ali alhasanawy, Maha Abdul Kareem mahmoud https://creativecommons.org/licenses/by/4.0
Effect of Propolis Lozenges Extract on IL-10 and Oral Health Condition in (19_24) Years Old
Background: Propolis is a natural resin produced by bees from plant exudates, combined with pollen, wax, and enzymes. It is known for its antibacterial and anti-inflammatory properties. Plaque is a yellowish white or grayish substance that adheres firmly to the surfaces of teeth and other complex structures in the mouth. The study aimed to evaluate the effects of lozenges containing propolis on the levels of Interleukin-10 (IL-10) and plaque accumulation. Method: A prospective cohort interventional case-control clinical trial. A total of 80 patients were divided into two groups: 40 participants in the case group and 40 in the control group. Participants in the case group received propolis lozenge extract after a baseline saliva sample was collected and the Plaque Index was measured. They were instructed to use the lozenge twice daily for 7 days, once in the morning and once in the evening. In contrast, the control group received only oral hygiene instructions. During the second visit, saliva samples were collected again, and the Plaque Index (PI) was measured. Result: The case group observed significant differences between the two visits regarding the mean Plaque Index (PI), whereas the control group did not show significant changes. Additionally, significant differences were found in the mean levels of interleukin-10 in the case group.
Copyright (c) 2025 ahmed finjan, Assisstant prof.mohammed kais mahmoud https://creativecommons.org/licenses/by/4.0
Effect Of Selective Dentin Etching And Ethanol Wet Bonding On Micro-Shear Bond Strength Of Adhesive
Aim: This in vitro study aimed to evaluate the impact of selective dentin etching for 3 seconds and ethanol pre-treatment on the micro-shear bond strength (µSBS) of Scotchbond Plus Universal (SBU), a hydrophilic adhesive containing 2-hydroxyethyl methacrylate (HEMA). Materials and Methods: Forty-eight sound premolars had their occlusal enamel ground to create flattened midcoronal dentin. Teeth were divided into four groups of 12 sample. In Group A (control), SBU plus was applied without prior treatment. Group B involved selective dentin etching with 37% phosphoric acid for 3 seconds. Group C treated dentin surfaces with 100% ethanol for 60 seconds. Group D combined 3-second phosphoric acid etching with 60-second ethanol pre-treatment. The adhesive resin was applied then light cured. Teeth were restored with Filtek Z350 (3M ESPE, USA) composite rods (1mm diameter). After composite placement, samples were stored in distilled water at 37°C for 24 hours and thermocycled for 500 cycles. µSBS was measured using a universal testing machine. Data were analyzed using one-way ANOVA. Results: ANOVA revealed significant differences among the groups (P < 0.001). Group D (selective dentin etching + ethanol pre-treatment) showed the highest µSBS at 57.16 MPa. The number of mixed failures was higher when dentin surfaces were treated with selective etching for 3 seconds and 100% ethanol. Conclusion: Under the conditions of this study, dentin etched with phosphoric acid for 3 seconds and rewetted with 100%
Copyright (c) 2025 ahmed ali, Haider Hasan Jasim https://creativecommons.org/licenses/by/4.0
Marginal Fitness in Vertical and Horizontal Crown Preparations: A Comparative Analysis
Objectives: This study focused on comparing the marginal fit of crowns made of zirconia and lithium disilicate, using two types of preparation designs (vertical feather edge, horizontal shoulder) for both cemented and non-cemented situations. Methods: Forty maxillary premolars (all extracted) were randomly assigned to one of two groups based on material type: Lithium Disilicate (Group A) and Monolithic Zirconia (Group B). Within each of these groups, the teeth were further divided into two subgroups based on margin design: Feather Edge and Shoulder Preparation Designs (n=10). All specimens had standardized preparations performed with the aid of a modified dental surveyor, followed by digital scans. For the Crown (s) & Processes created by ExoCad and constructed via Pressing Technique (Lithium Disilicate) and Milling Technique (Zirconia), the preparation margins were evaluated pre -& Post Cementation via digital microscopy at 40x magnification at each Specimens Marked 16 Standardized locations using ImageJ Software. All standardized evaluations were subjected to: Two-Way ANOVA, Tukey HSD, AND Paired 't-test' statistical analyses. Results: After cementation all groups exhibited more of a marginal gap. The groups with vertical preparations A1 and B1 had a significantly less marginal gap compared to groups with horizontal preparations A2 and B2 prior to and following cementation. Group A1 had the least amount of gap and therefore exhibited a more favorable marginal adaptation of the lithium disilicate when using a vertical preparation than did groups A2, B1, and B2. There were significant differences between groups according to statistical analysis (p < 0.05). Conclusion: The marginal adaptation of vertically prepared edges (feather edge/preparation) compared to horizontally prepared (shoulder) edges produced significant differences; this was regardless of which type or class of ceramic material used. The findings indicate that by using minimally invasive vertical preparation techniques; the longevity of restorations and their fit can be greatly enhanced
Copyright (c) 2026 Mustafa Younus Naji, Mohammed kassim Gholam https://creativecommons.org/licenses/by/4.0
Evaluating the Knowledge and Awareness of Oral Cancer among Dental and Medical Undergraduate Students
Aims: The purpose of this research was to evaluate the knowledge and awareness of undergraduate medical and dental students from various Iraqi universities regarding oral cancer. Methods: A cross-sectional survey was conducted, and questionnaires were distributed to 378 students. Awareness and knowledge of oral cancer were assessed through questions related to examinations, patient history, risk factors for oral cancer, and the clinical appearance of oral cancer.Results: Dental participants reported significantly higher percentages (84.8%) for routine oral examinations compared to medical students (50.4%). Smoking was identified as a risk factor by 90.8% of medical students and 77.0% of dental students. A very small percentage of both dental (9.7%) and medical (5.0%) students felt they were very well informed about the clinical appearance of oral cancer. Regarding oral changes associated with oral cancer, 70.6% of medical students and 56.8% of dental students recognized leukoplakia. The majority of medical (91.6%) and dental (94.9%) students indicated that they needed more information about oral cancer. Conclusions This study identified both strengths and weaknesses in oral cancer knowledge among dental and medical students. While dental students displayed greater awareness in certain areas, the overall findings emphasize the need for ongoing education and training.
Copyright (c) 2025 Ban Karem Hassan https://creativecommons.org/licenses/by/4.0
Comparative 3D Finite Element Stress Analysis of Monolithic Lithium Disilicate and Dual-Layered Endocrown Restorations
Aim: To evaluate and compare the stress distribution of monolithic lithium disilicate (LDS) and dual-layered endocrown restorations for endodontically treated teeth (ETT) using finite element analysis (FEA). Method: A mandibular first molar model was created using CBCT and CAD software with standardized cavity dimensions and material properties. Two models were designed: Model A (monolithic LDS endocrown) and Model B (dual-layered endocrown with a Lava Ultimate endocore veneered with LDS). FEA simulated stress distribution under a 600 N axial load. The von Mises stress values were analyzed to evaluate stress concentration and distribution. Result: Model A exhibited higher stress concentration at the occlusal surface and cervical regions, with a maximum von Mises (VM) stress of 17.20 MPa in LDS. In contrast, Model B demonstrated a more uniform stress distribution, with the maximum VM stress reduced to 4.87 MPa in LDS and 4.24 MPa for endocore. Additionally, Model A showed high stress levels at the cervical rim (16.05 MPa), while Model B presented a lower VM stress of 9.88 MPa. Dentin stress was also higher in Model A (4.37 MPa) compared to Model B (3.49 MPa). Conclusion: Dual-layered endocrowns demonstrated favorable stress distribution compared to monolithic designs, suggesting greater durability for restoring endodontically treated teeth. Experimental validation is recommended.
Copyright (c) 2025 Haider Ali Ibrahim, Haider Hasan Jasim https://creativecommons.org/licenses/by/4.0
Examining the role of grape seed extract in enhancing collagen crosslinking and its effect on the shear bond strength of Universal adhesive to contaminated dentine
Aim: The purpose of this study is to evaluate the effect of a collagen cross-linker, grape seed extract (GSE), applied at different times (1, 3, and 5 minutes) on the shear bond strength (SBS) of a universal adhesive bonding system applied to dentine after contamination with blood or blood and hemostatic agent (HA). Materials and Methods: Seventy-two teeth were divided into three main groups. Group A, the control group, (n=8) treated with only Scotchbond Universal. The remaining teeth were divided into two experimental groups, (n=32) for each according to the type of contamination. Group B was contaminated with blood, while Group C was contaminated with both blood and HA. Each contamination group was further divided into four subgroups based on the timing of GSE application. One subgroup did not receive any GSE application, while the other three subgroups had application of GSE for 1, 3, and 5 minutes. Then experimental groups had adhesive application as in group A, after adhesive application and composite resin placement. SBS was measured using a universal testing machine. Results: Groups that had GSE had nosinificant difference with control (p<0.05), Application of GSE for 3 min showed significant difference with the contamination only group. Conclusion: GSE treatment for durations of 1, 3 or 5 minutes enhanced bond strength to contaminated dentine.
Copyright (c) 2025 Hussein Salman Bachay Bachay, Hikmet A. Al-Gharrawi https://creativecommons.org/licenses/by/4.0
Casein Phosphopeptides-Amorphous Calcium Phosphate’s Effect on Microhardness of Teeth Treated With 5% Sodium Fluoride
Background: Dental caries is a common disease among humans, and its significant impact underscores the need to promote the mineralization of early enamel lesions. Numerous materials have been investigated to enhance the mineralization of teeth. Casein phosphopeptides-amorphous calcium phosphate (CPP-ACP), a milk protein known for its effectiveness in mineralization of tooth.Aim of study: To assess CPP-ACP’s effect on the enamel microhardness of teeth treated with 5% sodium fluoride. Materials and Method: Forty extracted sound upper first premolars were utilized in the study. The teeth underwent a pH cycle, after which, 20 teeth were treated with a 5% sodium fluoride solution (NaF), while the remaining 20 to deionized water. All teeth were placed in artificial saliva for 24 hours and subsequently treated with 10% CPP-ACP for seven days. Enamel microhardness was evaluated before and after the artificial formation of caries-like lesions, following the application of 5% sodium fluoride and deionized water, and after the application of CPP-ACP on the previously treated groups.Results: It was found that 5% NaF significantly elevated the microhardness of the enamel after demineralization (P=0.000), the mean microhardness value post-demineralization was (119.11), while post-remineralization was (195.910) and following the application of CPP-ACP it became (226.100) which was also significant (P=0.025).Conclusion: CPP-ACP is an effective material for mineralizing early carious lesions alone, but it performs its best effect when combined with NaF.
Copyright (c) 2025 zinah alsayed, Dr.Mohammed Qays Mahmood Fahmi, Ammar mashlah https://creativecommons.org/licenses/by/4.0
Anatomical Root Variation in The Permanent Mandibular Canine of Iraqi People Using CBCT: A preliminary study
Background: Knowledge of root canal morphology is essential for performing a successful RCT that includes proper mechanical and chemical debridement, as well as effective root canal filling. Failing to clean and shape all root canals can result in treatment failure due to persistent infection from microorganisms left in the untreated canal. Aim of the study: To evaluate the presence of a 2nd root in the lower canine or a single root with two canals in the mandibular canine via CBCT.Material and methods: A total of 316 patients visited our clinic in Baghdad, Iraq, for various treatment modalities. After CBCT imaging to analyse the morphology of the permanent mandibular canine on each side, data were collected and cases with any side of the canine being absent, incomplete root formation, root canal-treated teeth, teeth with periapical pathology, or any internal or external tooth resorption were excluded. Results: Double-rooted mandibular canines were observed in 32 out of 632 cases (5%). A bilateral examination revealed 8 cases with bilateral double-rooted mandibular canines, while the others exhibited these on the left side only. Variable root canal configuration occurred in 36 cases (5.6%). Significant differences in data were observed between men and women. Conclusions: Most people’s mandibular canines have one canal in single root according to the CBCT examination. All double-rooted mandibular canines occurred in women and most of these were found on the left side. Additionally, mandibular canines with two canals in one root were more frequently observed in women than in men.
Copyright (c) 2025 Othman Alani https://creativecommons.org/licenses/by/4.0
Cytotoxic Effect of Nano Polyvinylidene Fluoride On Human Gingival Fibroblast
Aim: This study examined the cytotoxic effects of Nano Polyvinylidene-Fluoride (PVDF) on Human Gingival Fibroblasts (HGF) cells in comparison to sodium fluoride (NaF) varnish. Method: The MTT-Assay was performed to evaluate the cytotoxicity of the tested materials on HGFs. To assess the toxic effects, cell viability after the application of NaF varnish (2.26%) and PVDF (1.26%, 2.26%, and 3.26%) at each concentration.Results: The findings indicated that all concentrations of PVDF exhibited lower cytotoxicity compared to NaF varnish. Within the PVDF groups, the 3.26% concentration demonstrated the least cytotoxicity, succeeded by 2.26% and 1.26% respectively. On the other hand, NaF varnish exhibited the greatest toxicity among the evaluated substances.Conclusion: This innovative study demonstrates that Nano-PVDF, particularly at a concentration of 3.26%, is a promising material exhibiting enhanced biocompatibility and less cytotoxicity relative to traditional NaF varnish. All data represented that Nano-PVDF may function as a safer option in dental treatments, with exhibiting little adverse effects on oral cells.
Copyright (c) 2025 Athraa Sarhan Awadh, Maha Jamal Abbas , Hayder Hamed Abed https://creativecommons.org/licenses/by/4.0
Background: Supernumerary teeth can appear anywhere in the oral cavity and are found in addition to standard primary and permanent teeth, both clinical and radiographic examinations usually lead to the diagnosis. Their definite etiology has not yet been completely understood. These teeth either erupt normally or remain impacted which may lead to many clinical complications. This study aimed to present clinical cases with supernumerary teeth including their management strategies. Methods: Three clinical cases were considered in this study. Case 1: 20 years aged healthy female complained of a hard mass in the nose with a rough texture clinical examination and radio-graphical examination showed a hard mass resembling a tooth was detected on the floor of the nose. The treatment was endoscopic removal of the ectopic tooth which was completely developed, under trans-oral general anesthesia. Case 2: A male child with 9 years old complaining of missing multiple permanent teeth. The specialist observed that the patient had impacted upper laterals on both sides otherwise they weren't visible in the oral cavity. Cone beam computed tomography (CBCT) image showed un-erupted upper lateral incisors, The treatment consisted of surgical removal of supernumeraries under local anesthesia. Case 3: A healthy 9-year-old male child with a new tooth erupted in the roof of his mouth. A computerized tomography CT scan with clinical examination showed a mesioden between upper centrals. Extraction of mesiodens with nearly 2 cm in length was done under local anesthesia. Conclusion: Supernumerary teeth may present as single or multiple teeth on one side or both sides of the maxilla and mandible; the favorite site is the premaxilla. When they are identified and diagnosed, they should be managed to prevent future complications, either aesthetic and/or functional problems.
Copyright (c) 2024 Noor Natik Raheem, Ahmed Naeem Al-Fattal, Mohamed Sahib Shalal, Lobna K. Al Khafaji4, Yousif Ismail Allawi5 https://creativecommons.org/licenses/by/4.0
Histological Evaluation of Pure Titanium Dental Implants Coated with a Mixture of Nano Titanium Oxide and Nano Hydroxyapatite
Background: Dental implant surface characteristics affect the success of implant treatment. Many studies have focused on coating titanium (Ti) implant surfaces with bioactive materials. Bio-active surfaces play a crucial role in enhancing the healing process of the human bone tissue surrounding dental implants.Aims of the research: This study aims to evaluate the histological response and bonding strength of titanium screws coated with a combination of nano-sized titanium oxide (TiO₂) and nano-hydroxyapatite (HA) after healing intervals of two and six weeks.Materials and methods: A suspension was prepared using 5.27 g of nano-hydroxyapatite and 2.68 g of nano-titanium oxide. Commercially pure Grade II titanium screws, measuring 3.0 mm in diameter and 8 mm in length, were coated using the dip-coating technique. The presence of the nano-coating on the titanium surfaces was confirmed through X-ray diffraction (XRD) and microscopic analysis. For histological evaluation, some screws were coated with the nano TiO₂–HA mixture, while others were coated solely with nano-HA, and both types were implanted into the tibiae of New Zealand rabbits. Peri-implant bone formation was analyzed at two and six weeks post-implantation using a light microscope equipped with a GT-N7100 camera. Results: Optical microscopy revealed a uniform, crack-free coating layer on the titanium screw surfaces. XRD patterns confirmed the presence of both hydroxyapatite and titanium dioxide phases. Histological analysis showed enhanced new bone formation in the group with the TiO₂–HA mixture coating, evidenced by early osteoblast proliferation and more advanced bone maturation at both two and six weeks post-surgery, when compared to implants coated only with nano-hydroxyapatite.Conclusion: The implant coating mixture of nano TiO2 & nano HA promotes new bone formation more rapidly than a coating of nano hydroxyapatite alone.
Copyright (c) 2025 hanan abdulrahman, Muna Nasir, Athraa y Al-hijazi https://creativecommons.org/licenses/by/4.0
Prevalence of Candida Species in Patients with Fixed Orthodontic Appliance
Background: Patients with tooth misalignment are typically treated with traditional brackets during orthodontic treatment. The complexity of bracket design often hinders proper oral hygiene, resulting in an increased load of microbiota. The shape of the brackets acts as a reservoir for Candida, leading to candidosis of the oral cavity.Aims: This investigation aims to evaluate the impact of fixed orthodontic appliances on the count and distribution of salivary Candida species compared to saliva from subjects without orthodontic appliances. Methods: Eightyparticipants from the Iraqi population wearing fixed orthodontic devices comprised the study group, while 20 participants without orthodontic devices served as the control group. Salivary samples were obtained from both groups, and Candida chromogenic agar was used for cultivation. The counting and identification of different Candida species were confirmed using the Vitek 2 system to validate cultural characteristics. Results: In this study, four types of Candida species were identified: C.parapsilosis, C.albicans, C. tropicalis & C.krusei in comparison to various published researchs, this study showed no statistically significant increase in colonization by any Candida species colonization during the orthodontic treatment. However, C. tropicalis was the most frequently isolated species for both test and control groups in comparison with other species. The fixed appliances had no impact on the existence, non-attendance or scale of habitation by Candida species and there were no considerable variation in the prevalence of Candida species, based on different factors (age, gender, and saliva pH) for both test and control groups.Conclusions: The results of this study indicate that fixed orthodontic treatment had no effect on the prevalence of Candida species. This suggests that Candida accumulation may be related to an individual's own oral flora and is influenced by oral hygiene
Copyright (c) 2025 Heba Faiz. Hamodat, suhad hamdoon, Raafat Jasim al-Adool https://creativecommons.org/licenses/by/4.0
Assessment of the compressive strength and surface roughness of acrylic denture bases reinforced with ostrich eggshell powder
Background: The material most frequently employed in the dental industry is polymethyl methacrylate (PMMA). Temporary dental restorations, including those for complex indications such as implants or large-span bridges, are manufactured using this material. However, its numerous limitations render it unsuitable for application in all situations. Consequently, individuals utilizing removable prostheses must be concerned regarding the potential for fracture. The purpose of this study: examined the effects of various particle sizes of 5% hydroxyapatite (which was prepared from ostrich eggshell powder) on the roughness and compressive strength of heat-cured acrylic resin. Materials and Methods: A total of 28 cylindrical samples composed of pink heat-treated acrylic resin were fabricated and subsequently categorized into four experimental groups; Group A (Control without any additive), Group B (Particle size 80µm), Group C (Particle size 70 µm), and Group D (Particles Size 50 µm). Each group consisted of seven samples categorized according to the varying sizes of hydroxyapatite particles. The test groups homogenously blended at a weight percentage of 5% of ostrich eggshell powder. Subsequently, an assessment was conducted to determine the collective compressive strength and surface roughness of this groups. Result: The results of the investigation showed significant variations in compressive strength for group B (107±3.742 MPA), group C (103.43±5.192 MPA), and group D (98.43±7.323 MPA) concerning the different sizes of hydroxyapatite particles compared to group A (74±4.163 MPA). While there was a significant increase in surface roughness for groups B (3.22±0.014), C (2.41±0.018), and D (2.36±0.077) compared to group A (1.451±0.073). Conclusion: Varying the particle size of hydroxyapatite added to the thermosetting acrylic resin (80μm, 70μm, and 50μm) increases both the material's compressive strength and surface roughness.
Copyright (c) 2024 Najwah Y. Hameed, Sarah A.Turki1, Atyaf M. Naser, Ghasak Gh.Alatrakchi https://creativecommons.org/licenses/by/4.0
Effect of Eggshell gel and CO2 laser on microhardness of enamel white spot lesions in comparison to sodium fluoride gel
Objective: The aim of this study was to evaluate the effect of chicken eggshell with and without CO2 laser on human enamel white spot lesions compared to sodium fluoride gel. Material and methods: To produce white patches on tooth enamel, (30) maxillary first premolars were divided into three distinct groups at randomly and then kept in a demineralizing liquid. Eggshell gel was used in the first group, CO2 laser irradiation with eggshell gel in the second, and sodium fluoride gel in the third. Following that, teeth were submerged in artificial saliva for 30 days. The enamel surface's hardness by Vickers was determined. One sample from each group was analyzed using a scanning electron microscope (SEM) to display the morphological characteristics of the enamel surface. Tukey's test and two-way evaluation of variance (ANOVA) were used to assess the data. Results: The degree of microhardness for enamel white spot lesions increased in all three groups under study. Eggshell gel with CO2 laser therapy (group 2) increased microhardness more than sodium fluoride gel treatment (group 3) and somewhat more than eggshell gel treatment alone (group 1). Conclusion: The using of eggshell gel, eggshell gel with CO2 laser, sodium fluoride gel are suggested to reharden the tooth enamel and the treatment with eggshell gel with CO2 laser showed a higher increasement in microhardness than sodium fluoride gel.
Copyright (c) 2025 Duaa Taher, Dalia K. Abbas https://creativecommons.org/licenses/by/4.0
Effect of Triton, HEDP and EDTA chelating irrigant’s protocol on micro-hardness of root canal dentine: An in vitro study
Aim: To assess and compare the effectiveness of different chelating irrigants (Triton, 1-hydroxyethylidene-1,1-bisphosphonate (HEDP) for continuous chelation, and 5.25% NaOCl+17% ethylenediaminetetraacetic acid (EDTA)) for conventional chelation on root canal dentine micro-hardness. Materials and methods: Forty mandibular premolars extracted for orthodontic reason were used in this study, teeth were then divided into four groups according to type of irrigation solution, Group A; Triton, Group B; HEDP, Group C; EDTA, Group D; Distilled water (control). The crowns removed to produce root length of 14 mm, all teeth prepared using ProTaper Next files up to size 40/0.06. Then the roots separated into two parts. The microhardness evaluated at three thirds (coronal, middle, and apical) for each half, 3 N load was used for 15s. The data were statistically analyzed using one-way ANOVA and Tukey post hoc test. The level of significance was set at p ≤ 0.05. Results: Triton had the least effect on micro-hardness, while EDTA had the highest effect. All chelating agents in this study reduced micro-hardness with no significant difference between them, but significantly different from the control group (p ≤ 0.05) at coronal third. Conclusion: All chelating agents reduced micro-hardness at three thirds.
Copyright (c) 2025 Tamara Al-Tai, Iman Mohammed Al-Zaka https://creativecommons.org/licenses/by/4.0
Assessment of Salivary C Reactive Protein level in Type Two Diabetic Patients with Different Stages of Periodontitis
The purpose of this study is to contrast the salivary levels of C-reactive protein between healthy controls and diabetic patients at various stages of periodontitis.Materials and methods: One hundred sixty men participated in this study; 32 of them were healthy control groups, while the other 128 men with type -2 diabetes were equally categorized into four groups according to stages of periodontitis (stage I, stage II, stage III, and stage IV). Following the collection of unstimulated salivary samples from each participant, (PPD, CAL, and BOP) clinical periodontal parameters were assessed. ELISA technique was used to measure the levels of CRP in saliva samples. Results: CRP was higher in diabetic patients with all stages of periodontitis than healthy controls. The level of CRP is increased when periodontitis progresses to higher stages. Stage IV group (515.33±258.51), stage III group (315.52±206.71), stage II group (206.61±124.64), stage I (160.07±97.49), control group (45.63±25.29) in which their salivary levels were the least with significant differences among the groups (p=0.000).Conclusion: The inflammatory marker CRP is increased in diabetic patients than in Control, especially when the stage of periodontitis gets worse.
Copyright (c) 2025 sajjad ali, Dalia Kudier Abbas, Okba Mahmoud https://creativecommons.org/licenses/by/4.0
Evaluation of Folic Acid level in Serum of Smokers and Non Smokers Patients with Periodontal Disease: A Case-Control Study
Objectives: Periodontitis is a complex disease, the reason of which remained unclear. Folic acid belongs to B complex vitamins. It is vital for the formation and division of new cells, as it serves as a crucial cofactor in DNA synthesis. Without the presence of folic acid, epithelial cells fail to divide correctly. Folic acid levels can be influenced by a number of factors, one of which is cigarette smoking. This study aimed to measure serum concentration of folic acid among patients with periodontitis associated to their smoking behaviors. Materials and Methods: The study included 75 subjects; divided in the following groups: group-I: 25 Smokers with periodontitis, group-II: 25 Non-smokers with periodontitis and group-III: 25 Non-smoker with healthy periodontium (control group). Clinical parameters were recorded including: Plaque Index(PLI), Gingival Index GI, Bleeding On Probing (BOP), Probing Pocket Depth(PPD) and Clinical Attachment Loss(CAL). Blood samples were taken and evaluated in the laboratory for folic acid levels by enzyme-linked immunosorbent assay ELISA technique. Results: Significantly low concentration of folic acid encountered in serum of smokers with periodontitis as compared to healthy non-smoker controls (P < 0.001). Additionally, smokers with periodontitis showed significantly higher PLI, PPD and CAL means than non-smokers with periodontitisConclusion: The results of the present study indicate that folic acid levels were decreased significantly in smokers with periodontitis. Smoking has a negative impact on folic acid level and periodontal health.
Copyright (c) 2024 ghasaq Asim Abdul-Wahab, Alyamama Mahmood Alwan, Sarah Ihsan Al-Karawi, Tameem Jassim Khuder https://creativecommons.org/licenses/by/4.0
The Effect of Fibers Insertion on Fracture Resistance of Maxillary Premolar Teeth with MOD Cavity Restored with Composite (In Vitro Study)
Aim of the study: The purpose of this in vitro investigation was to compare the impact of different fibers on the fracture resistance of maxillary first premolar teeth with MOD cavities. Materials and methods: Sixty sound, non-carious human maxillary first premolars were selected for this study and randomly divided into four groups (n = 15). Groups A, B, and C consisted of intact teeth utilized as the control group, teeth restored with ribbond, and teeth restored with composite (Palfique LX5, Tokuyama, Japan) respectively. Group D included dental restorations using SFRC Ever X Posterior (GC, Japan). The occlusal surface of each tooth was imprinted using flowable composite material (stamp technique), and all teeth were mounted in a 2cm² square block of self-curing acrylic resin. A large class II MOD cavity preparation was performed for all groups except for Group A. The dimensions of the cavities were standardized as follows: the occlusal depth was 3 mm, the occlusal width buccolingually was 2/3 of the intercuspal distance, and the MO and DO boxes were prepared with a height of 1.5 mm at their axial walls. The teeth were tested in a universal testing apparatus with a 0.5 mm/min compressive load rate till fractures take until fractures occurred. The analysis of variance (ANOVA) and Tukey’s (HSD) tests were used to determine the statistical significance of the variation in fracture resistance among the groups under investigation, using a significance level of 0.05.Results: The results revealed that the groups restored with fibers (Group B and Group D) exhibited greater fracture resistance than group restored with composite only (Group C).Conclusions: In the context of the present investigation, teeth restored with Ribbond insertion demonstrated a significant increase in fracture resistance compared to the other tested groups, followed by teeth restored with Ever X posterior. In contrast, teeth restored with Tokuyama Palfique LX5 composite without fibers exhibited the least fracture resistance.
Copyright (c) 2025 Mujtaba Salim, Baidaa M. Zeidan, Abeer A. Abbas, Abdulrahman Mohammed Almashhadani https://creativecommons.org/licenses/by/4.0