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Antibacterial and Antibiofilm Activity of Lavandula angustifolia Essential Oil for Inhibiting Primary Biofilm Colonizers: An In Vitro Study
No full textObjective: The present study aimed to assess the effectiveness of Lavandula angustifolia (L. angustifolia) essential oil (EO) in inhibiting bacterial growth and biofilm formation of primary colonizers, such as Streptococcus sanguinis (S. Sanguinis), Streptococcus mitis (S. mitis), and Streptococcus oralis (S. oralis), in an in vitro setting. Methods: Gas chromatography-mass spectrometry (GC–MS) analysis was used to examine the oil extracted from L. angustifolia EO by hydrodistillation. Agar well diffusion and broth dilution techniques were performed to evaluate antibacterial activity and Minimum Inhibitory Concentrations (MICs) and Minimum Bactericidal Concentrations (MBCs), respectively, against the three American Type Culture Collection (ATCC) strains. In contrast, the qualitative tube method was performed to assess the antibiofilm effect. Chlorhexidine 0.12% was used as a positive control, and all experiments were performed in triplicate (n = 3). Data were analyzed using SPSS (version 26), with p ≤ 0.05 considered statistically significant. Results: GC–MS identified 25 constituents in L. angustifolia EO, with linalool (20.99%) predominant. The EO (5–20%) showed dose-dependent antibacterial activity, producing inhibition zones up to 16.2 mm compared with 16–18 mm for chlorhexidine. MIC/MBC values (µL/mL) were 1.56/3.125 for S. mitis, 0.39/0.781 for S. oralis, and 0.156/3.12 for S. sanguinis. For the mixed-species consortium, MIC and MBC were 0.156 and 3.12 µL/mL, respectively. The EO demonstrated moderate to weak antibiofilm activity. Conclusions: L. angustifolia EO showed concentration-dependent antibacterial activity against primary oral colonizers. While chlorhexidine 0.12% produced larger inhibition zones overall, L. angustifolia EO at higher concentrations, especially 15%, demonstrated comparable efficacy against S. mitis. These findings suggest its potential as a supplementary therapeutic natural adjunct for preventing early plaque formation
Comparison of the gingival phenotype in diabetic and non-diabetic subjects among patients suffering from periodontal diseases
No full textObjective: This study aimed to compare the gingival phenotype (GP) in subjects with periodontal disease and type 2 diabetes mellitus (DM) with that in subjects without diabetes mellitus. Methods: A cross-sectional study was performed involving 182 subjects with periodontal diseases (102 with type 2 DM, 80 without DM), aged 40 to 65 years. Clinical parameters were assessed, including keratinized gingival width (KGW) and gingival thickness (GT), plaque index (PI), bleeding index (BI), probing depth (PD), and clinical attachment loss (CAL). Results: Diabetic patients displayed significantly higher KGW (5.58 ± 0.90 mm vs. 5.12 ± 0.58 mm, p = 0.006), PI (41.19 ± 19.71% vs. 28.38 ± 13.53%, p = 0.001), and BI (42.49 ± 18.16% vs. 28.19 ± 13.80%, p = 0.0001) in comparison to non-DM individuals. There were no significant differences in GT, PD, and CAL between the groups. Sex-based comparisons indicated no significant differences between any of the examined parameters. Correlation analysis and chi-square testing demonstrated substantial relationships between PI and BI (p = 0.0001), BI and CAL (p = 0.04), and PD with CAL (p = 0.0001). Conclusions: Diabetes significantly alters the GP by increasing KGW, plaque, and bleeding indices, whereas other clinical parameters, such as GT, PD, and CAL, remain predominantly unchanged. These findings underscore the importance of managing inflammation and closely monitoring treatment outcomes in individuals with diabetes with periodontal disease
A Novel Approach to Gutta-Percha Disinfection: Evaluating Hypochlorous Acid Against Standard Endodontic Disinfectants
No full textObjective: It is advisable to decontaminate gutta-percha cones before their insertion into the root canal system. The prevalence of contamination remains a contentious issue. This study aimed to assess and compare the effectiveness of several chemical agents for disinfecting gutta-percha cones (GP). Methods: One hundred and ninety size F3 GP cones were used. The cones were contaminated with Enterococcus faecalis and Candida albicans following immersion. Three chemical agents were used: 2% chlorhexidine gluconate (CHX), 5.25% sodium hypochlorite (NaOCl), and 200ppm hypochlorous acid (HOCL). GP cones were immersed in the chemical agents for periods of 1 and 5 minutes. Following disinfection, the cones were incubated in thioglycolate broth, and the turbidity of the medium was used to indicate bacterial growth. Results: CHX and NaOCl showed time-dependent regrowth of both microbes after short (1-minute) exposures; only a 5-minute NaOCl exposure achieved sustained bacterial elimination. In contrast, 200 ppm HOCl demonstrated immediate and complete eradication of both pathogens with all exposure times, showing no regrowth over 14 days. Conclusions: HOCl proved superior to CHX and NaOCl, exhibiting rapid, stable, and prolonged antimicrobial efficacy without significant reduction over time
Mandibular Asymmetry in Cleft Lip and Palate Versus Class I Malocclusion: A Panoramic Radiographic Study in Mosul
No full textObjective: This study aimed to evaluate the mandibular asymmetry between patients with Unilateral and Bilateral Cleft Lip and Palate in Mosul city by using panoramic radiographs and mandibular asymmetry index to compare with Class I malocclusion controls for selecting the type of treatment in future. Methods: A retrospective cross-sectional study was performed on 150 orthodontic patients (75 with CLP and 75 controls with Class I anterior relationship) visiting a dental hospital in Mosul city. Patients between 12 and 18 years of age who had not been previously treated orthodontically were included in the study. Digital orthopantomograms were analyzed for vertical ramus and condylar heights using Habets’ method. The mandibular asymmetry index for each patient was calculated as the percentage difference between right and left ramus or condylar heights. A p ≤ 0.05 was considered significant. Results: The CLP and Class I groups showed no statistically significant differences in mandibular asymmetry indices. The mean ramus asymmetry index was 2.61% in Class I vs 3.88% in CLP, and the mean condylar asymmetry index was 7.68% vs 8.99%, respectively (both comparisons, p 0.05). Within each group, the right and left ramus and condylar heights were symmetric (no significant side-to-side differences, p 0.1). Age was associated with increased asymmetry: older adolescents exhibited higher ramus asymmetry, significantly in the Class I group (p 0.01). Sex had no significant influence on asymmetry in either group (p 0.05). Conclusions: Both groups had vertical mandibular asymmetry, with no difference in asymmetry between CLP subjects and Class I malocclusion controls. The average asymmetry indices for both groups were greater than 3%, implying that mild vertical mandibular asymmetry was present in both boys and girls
Comparative Analysis of FGFR2 Exon 8 and Exon 10 Sequences in Retrognathic Mandible Patients: A Case-Control Study
No full textObjective: Class II malocclusion is associated with the gene FGFR2. Genotyping involved conducting genome linkage scans to identify mutations in various mandibular genes and loci associated with Class II malocclusion. The present study aimed to improve the current understanding of genetic factors involved in the development of a retrognathic mandible and to correlate genetic variations with phenotypic characteristics. Methods: Two hundred patients with class II jaw relation have been examined; twenty patients with a retrognathic mandible and another twenty with normal mandibular size and position have been selected from the population by analyzing their lateral cephalometric radiographs. DNA was extracted from saliva samples collected from 40 individuals. FGFR2-8 and FGFR2-10 genes were amplified using the genomic DNA of patients' saliva by PCR. The results of sequenced samples were analyzed using a phylogenetic tree. Results: Cephalometric readings indicated that patients with class II had a retrognathic mandible, while their maxilla was normally positioned. Genetically, when comparing FGFR2 exon 8 and exon 10, exon 10 is more promising for detecting class I and class II, because it mimics the results of clinical examination by cephalometric radiographs. In FGFR2-10 the controls were in one group of the phylogenetic tree. Conclusions: This study concludes that FGFR2-10 may be promising for detecting class II malocclusion, while FGFR2-8 was not very specific. All found mutations were point mutations and can be considered new SNPs (Single Nucleotide Polymorphisms). FGFR2-10 showed clearer grouping patterns between cases and controls in the phylogenetic tree; these findings may serve as a diagnostic aid and require further validation
Comparative evaluation of three electronic apex locators in determining working length: An in-vitro study
No full textObjective: The purpose of this in-vitro study was to determine the precision of three electronic apex locators (AppleDent AL, Eighteeth AL, and Coxo AL) in determining the working length (WL) of root canals using extracted human teeth. Although several new apex locator models have recently become commercially available, independent evidence regarding their measurement accuracy remains limited, underscoring the need for objective evaluation. Methods: A total of 90 freshly extracted human permanent single-rooted teeth with mature apices were standardized. Access cavities were prepared and canal patency was controlled (with a 10 K file) and AWL (with size 15 K file at ×25 magnification) were detected by the stereomicroscope. After embedding them in alginate to recreate the periodontium, teeth were randomly divided into 3 groups (n = 30). The average of 3 repeated measurements was used for the calculation of the EWL in each group. The value of AWL and EWL have been calculated. The accuracy was measured under ±0.5 mm and ±1.0 mm. Data were statistically treated with Shapiro-Wilk test (to assess data normality), Levene´s test, one-way ANOVA and Tukey's post hoc testing (α = 0.05). Results: In comparison with Eighteeth AL (0.41 ± 0.27 mm), the mean deviations of AppleDent AL and Coxo AL from AWL were by a lower level (by 0.24 ± 0.58 mm and by 0.24 ± 0.33 mm, respectively). Precision within ±0.5 mm was 50.0%, 86.7%, and 73.3% for AppleDent, Coxo, and Eighteeth models, respectively. All devices achieved a 90% or greater accuracy within ±1.0 mm. The ANOVA analysis confirmed that Eighteeth was different from AppleDent and Coxo (p = 0.012), which the Tukey's test also confirmed. Conclusions: All 3 electronic foramen locators showed clinical accuracy. Coxo AL performed far better, while AppleDent AL showed similar mean scores, but had higher variability, and Eighteeth overestimated the working length
Cone Beam Computed Tomography Evaluation of the Styloid Process Length Variations in a Sample Group of the Iraqi Population
No full textObjective: The scarce literature data on the mean length of the styloid process in the Iraqi population gave rise to the need for this study to determine the mean length of the styloid process in an Iraqi subpopulation, highlighting the possible importance in clinical and surgical conditions considered. Methods: Cone-Beam Computed Tomography (CBCT) images of 229 Iraqi patients comprising 73 males (31.1%) and 156 females (68.9%), with a mean age of 40.48 ±16.326, were included in this retrospective study. The data obtained were transformed into SPSS v25, and descriptive and inferential analyses were performed. Results: The mean length of the styloid process in males was found to be 26.16 ±1.08324mm on the right side and 26.42±1.12595mm on the left side, while the mean length of styloid process in females was found to be 26.13±1.12595mm on the right side and 26.15±0.74133mm on the left side. Conclusions: There was no statistically significant difference in the length of the styloid process between the two sex groups (p 0.05) or between the right and left sides of each sex group (p 0.05)
Decisions in Restorative Dentistry Based on Gender, Knowledge, and Experience
Full text linkObjective: The increasing emphasis on esthetic outcomes and patient-centered care has significantly shaped clinical decisions in restorative dentistry. This study investigates how dentists’ knowledge and professional experience influence treatment choices in various restorative scenarios. Methods: A questionnaire was distributed to general dentists and specialists in Kurdistan Region of Iraq. It assessed treatment choices in restorative scenarios and gathered demographic data. Statistical analysis examined links between clinical decisions and factors like gender, experience, and specialization. Results: The results revealed significant differences in treatment choices based on gender and experience. Male dentists were more likely to choose root canal therapy and place posts, while females showed a greater tendency toward conservative treatment options. More experienced dentists preferred full crowns for severely damaged teeth, whereas less experienced ones were more likely to opt for direct restorations. Additionally, most practitioners discussed esthetic decisions, such as veneer shade, with patients, and the majority favored implants over bridges for replacing missing teeth. Conclusions: These findings highlight the influence of demographic and professional characteristics on clinical decision-making in restorative dentistry. Knowledge, and experience contribute to differing approaches in treatment planning, reflecting a balance between technical knowledge and evolving trends in patient-centered, esthetically driven care
Cone Beam Computed Tomography Evaluation of the Clinical Correlation between the Stature of the Patient and Tooth Anatomic Odontometry in Iraqi Subpopulation (A Cross-sectional Study)
No full textObjective: The odontometric assessment of teeth has been considered as crucial for the identification of individuals due to its correlation with body stature. This investigation aims to collect odontometric data on the anatomical dimensions of both mandibular and maxillary anterior and posterior teeth, and to correlate these variables with stature and gender within the Iraqi subpopulation using cone-beam computed tomography analysis. Methods: This prospective study involved 826 participants, comprising 370 females (44.8%) and 456 males (55.2%), categorized into two height groups: short and tall, based on average height thresholds. Odontometric data, including total tooth length, root length, crown length, and crown width measurements, were recorded via Cone-beam computed tomography. Additionally, physical stature was measured using standardized anthropometric techniques. Statistical analysis was performed using Student's t-test. Results: Overall, the findings indicate a positive and statistically significant correlation between all odontometric measurements and stature for both genders, with p-values less than 0.05. Notably, maxillary canines exhibited the strongest correlation with stature, followed by maxillary first molars. In contrast, lower central incisors for males and lower second premolars for females showed the weakest correlation. The correlation for crown width was strongest for maxillary canines and mandibular first molars, while lateral incisors and maxillary second molars presented the weakest correlation. Comparing the dimensions of corresponding right and left side teeth revealed some variations, with a few patients displaying differences exceeding 0.45 mm. At the same time, differences were found to be statistically insignificant for the majority of other teeth, with maximum variations reaching only 0.08 mm between contralateral teeth. Furthermore, significant sexual dimorphism was also observed, with male teeth presenting significantly greater dimensions than female teeth, except in the lower central incisors. Conclusions: The current clinical study highlights the presence of significant sexual dimorphism and confirms a positive and significant relationship between individual stature and tooth dimensions across both genders
Accuracy Comparison of Guided Implant Placement Between Tooth and Mucosal Supported Stereolithographic Models in the Maxillary Arch. (An experimental study)
Full text linkObjective: Employing stereolithographic surgical guides is highly beneficial for enhancing and analyzing implant position accuracy. This study aimed to differentiate between the accuracy of implant position with two different models employing guided surgery based on the support level (tooth-mucosa). Methods: A total of 80 implants were virtually planned and surgically positioned on twenty maxillary dental arches utilizing two distinct stereolithographic models (40 using tissue and 40 using tooth supported surgical guides). Four virtual implants were planned for each dental arch in the implant planning software. Accuracy measurement was made possible by matching process within the software between virtually planned and actually positioned implants, utilizing radiographic markers in the maxillary arch as matching points. Measuring was carried out at the center of the implant hexagon, apex and angle deviations. Results: The overall difference between tooth- and mucosa-supported surgical models for angular and apical deviations was not statistically significant except for hexagonal deviation, which showed (P 0.001), where the mean distance deviations at the hexagons and apices level showed 1.24 ± 0.38 mm and 1.22 ± 0.51 mm for the guides supported by teeth, and 1.83 ±1.09 mm and 1.24 ±0.69 mm for the guides supported by mucosa. The angular deviation for tooth- and mucosa-supported guides measured 4.38 ± 3.22 and 3.9 ±2.61 degrees, respectively. Conclusions: Based on this study’s results, it is concluded that there is a correlation between implant placement accuracy and the type of surgical guide support. Specifically, surgical guides supported by mucosa showed lower accuracy at the hexagon level compared to those supported by tooth structures. The resiliency of the mucosa may influence implant placement accuracy and subsequent prosthetic plan