Frontiers in Dentistry

Objectives: Toothpastes and mouthwashes contain chemicals that may be harmful to oral tissues. This study assessed the cytotoxicity and antibacterial activity of toothpastes and compare the Iranian and foreign toothpastes and mouthwashes available in the Iranian market in this respect.
Materials and Methods: Twenty samples (13 toothpastes and 4 mouthwashes) were selected. The cytotoxicity of 1, 10, and 50 mg/mL of toothpastes and 0.05, 2 and 10 µL of mouthwashes was measured after 1, 15 and 30 min of exposure to human gingival fibroblasts, each in triplicate. The methyl thiazolyl tetrazolium (MTT) assay was used for cytotoxicity testing. The serial dilution method was utilized to determine the minimum inhibitory concentration (MIC) of each sample against Lactobacillus acidophilus (L. acidophilus) and Streptococcus mutans (S. mutans). Two-way ANOVA and Tukey’s test were used for data analysis.
Results: A significant difference in cytotoxicity was noted among different products (P=0.00). The difference in cytotoxicity of each sample was not significant at 1, 15 and 30 min (P=0.08). The obtained MIC for all toothpastes and mouthwashes was between 0.0039 mg/mL and 0.0156 mg/mL, except for Sensodyne toothpaste and Oral B mouthwash.
Conclusion: Some brands of toothpastes have higher cytotoxicity due to their composition, and their cytotoxicity should not be overlooked. The antibacterial activity of the samples was almost equal when they were in contact with L. acidophilus and S. mutans except for the Irsha mouthwash, Sehat, Darugar and Bath toothpastes. The antibacterial effect of toothpastes and mouthwashes increased with an increase in exposure time.

Objectives: Intraoral scanners have shown promising results when used as an adjunct or alternative to conventional impression techniques. This study compared the accuracy of digital impression taking using an intraoral scanner versus the conventional technique.
Materials and Methods: In this in-vitro experimental study, a typodont molar tooth was prepared as the standard model and scanned by TRIOS intraoral scanner. Ten digital impressions were fabricated as such and intraoral scans were sent to the manufacturers. In the conventional method, using addition silicone impression material, a stone die was fabricated. Using a computer-aided design/computer-aided manufacturing scanner, the die was scanned, and the data were transferred to the software. After the fabrication of frameworks, the replica technique was used. The replicas’ thickness (indicative of the gap between the framework and the model and the accuracy of impression taking) was 12 points. The data were analyzed using student's t-test.
Results: The mean thickness of replicas (gap between the internal surface of frameworks and the standard model) at the three points in the buccal, lingual, mesial, and distal sections in the digital impression technique was lower than that in the conventional technique (P<0.0001). In other words, the accuracy of impressions taken by the digital method was significantly higher than those taken by the conventional method.
Conclusion: Intraoral digital scanner had significantly higher accuracy than the conventional method in all points. Thus, the digital method can be reliably used as an adjunct or alternative to the conventional method to increase the accuracy of impression taking.

Objectives: Traumatic dental injuries (TDIs) commonly occur in sport clubs. The knowledge and performance of fitness trainers play an important role in management of such injuries. This study sought to assess the effect of an educational pamphlet on knowledge level and performance of fitness trainers about TDIs in Tehran in 2018.
Materials and Methods: In this interventional study, a pamphlet was designed to enhance the knowledge level of fitness trainers. Ninety-five fitness trainers were randomly divided into two groups of intervention and control (n=49 in the control group and n=46 in the interventional group), and were requested to fill out a valid and reliable researcher-designed questionnaire about TDIs before and 1 month after pamphlet distribution. The questionnaire consisted of three domains of demographic information, knowledge questions, and performance questions. The results were analyzed using SPSS 25 via the Chi-square test and repeated measures ANOVA considering the intervention as the between-subject factor.
Results: The knowledge score of fitness trainers about TDIs was not adequately high in the intervention or the control group before the intervention. After the intervention, the performance of participants improved in both groups. This increase was significantly greater in the intervention group (P=0.035). There was no significant difference between the two groups in the knowledge domain (P=0.185).
Conclusion: Educational pamphlets can effectively enhance the knowledge level of fitness trainers about TDIs. However, the magnitude of this effect was not significant in our study. Future studies are recommended to compare the efficacy of educational pamphlets with other educational tools.

Objectives: This study aimed to assess the effect of tea on color stability of enamel lesions treated with resin infiltrant (RI).
Materials and Methods: This in vitro, experimental study evaluated 30 extracted human third molars with no caries, cracks, or enamel defects. Enamel-dentin samples measuring 5 x 5 x 3 mm were prepared from the buccal surfaces of the teeth by a microtome. The samples were divided into three groups of 10 namely sound enamel, demineralized enamel, and demineralized enamel plus RI. White spot lesions (WSLs) were artificially created by immersing the samples in hydroxyethyl cellulose demineralizing gel with a pH of 4.5 for 4 days. Next, Icon RI was applied on the samples in group 3. The baseline color of the samples was measured using a spectrophotometer. They were immersed in tea solution 3 times a day, each time for 15 min, for a period of 2 weeks and then underwent colorimetry again. Data were analyzed using one-way ANOVA.
Results: The maximum color change (∆E) was noted in demineralized enamel plus RI group (38.59±6.13) with significant differences with sound enamel (20.00±2.94) and demineralized enamel (25.27±7.47) groups (P<0.05). The difference between the latter two groups was not significant (P>0.05).
Conclusion: Within the limitations of this in vitro study, the results showed that tea solution caused clinically unacceptable color change in all groups. However, the color stability of WSLs treated with RI was significantly lower than other groups following immersion in tea solution.

Objectives: Marginal and internal fit of restorations are two important clinical factors for assessing the quality and durability of computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated monolithic zirconia restorations. The purpose of this study was to evaluate the marginal and internal fit of CAD/CAM zirconia crowns with two different scanners (i3D scanner and 3Shape D700).
Materials and Methods: Twelve extracted sound human posterior teeth were prepared for full zirconia crowns. Two different extraoral scanners namely i3D scanner and 3Shape D700 were used to digitize type IV gypsum casts poured from impressions. The crowns were milled from presintered monolithic zirconia blocks by a 5-axis milling machine. The replica technique and MIP4 microscopic image analysis software were utilized to measure the marginal and internal fit by a stereomicroscope at ×40 magnification. The collected data were analyzed by paired t-test.
Results: The mean marginal gap was 203.62 μm with 3Shape D700 scanner and 241.07 μm with i3D scanner. The mean internal gap was 192.30 μm with 3Shape D700 scanner and 196.06 μm with i3D scanner. The results of paired t-test indicated that there was a statistically significant difference between the two scanners in marginal fit (P=0.04); while, there was no statistically significant difference in internal fit (P=0.761).
Conclusion: Within the limitations of this study, the results showed that type of extraoral scanner affected the marginal fit of CAD/CAM fabricated crowns; however, it did not have a significant effect on their internal fit.

Giant cell fibroma (GCF) is a relatively rare lesion in the oral cavity. Despite having unique microscopic features, it can be easily misdiagnosed clinically as any common hyperplastic lesion. This report presents a case of a 21-year old male with a lesion involving the papilla between the mandibular central incisors. The lesion was excised completely under topical anesthesia using a 980 nm diode laser. On histopathological examination of the excised tissue, no thermal damage or any other alteration was observed, while the features were suggestive of GCF. Healing of the gingiva was uneventful and without any signs of recurrence. Apart from the widely known advantages of the diode laser, it also appears to maintain the integrity of biopsy specimens, if used with appropriate settings. This advantage may play a vital role in the biopsy of rare lesions where the diagnosis is entirely based on accurate histopathological examination.