Objectives: To evaluate the effect of adding the sodium fluoride to different phosphoric acid concentrations on Shear Bond Strength (SBS) of orthodontics brackets bonded to enamel surface. Methods: Forty eight freshly extracted human premolar for orthodontic purposes, were collected, and were randomly divided into four Groups. G1 etched by 37% Phosphoric acid for 30 s, G2 etched by 25% Phosphoric acid for 30 s, G 3 etched by 37% fluoridated Phosphoric acid (0.863% F-) for 30 s, G4 etched by fluoridated 25 % Phosphoric acid (0.694% F-) for 30s. Stainless steel metal brackets (Forestadent Company-sprint-Brackets) were bonded to teeth using self curing composite (system–RMO/ mono-lok2 bonding). A Universal Testing Machine (Testometric M350-5KN, UK) was used to measure SBS, 24 hours after bonding, and the force applied to the ligature groove between bracket base and wings. Data were analyzed using OneWay ANOVA with Tukey post-hoc test (p = 0.05). Results: The mean SBSs were 14.97 MPa, 15.47MPa, 13.09 MPa and 11.16MPa for Groups 1-4 respectively. Significant differences in shear bond strengths were shown between Groups 2 and 4. Significance: The results suggested that the using mixed phosphoric acid 37% with NaF gel 1.23% for 30 s (0.863%F-) have no effect on SBS and may have a clinical application in the prevention of demineralization or caries surrounding and under orthodontic brackets bonded to enamel. Nevertheless, mixed phosphoric acid 25% with NaF% gel (0.694% F-) results to reducing SBS it may have a clinical application.

Objectives: To evaluate the effect of adding the sodium fluoride to different phosphoric acid concentrations on Shear Bond Strength (SBS) of orthodontics brackets bonded to enamel surface. Methods: Forty eight freshly extracted human premolar for orthodontic purposes, were collected, and were randomly divided into four Groups. G1 etched by 37% Phosphoric acid for 30 s, G2 etched by 25% Phosphoric acid for 30 s, G 3 etched by 37% fluoridated Phosphoric acid (0.863% F-) for 30 s, G4 etched by fluoridated 25 % Phosphoric acid (0.694% F-) for 30s. Stainless steel metal brackets (Forestadent Company-sprint-Brackets) were bonded to teeth using self curing composite (system–RMO/ mono-lok2 bonding). A Universal Testing Machine (Testometric M350-5KN, UK) was used to measure SBS, 24 hours after bonding, and the force applied to the ligature groove between bracket base and wings. Data were analyzed using One- Way ANOVA with Tukey post-hoc test (p = 0.05). Results: The mean SBSs were 14.97 MPa, 15.47MPa, 13.09 MPa and 11.16MPa for Groups 1-4 respectively. Significant differences in shear bond strengths were shown between Groups 2 and 4. Significance: The results suggested that the using mixed phosphoric acid 37% with NaF gel 1.23% for 30 s (0.863%F-) have no effect on SBS and may have a clinical application in the prevention of demineralization or caries surrounding and under orthodontic brackets bonded to enamel. Nevertheless, mixed phosphoric acid 25% with NaF% gel (0.694% F-) results to reducing SBS it may have a clinical application.

Objective: To establish reliability of cephalometric landmark identification in threedimensions using ProPlan CMF software. Methods: Two orthodontist identified a series of 33 cephalometric landmarks on 20 CBCT scans of Class I, pre-orthodontic patients and repeated the landmark identification about two months later. Intraclass correlations (ICC) were calculated by landmark in the X, Y, and Z dimensions and F-test were used to assess difference in landmark location in the X, Y, and Z dimensions. Results: The majority of landmarks had good to excellent ICC for both inter- and intraobserver reliability. F-test also showed the majority of landmarks had no significant difference between the observers. Conclusion: Most landmarks showed good to very good reliability and reproducibility using ProPlan CMF, with some landmarks proving more reliable than others and further research is needed to establish the utility and practicality of three-dimensional cephalometrics as a common diagnostic tool in orthodontics

Objective: To establish reliability of cephalometric landmark identification in threedimensions using ProPlan CMF software. Methods: Two orthodontist identified a series of 33 cephalometric landmarks on 20 CBCT scans of Class I, pre-orthodontic patients and repeated the landmark identification about two months later. Intraclass correlations (ICC) were calculated by landmark in the X, Y, and Z dimensions and F-test were used to assess difference in landmark location in the X, Y, and Z dimensions. Results: The majority of landmarks had good to excellent ICC for both inter- and intraobserver reliability. F-test also showed the majority of landmarks had no significant difference between the observers. Conclusion: Most landmarks showed good to very good reliability and reproducibility using ProPlan CMF, with some landmarks proving more reliable than others and further research is needed to establish the utility and practicality of three-dimensional cephalometrics as a common diagnostic tool in orthodontics.

Objective: To exam the pharyngeal airway dimensions in cleft lip and palate subjects and to compare them with controls before orthognathic surgery and to assess the need for orthognathic surgery for these cases. Material and Methods: Pre-orthodontic cephalograms of two hundred patients were used in this study. Twenty one landmarks for sagittal pharyngeal airway and soft tissue measurements had been identified for each cephalogram. Patients were selected according to the specific inclusion criteria and divided into 2 groups according to the presence of cleft lip and palate. The first group was Jordanian cleft lip and palate and consisted of 100 subjects (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.4 ± 2.4 years), and the second group was 100 controls without cleft lip and palate (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.7 ± 2.2 years). Independent t-test was used to detect differences between the two groups. Results: Subject’s pharyngeal airway dimensions were significantly narrower, in the lower airway thickness (PNS - AD1) (P= 0.000), upper airway thickness (PNS - AD2) (P= 0.000), total lower sagittal depth of the bony nasopharynx (PNS - Ba) (P= 0.000), posterior sagittal depth of the bony nasopharynx (Ptm - Ba) (P= 0.000), total upper airway thickness (PNS - H) (P= 0.000) and McNamara’s lower pharynx dimension (P= 0.007) when compared to control. On the other hand, control group showed significantly longer soft palate (PNS–P) (P= 0.000), and wider in both thickness of tongue (TGH) and soft palate (MPT) with (P= 0.000). The Tongue Length (TGL) and hyoid bone position did not record any significant difference when compared to subject group. Conclusions: Subjects had narrower pharyngeal airway dimensions when compared with the controls and this was not due to soft tissue hypertrophy but attributed to the smaller bony nasopharyngeal framework and skeletal deformations. Orthognathic surgery is indicated in cleft lip and palate population to correct skeletal discrepancies.

Objective: To exam the pharyngeal airway dimensions in cleft lip and palate subjects and to compare them with controls before orthognathic surgery and to assess the need for orthognathic surgery for these cases. Material and Methods: Pre-orthodontic cephalograms of two hundred patients were used in this study. Twenty one landmarks for sagittal pharyngeal airway and soft tissue measurements had been identified for each cephalogram. Patients were selected according to the specific inclusion criteria and divided into 2 groups according to the presence of cleft lip and palate. The first group was Jordanian cleft lip and palate and consisted of 100 subjects (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.4 ± 2.4 years), and the second group was 100 controls without cleft lip and palate (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.7 ± 2.2 years). Independent t-test was used to detect differences between the two groups. Results: Subject’s pharyngeal airway dimensions were significantly narrower, in the lower airway thickness (PNS - AD1) (P= 0.000), upper airway thickness (PNS - AD2) (P= 0.000), total lower sagittal depth of the bony nasopharynx (PNS - Ba) (P= 0.000), posterior sagittal depth of the bony nasopharynx (Ptm - Ba) (P= 0.000), total upper airway thickness (PNS - H) (P= 0.000) and McNamara’s lower pharynx dimension (P= 0.007) when compared to control. On the other hand, control group showed significantly longer soft palate (PNS–P) (P= 0.000), and wider in both thickness of tongue (TGH) and soft palate (MPT) with (P= 0.000). The Tongue Length (TGL) and hyoid bone position did not record any significant difference when compared to subject group. Conclusions: Subjects had narrower pharyngeal airway dimensions when compared with the controls and this was not due to soft tissue hypertrophy but attributed to the smaller bony nasopharyngeal framework and skeletal deformations. Orthognathic surgery is indicated in cleft lip and palate population to correct skeletal discrepancies.

Objective: To exam the pharyngeal airway dimensions in cleft lip and palate subjects and to compare them with controls before orthognathic surgery and to assess the need for orthognathic surgery for these cases. Material and Methods: Pre-orthodontic cephalograms of two hundred patients were used in this study. Twenty one landmarks for sagittal pharyngeal airway and soft tissue measurements had been identified for each cephalogram. Patients were selected according to the specific inclusion criteria and divided into 2 groups according to the presence of cleft lip and palate. The first group was Jordanian cleft lip and palate and consisted of 100 subjects (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.4 ± 2.4 years), and the second group was 100 controls without cleft lip and palate (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.7 ± 2.2 years). Independent t-test was used to detect differences between the two groups. Results: Subject’s pharyngeal airway dimensions were significantly narrower, in the lower airway thickness (PNS - AD1) (P= 0.000), upper airway thickness (PNS - AD2) (P= 0.000), total lower sagittal depth of the bony nasopharynx (PNS - Ba) (P= 0.000), posterior sagittal depth of the bony nasopharynx (Ptm - Ba) (P= 0.000), total upper airway thickness (PNS - H) (P= 0.000) and McNamara’s lower pharynx dimension (P= 0.007) when compared to control. On the other hand, control group showed significantly longer soft palate (PNS–P) (P= 0.000), and wider in both thickness of tongue (TGH) and soft palate (MPT) with (P= 0.000). The Tongue Length (TGL) and hyoid bone position did not record any significant difference when compared to subject group. Conclusions: Subjects had narrower pharyngeal airway dimensions when compared with the controls and this was not due to soft tissue hypertrophy but attributed to the smaller bony nasopharyngeal framework and skeletal deformations. Orthognathic surgery is indicated in cleft lip and palate population to correct skeletal discrepancies.

Introduction: Many variables may influence post-operative symptoms after lower third molar extraction Objectives: To assess which pre and intra-operative variables may influence postoperative signs and symptoms after lower third molar extraction. Materials and Methods: 17 patients scheduled for lower third molar extraction were included in this study. Patients were pre-operatively asked to perform a cold pressor test and to fill a questionnaire about the expectation of pain. Modified Dental Anxiety Scale (MDAS) was used to assess dental anxiety. Swelling and trismus were assessed before surgery, and two days and seven day after surgery. Postoperative pain was assessed at the end of the surgery and for the subsequent 6 days. Maximum post-operative pain was used as main outcome variable. Pearson correlation was used as statistical analysis (p < 0.05). Results: The only two variables correlated to maximum post-operative pain were the expectation of pain during the first day after surgery (r= 0.64, p= 0.006) and the duration of cold pressor test (r= 0.52, p= 0.03). The only variable correlated to trismus and swelling at 2 days was the duration of surgery (r=-.66, p=.007 and r= 0.79, p < 0.001, respectively). Conclusions: Post-operative pain after lower third molar extraction results to be associated to subjective variables as pain expectation and tolerance, instead post-operative signs are found to be associated to the duration of surgery.

Objectives: Identify the social determinants of health (SDH) factors associated with the prevalence of severe periodontal disease in postmenopausal women (PMW) and to compare periodontal parameters with demographic, lifestyle factors, anthropometric measurements and pre-existing diseases in the northeast region of Ohio. Methods: Retrospective, cross-sectional study was conducted using the Case Cleveland Clinic Postmenopausal Wellness Consortium (CCCPWC), a database of over 900 PMW. The periodontal parameters median probing depth (MPD), number of loss teeth (TL), bleeding on probing (BOP) were collected from charts as endpoint measurements. Recession (MR) was likewise collected as a supporting metric. Results: PMW with diabetes had significantly higher TL (13 vs 5; p < 0.001) and BOP (86.2% vs 59.2%; p=0.02); those with osteoporosis had significantly higher TL (10 vs 5; p <0.001) and significantly higher BOP (80% vs 59.9%; p=0.005). MPD was greater in smokers (2 mm vs. 1 mm, p < 0.001). PMW using MSU had significantly higher TL (9 vs 4; p < 0.001) PMW and significantly higher BOP (35.1% vs 20.9%; p=0.003). TL was significantly higher High School Graduate/GED compared to greater than High School, (8 vs 5; p=0.014) PMW with less than High School had significantly higher BOP (p < 0.001). TL was higher in White compared to Mexican American/Other Hispanics (8 vs 5, respectively; p < 0.001). Conclusion: Social determinants play a role in tooth loss and oral inflammation. Strategies to counterbalance social determinants which have an impact on oral health require further investigation and implementation.

Objectives: To evaluate the effect of adding the sodium fluoride to different phosphoric acid concentrations on Shear Bond Strength (SBS) of orthodontics brackets bonded to enamel surface. Methods: Forty eight freshly extracted human premolar for orthodontic purposes, were collected, and were randomly divided into four Groups. G1 etched by 37% Phosphoric acid for 30 s, G2 etched by 25% Phosphoric acid for 30 s, G 3 etched by 37% fluoridated Phosphoric acid (0.863% F-) for 30 s, G4 etched by fluoridated 25 % Phosphoric acid (0.694% F-) for 30s. Stainless steel metal brackets (Forestadent Company-sprint-Brackets) were bonded to teeth using self curing composite (system–RMO/ mono-lok2 bonding). A Universal Testing Machine (Testometric M350-5KN, UK) was used to measure SBS, 24 hours after bonding, and the force applied to the ligature groove between bracket base and wings. Data were analyzed using One- Way ANOVA with Tukey post-hoc test (p = 0.05). Results: The mean SBSs were 14.97 MPa, 15.47MPa, 13.09 MPa and 11.16MPa for Groups 1-4 respectively. Significant differences in shear bond strengths were shown between Groups 2 and 4. Significance: The results suggested that the using mixed phosphoric acid 37% with NaF gel 1.23% for 30 s (0.863%F-) have no effect on SBS and may have a clinical application in the prevention of demineralization or caries surrounding and under orthodontic brackets bonded to enamel. Nevertheless, mixed phosphoric acid 25% with NaF% gel (0.694% F-) results to reducing SBS it may have a clinical application.

Objective: To establish reliability of cephalometric landmark identification in threedimensions using ProPlan CMF software. Methods: Two orthodontist identified a series of 33 cephalometric landmarks on 20 CBCT scans of Class I, pre-orthodontic patients and repeated the landmark identification about two months later. Intraclass correlations (ICC) were calculated by landmark in the X, Y, and Z dimensions and F-test were used to assess difference in landmark location in the X, Y, and Z dimensions. Results: The majority of landmarks had good to excellent ICC for both inter- and intraobserver reliability. F-test also showed the majority of landmarks had no significant difference between the observers. Conclusion: Most landmarks showed good to very good reliability and reproducibility using ProPlan CMF, with some landmarks proving more reliable than others and further research is needed to establish the utility and practicality of three-dimensional cephalometrics as a common diagnostic tool in orthodontics.

Objective: To exam the pharyngeal airway dimensions in cleft lip and palate subjects and to compare them with controls before orthognathic surgery and to assess the need for orthognathic surgery for these cases. Material and Methods: Pre-orthodontic cephalograms of two hundred patients were used in this study. Twenty one landmarks for sagittal pharyngeal airway and soft tissue measurements had been identified for each cephalogram. Patients were selected according to the specific inclusion criteria and divided into 2 groups according to the presence of cleft lip and palate. The first group was Jordanian cleft lip and palate and consisted of 100 subjects (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.4 ± 2.4 years), and the second group was 100 controls without cleft lip and palate (50 females and 50 males, age ranged between 5 and 12 years, mean age was 8.7 ± 2.2 years). Independent t-test was used to detect differences between the two groups. Results: Subject’s pharyngeal airway dimensions were significantly narrower, in the lower airway thickness (PNS - AD1) (P= 0.000), upper airway thickness (PNS - AD2) (P= 0.000), total lower sagittal depth of the bony nasopharynx (PNS - Ba) (P= 0.000), posterior sagittal depth of the bony nasopharynx (Ptm - Ba) (P= 0.000), total upper airway thickness (PNS - H) (P= 0.000) and McNamara’s lower pharynx dimension (P= 0.007) when compared to control. On the other hand, control group showed significantly longer soft palate (PNS–P) (P= 0.000), and wider in both thickness of tongue (TGH) and soft palate (MPT) with (P= 0.000). The Tongue Length (TGL) and hyoid bone position did not record any significant difference when compared to subject group. Conclusions: Subjects had narrower pharyngeal airway dimensions when compared with the controls and this was not due to soft tissue hypertrophy but attributed to the smaller bony nasopharyngeal framework and skeletal deformations. Orthognathic surgery is indicated in cleft lip and palate population to correct skeletal discrepancies.

Introduction: Many variables may influence post-operative symptoms after lower third molar extraction Objectives: To assess which pre and intra-operative variables may influence postoperative signs and symptoms after lower third molar extraction. Materials and Methods: 17 patients scheduled for lower third molar extraction were included in this study. Patients were pre-operatively asked to perform a cold pressor test and to fill a questionnaire about the expectation of pain. Modified Dental Anxiety Scale (MDAS) was used to assess dental anxiety. Swelling and trismus were assessed before surgery, and two days and seven day after surgery. Postoperative pain was assessed at the end of the surgery and for the subsequent 6 days. Maximum post-operative pain was used as main outcome variable. Pearson correlation was used as statistical analysis (p < 0.05). Results: The only two variables correlated to maximum post-operative pain were the expectation of pain during the first day after surgery (r= 0.64, p= 0.006) and the duration of cold pressor test (r= 0.52, p= 0.03). The only variable correlated to trismus and swelling at 2 days was the duration of surgery (r=-.66, p=.007 and r= 0.79, p < 0.001, respectively). Conclusions: Post-operative pain after lower third molar extraction results to be associated to subjective variables as pain expectation and tolerance, instead post-operative signs are found to be associated to the duration of surgery.

Objectives: Identify the social determinants of health (SDH) factors associated with the prevalence of severe periodontal disease in postmenopausal women (PMW) and to compare periodontal parameters with demographic, lifestyle factors, anthropometric measurements and pre-existing diseases in the northeast region of Ohio. Methods: Retrospective, cross-sectional study was conducted using the Case Cleveland Clinic Postmenopausal Wellness Consortium (CCCPWC), a database of over 900 PMW. The periodontal parameters median probing depth (MPD), number of loss teeth (TL), bleeding on probing (BOP) were collected from charts as endpoint measurements. Recession (MR) was likewise collected as a supporting metric. Results: PMW with diabetes had significantly higher TL (13 vs 5; p < 0.001) and BOP (86.2% vs 59.2%; p=0.02); those with osteoporosis had significantly higher TL (10 vs 5; p <0.001) and significantly higher BOP (80% vs 59.9%; p=0.005). MPD was greater in smokers (2 mm vs. 1 mm, p < 0.001). PMW using MSU had significantly higher TL (9 vs 4; p < 0.001) PMW and significantly higher BOP (35.1% vs 20.9%; p=0.003). TL was significantly higher High School Graduate/GED compared to greater than High School, (8 vs 5; p=0.014) PMW with less than High School had significantly higher BOP (p < 0.001). TL was higher in White compared to Mexican American/Other Hispanics (8 vs 5, respectively; p < 0.001). Conclusion: Social determinants play a role in tooth loss and oral inflammation. Strategies to counterbalance social determinants which have an impact on oral health require further investigation and implementation.

Hyaloronic acid is used widely for as a dermal filler for soft tissue augmentation. It may be injected to the perioral region by dental practitioners. Dental implantation is a common procedure in the dental practice. The article describes a case of dental implant failure following dermal filler injection and describes the possible reasons.

Background: Synaptic adhesion molecules regulate synapse development and maintenance. Neurexins and neuroligins have been implicated in psychiatric disorders, and shown that they are related to vascular system and carcinomas in recent studies. In the present study we focused neurexin 1 and neuroligin1, and investigated the relationship between those two molecules expression and clinical features of oral cancer. Materials and methods: Fifty-six biopsy samples from oral squamous cell carcinomas (OSCCs) were analyzed semi quantitatively by immunohistochemistry. Correlations between the expression level of neurexin 1, neuroligin 1, p53, Ki67 and the clinical features of OSCCs were statistically analyzed. Results: The neurexin 1 expression group contained significantly advanced T (P < 0.05) and N classification positive cases (P < 0.01) by univariate analysis. Overall survival was compared with Kaplan-Meier analysis and the log rank statistic. The prognosis of neuroligin 1 expression group was significantly more favorable (P < 0.05). A Cox proportional hazards model was used to test the significance of survival time, and N classification positive (P < 0.05), neurexin 1 (P < 0.05) and neuroligin 1 (P < 0.01) were predictive factor for survival. Conclusions: Synaptic adhesive molecule could be useful prognosis factor for OSCC and may help to determine therapeutic policy

The purpose of this article is to discuss the management of postoperative complications such as bleeding and the “liver clot” formation. The diagnosis of “lover clot” is based on the clinical appearance, due to the similarity to the tissue of the liver. Minor bleeding post extraction is a common occurrence in oral surgery. This event might occur during the procedure, immediate after the extraction or about 1-3 days post-surgery. However, significant bleeding is an unusual, if not rare event encountered post treatment, in dental practice, even for patients without any known risk factors. A review of the medical and dental literature revealed only ten reports of excessive bleeding, drug-abuse related following dental procedures [1]. To achieve a proper hemostasis, a certain protocol should be followed. Detailed review of patient’s medical history is imperative in preventing any post extraction complications. In some cases consultation with patient’s physician is necessary. Certain conditions such as liver disease, cancer, congestive heart failure, antiplatelet agents, anticoagulants and pain management medications, as well as advanced age can contribute to excessive post extraction bleeding. In some extreme cases (lower than 20000 platelets per microliter), platelets transfusion is indicated. On the other hand, several observational studies demonstrated the safety in performing invasive procedures for patients with thrombocytopenia whom did not receive any prophylactic PLT transfusions. These findings support the notion that in patients with INR < 3.0, it is relatively safe to perform tooth extraction without a significant increase in the risk of bleeding [2]. However if a patient with blood clotting problems presents for an emergency visit, the decision to provide treatment might be based on dentist’s level of comfort in performing the surgical procedure. The utilization of certain local measures: local infiltration anesthesia in addition to inferior alveolar nerve block, placement of Gelfoam, careful suturing, Ice pack utilization, etc., will contribute to a successful outcome.

In the genus Slackia, Slackia exigua (formerly Eubacterium exiguum) is isolated from the human oral cavity. A relationship was recently reported between S. exigua and periodontal disease, including chronic periodontitis and peri-implantitis. A suitable selective medium for the isolation of S. exigua is needed in order to assess the veritable prevalence of this organism in various lesions of the oral cavity. The purpose of the present study was to develop selective media for the isolation of S. exigua and investigate whether the monitoring of S. exigua levels is useful as a clinical indicator for the diagnosis of peri-implantitis. In order to examine the bacterium population in the oral cavity, a novel selective medium (SEXSM) was herein developed for the isolation of S. exigua. SEXSM consists of tryptic soy agar, yeast extract, hemin, Vitamin K1, L-cysteine, sheep blood, 2-phenylethanol, trimethoprim, nalidixic acid, and polymyxin B. The average growth recovery of S. exigua on SEXSM was 98.3% that on CDC blood agar. The growth of other representative oral bacteria, i.e., the genera Streptococcus, Actinomyces, Neisseria, Corynebacterium, Veillonella, Fusobacterium, and Rothia, was strongly inhibited on the selective medium. PCR primers were designed based on partial sequences of the 16S rDNA genes of S. exigua. These primers reacted with S. exigua, but not with other representative oral bacteria. These results indicate that these primers are useful for identifying S. exigua. The proportion of S. exigua in Gingival Crevicular Fluids (GCF) collected from periodontally Healthy with Implants (HI) and Peri-Implantitis (PI) groups was examined. Colonies on SEXSM were subcultured for confirmation by a PCR analysis using the primers designed in the present study. The growth recoveries of S. exigua strains on SEXSM were very satisfactory. S. exigua in GCFs of the HI and PI groups were detected at 0.002%, and 1.7% to the total bacteria number, respectively. The selective medium, designated SEXSM, and a PCR method using the primers designed in the present study were useful for the isolation and identification of S. exigua. Moreover, the monitoring of S. exigua levels was useful as a clinical indicator for the diagnosis of periimplantitis.

In this case, ISW (improved superelastic Ti–Ni alloy wire, commonly called a lowhysteresis wire, developed by Tokyo Medical and Dental University) was employed in the treatment of an adult facial asymmetry skeletal Class III case without extraction and surgery. A 23-year-old man came to our clinic with a chief complaint of poor bite and for esthetic consultation. A clinical examination revealed a bilateral Class III molar relationship with anterior crossbite and mild crowding with a lower midline deviated to the right. Active treatment included establishment of a crossbite arch in the upper arch by using an ISW without extraction and removal of the lower-right fixed bridge prosthesis. Using ISW and adequate Class III intermaxillary elastic traction meant that the malocclusion was corrected with a minimal orthodontic approach. Treatment was completed within 19 months, and a stable occlusion was achieved after the active treatment.

Purpose: The purpose of this study was to compare the retention of zirconia copings cemented onto zirconia implant abutments using four methacrylate-based resin cements and a temporary cement. Materials and Methods: Fifty zirconia copings (Cercon Base) and 10 zirconia abutments (Procera Esthetic Abutments) were fabricated and cemented using four methacrylate-based resin cements and one temporary cement (n = 10). All copings were thermal cycled and the tensile bond strength of the copings was recorded using universal testing machine. One-way analysis of variance (ANOVA) and Tamhane’s T2 tests were used for statistical analysis. Results: Retention values of different cements presented significant differences (P < 0.01). The methacrylate-based resin cements [Premier: 127,95 (± 19,18), Dentotemp: 110 (± 15,48), Cem-implant: 70,38 (± 12,11), Improv: 69,64 (± 16,63)] had more retention than the temporary cement [Tempbond:36,92 (±6,2)].With a higher percentage (78%), cement failure occurred at the cement/abutment interface and the cement remained mostly within the zirconia coping. Conclusion: The cement type may have an influence on the retention of zirconia copings cemented onto zirconia implant abutments. The ranking of the methacrylate-based resin cements used, may direct the cement preference of a clinician in terms of providing desired retention.

The aim of this study is to determine the correlation between the DMFT index of 12-yearold children from the Southeast region and the concentration of fluorine in drinking water from the populated areas where children live. Material and methods: In the examination, 129 children were enrolled, out of 2 central and 2 regional primary schools, at which the DMFT index was determined. The children live in 2 different cities and 2 different villages. Four water samples were taken from the examined area to determine the fluorine concentration by using the electrochemical method using the pH / ISE meter-Thermo-Orion with a special F-electrode (Thermo Orion Ion Plus Fluoride Electrode) at the Institute for public health. Spearman’s method was used to determine the correlation between the specified variables. Results: The total number of children in the examined sample was 129, out of which 70 (54.3%) were male and 59(45.7%) were female. The average DMFT index in this group of children was 1.94 with a standard deviation of ± 2.5. Maximum concentration of fluorine in drinking water of 1.36 ppmF was determined in the village Bansko, and 0.36 ppmF in the village Murtino, while the minimum (0.08 ppmF) in the city Strumica. Correlation of the DMFT index in 12-year old children from the Southeast region and the concentration of fluorine in the drinking water has a negative, indirect correlation, with the value of the coefficient r = - 0.1655. Conclusion: The correlation between the DMFT index and the concentration of drinking water is a negative, indirect correlation and statistically, this correlation is highly significant (p < 0.05).

Objectives: To determine the quality of maintained dental records and analyze the knowledge and use of them in any of forensic or medico-legal purposes by Sirte’s dental practitioners. Materials and Methods: A cross-sectional survey was conducted in a sample of 70 dental practitioners in Sirte and data were collected through a structured questionnaire. The data so gathered were subjected for descriptive analysis. Results: 80 % of surveyed dentists maintained records but only 10% of them kept the complete dental record. When asked about duration of maintained records, 61% of them kept for less than three years. About 56% of sample used paper prepared form as method to maintain dental records and only 20% used computer software. 91% of practitioners did not think that mandatory to legally maintain the dental records, when asked about whether the legal rights of owning the dental records in Sirte is it medico-legally important, 98% response was yes. The significance of dental records for forensic needs was evaluated, only 18% dental practitioners were asked to produce any records in forensic court of law. Only 3% asked to produce dental file for forensic purposes. 55% of practitioners did not know how to estimate the age of individual. About 94% of sample did not have any training in forensic dentistry. All the surveyed dentists’ response was yes, when asked about the importance of forensic dentistry in Libya. Conclusions: The present study showed Non-maintenance or poor quality of dental records maintained. Our study revealed that the dentists in Sirte are not prepared for any kind of forensic and medico-legal need if it arises due to the poor knowledge, attitude and lack of practice of forensic odontology

ynchronous malignancy with squamous cell carcinoma (SCC) in the head and neck occurs mainly in the aerodigestive tract, with a frequency of 60-70%. In contrast, SCC in the head and neck very rarely coincides with malignant lymphoma (ML). Here we report a case of synchronous SCC on the lower-left surface of the tongue and ML on the left –side of the neck in a 75-year-old man. The patient had consulted a local doctor for a mass on the left side of his neck. After enucleation of the neck mass, the pathological diagnosis was metastatic malignant tumor of unspecified origin. On the other hand, the tongue lesion was regarded as benign and followed-up. For further diagnosis of the lesions, the patient was transferred to our hospital in March 2015. Biopsy indicated tongue SCC. Resection of the primary tongue lesion and radical neck dissection of the left side neck were then performed. The cervical mass was diagnosed as ML, and found to be simultaneously affected by the tongue SCC and cervical ML. Approximately two years later, a follow-up CT showed recurrent ML on the left tonsil, which was treated by chemotherapy.

Objectives: To determine the quality of maintained dental records and analyze the knowledge and use of them in any of forensic or medico-legal purposes by Sirte’s dental practitioners. Materials and Methods: A cross-sectional survey was conducted in a sample of 70 dental practitioners in Sirte and data were collected through a structured questionnaire. The data so gathered were subjected for descriptive analysis. Results: 80 % of surveyed dentists maintained records but only 10% of them kept the complete dental record. When asked about duration of maintained records, 61% of them kept for less than three years. About 56% of sample used paper prepared form as method to maintain dental records and only 20% used computer software. 91% of practitioners did not think that mandatory to legally maintain the dental records, when asked about whether the legal rights of owning the dental records in Sirte is it medico-legally important, 98% response was yes. The significance of dental records for forensic needs was evaluated, only 18% dental practitioners were asked to produce any records in forensic court of law. Only 3% asked to produce dental file for forensic purposes. 55% of practitioners did not know how to estimate the age of individual. About 94% of sample did not have any training in forensic dentistry. All the surveyed dentists’ response was yes, when asked about the importance of forensic dentistry in Libya. Conclusions: The present study showed Non-maintenance or poor quality of dental records maintained. Our study revealed that the dentists in Sirte are not prepared for any kind of forensic and medico-legal need if it arises due to the poor knowledge, attitude and lack of practice of forensic odontology.