Dental education in Lebanon is delivered by three universities, one public and two private, throu... more Dental education in Lebanon is delivered by three universities, one public and two private, through multiple programs and teaching languages, in the absence of a national competency framework for dentistry education. Additionally, one private university offers a postgraduate training program in orthodontics without having a dentistry program. Dental education in Lebanon produces dentists with a good reputation, recognized nationally and internationally, for their knowledge, expertise, and professionalism. This high-quality dental care has attracted Lebanese expatriates and
Dental education in Lebanon is delivered by three universities, one public and two private, throu... more Dental education in Lebanon is delivered by three universities, one public and two private, through multiple programs and teaching languages, in the absence of a national competency framework for dentistry education. Additionally, one private university offers a postgraduate training program in orthodontics without having a dentistry program. Dental education in Lebanon produces dentists with a good reputation, recognized nationally and internationally, for their knowledge, expertise, and professionalism. This high-quality dental care has attracted Lebanese expatriates and
Aims: The aim of the present in vitro study was to compare the effectiveness of passive ultrasoni... more Aims: The aim of the present in vitro study was to compare the effectiveness of passive ultrasonic irrigation (PUI), sonic irrigation, and mechanic dynamic activation on the removal of debris and smear layer from primary mandibular second molars during pulpectomy. Materials and methods: Mesial roots of 48 primary mandibular second molars were prepared with an R-motion 21 mm file (30/0.04) (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland), irrigated with 1% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), and divided into four groups (n = 24 canals) according to the final irrigation activation technique: control group without activation, PUI with Ultra-X (Eighteeth, Changzhou, China), mechanical activation with XP-endo Finisher (FKG), and sonic irrigation with EQ-S (Meta Biomed, Chungcheongbuk-do, Korea). The roots were split longitudinally and analyzed using scanning electron microscopy (SEM). The presence of debris and smear layer was assessed using a 5-grade scoring scale with 200× and 1000× magnification, respectively. The Kruskal-Wallis and Friedman tests were used for data analysis. Results: The activation of the irrigant significantly improved debris and smear layer removal (p < 0.001). There was no significant difference between Ultra-X, XP-endo Finisher, and EQ-S (p > 0.05). No activation technique was able to completely eliminate debris and smear layer from the root canals of primary mandibular second molars. Conclusions: During pediatric pulpectomy, the irrigation protocol must include activation of the irrigation solutions using either ultrasonic, sonic, or mechanical activation techniques to enhance the removal of debris and smear layer for a better prognosis. Clinical significance: During root canal treatment on primary teeth, the clinician must incorporate an activation technique in the irrigation protocol to enhance the removal of debris and smear layer and increase the success of the treatment.
Pulpotomy is a frequent endodontic treatment performed in children. Even though it is a safe proc... more Pulpotomy is a frequent endodontic treatment performed in children. Even though it is a safe procedure, side effects have been reported. Case Report: A 10-year-old boy came for a dental checkup. X-ray findings showed a radiolucent lesion above the maxillary second deciduous left molar, related to the permanent tooth. Extraction of the first and second deciduous molars was realized under local anesthesia. The cystic lesion was removed surgically, and histo-pathological analysis showed an inflammatory dentigerous cyst. A marsupialization cavity was created to allow eruption of the premolars. After a one-year follow-up, the bone had completely regenerated, and premolars had completely erupted. Conclusion: This case report highlights the need for regular supervision of pulp treated teeth, even if they are asymptomatic, as well as eruption phase of permanent and deciduous teeth. Marsupialization of the dentigerous cyst provided effective treatment and allowed preservation of the involved...
Purpose: Because of the high rate of agenesis and supernumerary teeth in orthodontic patients and... more Purpose: Because of the high rate of agenesis and supernumerary teeth in orthodontic patients and the lack of studies in Lebanon that document the prevalence of those anomalies, the aim of this study was to determine the prevalence of hypodontia and supernumerary teeth in patients attending a pediatric dental office and examine the associated factors. Study design: This was a cross-sectional design study. The patients were clinically examined followed by panoramic radiograph. Two calibrated investigators have examined the radiographic films and diagnosed the dental anomalies. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Tooth agenesis was diagnosed when there were no sign of crown calcification and no evidence or history of loss attributable to orthodontic treatment, caries, periodontal problems and dental trauma. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Chi-Square tests and Fisher Exact tests were performed t...
The aim of this in vitro study was to assess the dentinal tubule penetration of three different s... more The aim of this in vitro study was to assess the dentinal tubule penetration of three different sealers, AH Plus, BC Sealer and a novel tricalcium silicate sealer (NTS). Ninety-six human maxillary central incisors were divided into three experimental groups (n = 32) and were filled with gutta-percha using a single-cone technique in conjunction with one of the three sealers: AH Plus, BC Sealer or NTS. The roots in each group were cross-sectioned at 1 and 5 mm from the root apex, and the surfaces were examined under confocal laser scanning microscopy (CLSM). The sealer penetration depths were measured at their maximum depths and at four circumferential depths (12, 3, 6 and 9 o'clock) and were evaluated using ImageJ software (ImageJ, NIH). The maximum and mean penetration depths were significantly higher at 5 mm compared to 1 mm from the apex in the AH Plus (p < 0.001), BC Sealer (p < 0.001) and NTS groups (p < 0.001). No significant difference was observed between the gro...
Journal of International Society of Preventive & Community Dentistry
Minimal invasive endodontics preserve coronal and radicular tooth structure to increase the fract... more Minimal invasive endodontics preserve coronal and radicular tooth structure to increase the fracture resistance of teeth. The aim of this study was to assess the influence of final preparation taper on the fracture resistance of maxillary premolars. Sixty maxillary premolars were selected and divided into 2 groups: 30 were shaped with a final apical diameter 30 and a 4% taper and 30 with 6% taper using iRaCe instrument (FKG dentaire, Switzerland). All root canals were irrigated with sodium hypochlorite and final rinse with ethylenediaminetetraacetic acid. All canals were filled with gutta-percha single-cone filling technique and AHPlus sealer (Dentsply- Maillefer, Baillagues, Switzerland) and access cavity restored with resin composite. Roots were wax coated, placed in an acrylic mold and loaded to compressive strength fracture in a mechanical material testing machine recording the maximum load at fracture and fracture pattern (favorable/restorable or unfavorable/unrestorable). Frac...
Statement of problem. Data for the color stability of dual‐polymerized and light‐polymerized resi... more Statement of problem. Data for the color stability of dual‐polymerized and light‐polymerized resin cements used in esthetic dentistry are lacking. Purpose. The purpose of this in vitro study was to evaluate the color stability of 4 types of composite resin cements after water aging. Material and methods. Specimens (n=30) of each resin cement (Variolink Esthetic LC, RelyX Ultimate DC, Nexus 3 DC, Nexus 3 LC) were prepared. The shade selected was Light+ for Variolink Esthetic, B 0.5 for RelyX Ultimate, and White for both Nexus 3 DC and LC. All 120 specimens were aged by water for 30 days at 37°C under dark conditions, using a thermocycling machine. The specimens' color characteristics (L*, luminosity; a*, red‐green; b*, yellow‐blue) and color differences (&Dgr;E) were measured with a spectrophotometer before day 0, after day 1, and after 30 days of immersion. Statistical analysis used ANOVA and Tukey post hoc tests (&agr;=.05). Results. Considering &Dgr;E<3.3 as clinically acceptable, results showed significant color variations for all cements (RelyX Ultimate=3.69; Nexus 3 LC=3.76; Nexus 3 DC=5.34), except for Variolink Esthetic (0.88). However, this variation was significantly less when day 1 was considered the baseline measurement, showing clinically acceptable &Dgr;E values for all types of cement. Conclusions. Water aging had a significant effect on color stability; most color variations occurred in the first 24 hours of polymerization, with relatively nonsignificant variations afterwards.
Journal of Contemporary Dental Practice, Nov 1, 2018
The aim of this study was to compare and evaluate the retention of two new attachment systems use... more The aim of this study was to compare and evaluate the retention of two new attachment systems used for implant-supported overdentures subjected to insertion-removal cycles. Twenty custom-manufactured polyvinyl chloride models mimicking implant-retained over-dentureresin blocks were fabricated and divided into two groups (n = 10): group 1 ('Kerator' attachment) and group 2 ('EMI' attachment). Each model received two parallel implants (JD evolution®) 20 mm apart and was subjected to cyclic retention forces of 10, 100, 1000, 5000, 10000 and 14600 cycles using a universal testing machine in a 0.9% sodium chloride water solution at 22° C. Data were analyzed using one-way analysis of variance; the level of significance was set at a < 0.05. The 'Kerator' and 'EMI' attachment systems reported a significant decrease in retention (64 and 56.6% respectively) after 14600 insertion-removal cycles (p < 0.001). The 'EMI' attachment showed significant h...
Lead exposure is a global environmental problem inducing lifelong adverse health effects. Childre... more Lead exposure is a global environmental problem inducing lifelong adverse health effects. Children's exposure to lead, from birth to 6 months, is typically dominated by dietary sources. The first primary mandibular molar could provide an integrated record of lead exposure. The aim of this study is to detect the level of lead in the first primary molar of a group of Lebanese children born between 1990 and 2000, living in Beirut and suburbs, and to compare the amount of lead according to gender and feeding mode.
The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have recommend... more The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have recommended that the child's first dental visit should be during the child's first year of life for dental disease prevention and to decrease the invasive restorative interventions. In Lebanon, no study has been conducted to determine the age and the reasons of the first dental visit of children and who requested the first dental screening. To assess at what age occurred the first dental visit in a group of Lebanese children visiting a private pediatric dental clinic and to explore the reasons for their first dental consultation. An observational cross-sectional study was conducted. During a five-year period, all children visiting the pediatric clinic were invited to participate in the study. Parents were asked about the general health status of their child, the use of antibiotics before the age of 2 years. Parents were also requested to give the dental reasons for their initial visit to ...
Dental education in Lebanon is delivered by three universities, one public and two private, throu... more Dental education in Lebanon is delivered by three universities, one public and two private, through multiple programs and teaching languages, in the absence of a national competency framework for dentistry education. Additionally, one private university offers a postgraduate training program in orthodontics without having a dentistry program. Dental education in Lebanon produces dentists with a good reputation, recognized nationally and internationally, for their knowledge, expertise, and professionalism. This high-quality dental care has attracted Lebanese expatriates and
Dental education in Lebanon is delivered by three universities, one public and two private, throu... more Dental education in Lebanon is delivered by three universities, one public and two private, through multiple programs and teaching languages, in the absence of a national competency framework for dentistry education. Additionally, one private university offers a postgraduate training program in orthodontics without having a dentistry program. Dental education in Lebanon produces dentists with a good reputation, recognized nationally and internationally, for their knowledge, expertise, and professionalism. This high-quality dental care has attracted Lebanese expatriates and
Aims: The aim of the present in vitro study was to compare the effectiveness of passive ultrasoni... more Aims: The aim of the present in vitro study was to compare the effectiveness of passive ultrasonic irrigation (PUI), sonic irrigation, and mechanic dynamic activation on the removal of debris and smear layer from primary mandibular second molars during pulpectomy. Materials and methods: Mesial roots of 48 primary mandibular second molars were prepared with an R-motion 21 mm file (30/0.04) (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland), irrigated with 1% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), and divided into four groups (n = 24 canals) according to the final irrigation activation technique: control group without activation, PUI with Ultra-X (Eighteeth, Changzhou, China), mechanical activation with XP-endo Finisher (FKG), and sonic irrigation with EQ-S (Meta Biomed, Chungcheongbuk-do, Korea). The roots were split longitudinally and analyzed using scanning electron microscopy (SEM). The presence of debris and smear layer was assessed using a 5-grade scoring scale with 200× and 1000× magnification, respectively. The Kruskal-Wallis and Friedman tests were used for data analysis. Results: The activation of the irrigant significantly improved debris and smear layer removal (p < 0.001). There was no significant difference between Ultra-X, XP-endo Finisher, and EQ-S (p > 0.05). No activation technique was able to completely eliminate debris and smear layer from the root canals of primary mandibular second molars. Conclusions: During pediatric pulpectomy, the irrigation protocol must include activation of the irrigation solutions using either ultrasonic, sonic, or mechanical activation techniques to enhance the removal of debris and smear layer for a better prognosis. Clinical significance: During root canal treatment on primary teeth, the clinician must incorporate an activation technique in the irrigation protocol to enhance the removal of debris and smear layer and increase the success of the treatment.
Pulpotomy is a frequent endodontic treatment performed in children. Even though it is a safe proc... more Pulpotomy is a frequent endodontic treatment performed in children. Even though it is a safe procedure, side effects have been reported. Case Report: A 10-year-old boy came for a dental checkup. X-ray findings showed a radiolucent lesion above the maxillary second deciduous left molar, related to the permanent tooth. Extraction of the first and second deciduous molars was realized under local anesthesia. The cystic lesion was removed surgically, and histo-pathological analysis showed an inflammatory dentigerous cyst. A marsupialization cavity was created to allow eruption of the premolars. After a one-year follow-up, the bone had completely regenerated, and premolars had completely erupted. Conclusion: This case report highlights the need for regular supervision of pulp treated teeth, even if they are asymptomatic, as well as eruption phase of permanent and deciduous teeth. Marsupialization of the dentigerous cyst provided effective treatment and allowed preservation of the involved...
Purpose: Because of the high rate of agenesis and supernumerary teeth in orthodontic patients and... more Purpose: Because of the high rate of agenesis and supernumerary teeth in orthodontic patients and the lack of studies in Lebanon that document the prevalence of those anomalies, the aim of this study was to determine the prevalence of hypodontia and supernumerary teeth in patients attending a pediatric dental office and examine the associated factors. Study design: This was a cross-sectional design study. The patients were clinically examined followed by panoramic radiograph. Two calibrated investigators have examined the radiographic films and diagnosed the dental anomalies. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Tooth agenesis was diagnosed when there were no sign of crown calcification and no evidence or history of loss attributable to orthodontic treatment, caries, periodontal problems and dental trauma. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Chi-Square tests and Fisher Exact tests were performed t...
The aim of this in vitro study was to assess the dentinal tubule penetration of three different s... more The aim of this in vitro study was to assess the dentinal tubule penetration of three different sealers, AH Plus, BC Sealer and a novel tricalcium silicate sealer (NTS). Ninety-six human maxillary central incisors were divided into three experimental groups (n = 32) and were filled with gutta-percha using a single-cone technique in conjunction with one of the three sealers: AH Plus, BC Sealer or NTS. The roots in each group were cross-sectioned at 1 and 5 mm from the root apex, and the surfaces were examined under confocal laser scanning microscopy (CLSM). The sealer penetration depths were measured at their maximum depths and at four circumferential depths (12, 3, 6 and 9 o'clock) and were evaluated using ImageJ software (ImageJ, NIH). The maximum and mean penetration depths were significantly higher at 5 mm compared to 1 mm from the apex in the AH Plus (p < 0.001), BC Sealer (p < 0.001) and NTS groups (p < 0.001). No significant difference was observed between the gro...
Journal of International Society of Preventive & Community Dentistry
Minimal invasive endodontics preserve coronal and radicular tooth structure to increase the fract... more Minimal invasive endodontics preserve coronal and radicular tooth structure to increase the fracture resistance of teeth. The aim of this study was to assess the influence of final preparation taper on the fracture resistance of maxillary premolars. Sixty maxillary premolars were selected and divided into 2 groups: 30 were shaped with a final apical diameter 30 and a 4% taper and 30 with 6% taper using iRaCe instrument (FKG dentaire, Switzerland). All root canals were irrigated with sodium hypochlorite and final rinse with ethylenediaminetetraacetic acid. All canals were filled with gutta-percha single-cone filling technique and AHPlus sealer (Dentsply- Maillefer, Baillagues, Switzerland) and access cavity restored with resin composite. Roots were wax coated, placed in an acrylic mold and loaded to compressive strength fracture in a mechanical material testing machine recording the maximum load at fracture and fracture pattern (favorable/restorable or unfavorable/unrestorable). Frac...
Statement of problem. Data for the color stability of dual‐polymerized and light‐polymerized resi... more Statement of problem. Data for the color stability of dual‐polymerized and light‐polymerized resin cements used in esthetic dentistry are lacking. Purpose. The purpose of this in vitro study was to evaluate the color stability of 4 types of composite resin cements after water aging. Material and methods. Specimens (n=30) of each resin cement (Variolink Esthetic LC, RelyX Ultimate DC, Nexus 3 DC, Nexus 3 LC) were prepared. The shade selected was Light+ for Variolink Esthetic, B 0.5 for RelyX Ultimate, and White for both Nexus 3 DC and LC. All 120 specimens were aged by water for 30 days at 37°C under dark conditions, using a thermocycling machine. The specimens' color characteristics (L*, luminosity; a*, red‐green; b*, yellow‐blue) and color differences (&Dgr;E) were measured with a spectrophotometer before day 0, after day 1, and after 30 days of immersion. Statistical analysis used ANOVA and Tukey post hoc tests (&agr;=.05). Results. Considering &Dgr;E<3.3 as clinically acceptable, results showed significant color variations for all cements (RelyX Ultimate=3.69; Nexus 3 LC=3.76; Nexus 3 DC=5.34), except for Variolink Esthetic (0.88). However, this variation was significantly less when day 1 was considered the baseline measurement, showing clinically acceptable &Dgr;E values for all types of cement. Conclusions. Water aging had a significant effect on color stability; most color variations occurred in the first 24 hours of polymerization, with relatively nonsignificant variations afterwards.
Journal of Contemporary Dental Practice, Nov 1, 2018
The aim of this study was to compare and evaluate the retention of two new attachment systems use... more The aim of this study was to compare and evaluate the retention of two new attachment systems used for implant-supported overdentures subjected to insertion-removal cycles. Twenty custom-manufactured polyvinyl chloride models mimicking implant-retained over-dentureresin blocks were fabricated and divided into two groups (n = 10): group 1 ('Kerator' attachment) and group 2 ('EMI' attachment). Each model received two parallel implants (JD evolution®) 20 mm apart and was subjected to cyclic retention forces of 10, 100, 1000, 5000, 10000 and 14600 cycles using a universal testing machine in a 0.9% sodium chloride water solution at 22° C. Data were analyzed using one-way analysis of variance; the level of significance was set at a < 0.05. The 'Kerator' and 'EMI' attachment systems reported a significant decrease in retention (64 and 56.6% respectively) after 14600 insertion-removal cycles (p < 0.001). The 'EMI' attachment showed significant h...
Lead exposure is a global environmental problem inducing lifelong adverse health effects. Childre... more Lead exposure is a global environmental problem inducing lifelong adverse health effects. Children's exposure to lead, from birth to 6 months, is typically dominated by dietary sources. The first primary mandibular molar could provide an integrated record of lead exposure. The aim of this study is to detect the level of lead in the first primary molar of a group of Lebanese children born between 1990 and 2000, living in Beirut and suburbs, and to compare the amount of lead according to gender and feeding mode.
The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have recommend... more The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have recommended that the child's first dental visit should be during the child's first year of life for dental disease prevention and to decrease the invasive restorative interventions. In Lebanon, no study has been conducted to determine the age and the reasons of the first dental visit of children and who requested the first dental screening. To assess at what age occurred the first dental visit in a group of Lebanese children visiting a private pediatric dental clinic and to explore the reasons for their first dental consultation. An observational cross-sectional study was conducted. During a five-year period, all children visiting the pediatric clinic were invited to participate in the study. Parents were asked about the general health status of their child, the use of antibiotics before the age of 2 years. Parents were also requested to give the dental reasons for their initial visit to ...
Resin composites, which are commonly used in restorative dentistry, consist of a cross-linked pol... more Resin composites, which are commonly used in restorative dentistry, consist of a cross-linked polymer matrix and fillers at 60 to 80 % by weight. The resins used are generally made of very large molecules, like bisphenol A glycidyl methacrylate (BIS-GMA), a highly viscous component. In view of reducing the composite’s viscosity and improving its handling properties, other components are usually added, such as the diluent tri-ethylene glycoldimethacrylate (TEGDMA). The mineral fillers should be of very small size and treated on their surface by a silane coupling agent,which is added and linked to the particles in order to achieve strong bonding with the resin during polymerization.
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