ObjectiveEnterococcus faecalis (E. faecalis) is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine (CHX) is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature.Material and MethodsA comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05.ResultsEighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles). Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa) was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (p<0.001). Random effect model demonstrated no significant difference between CH/CHX mixture and CH alone in their effect on E. faecalis (p=0.115).ConclusionsAccording to the evidence available now, mixing CH with CHX does not significantly increase the antimicrobial activity of CH against E. faecalis. It appears that mixing CH with CHX does not improve its ex vivo antibacterial property as an intracanal medicament against E. faecalis. Further in vivo studies are necessary to confirm and correlate the findings of this study with the clinical outcomes.

Changing the injection site anteropos-teriorly did not influence the success rate of the AMSA nerve block injection.

Aim. The aim of this study was to compare lower dental arch changes using two types of space regainers, including a removable appliance with a distalizing screw and a fixed double-banded appliance. Methods and Materials. In this case-control study, the study sample was comprised of thirty-eight children with mixed dentitions, all of whom had unilateral space deficiency due to premature loss of the second deciduous molar in the mandibular arch. Patients were treated with either a removable appliance with a distalizing screw or a fixed double-banded space regainer (DBSR) (n = 19). Pre- and posttreatment dental casts and lateral cephalograms of patients were evaluated to compare the effects of the two space-regaining devices on the mandibular dental arch. The data were analyzed using paired and independent t-tests. Results. Available space, molar angle, IMPA, and the first molar distance to the mandibular plane and symphysis increased significantly in both groups ( P < 0.001 ). The mean amount of IMPA changes was significantly greater in the distalizing screw group than in the DBSR group ( P < 0.05 ). But, there were no statistically significant differences between the mean changes of available space, molar angle, and the first molar distance to the mandibular plane and symphysis in the distalizing screw and the DBSR group ( P < 0.05 ). The DBSR group’s treatment time was significantly shorter ( P < 0.001 ). Conclusion. The removable device with a distalizing screw and the DBSR were both able to regain mild-to-moderate unilateral space loss, achieving an increase in molar angle, IMPA, and molar extrusion. However, treatment time with the DBSR was shorter and with less incisor tipping as a side effect.

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Background Nicotine can have detrimental effects on dental implant osseointegration. This study aimed to evaluate the influence of systemic l-arginine supplement on the osseointegration of dental implants in nicotine consumer dogs. Methods Twelve 1-year Labrador Retriever dogs had their right and left third and fourth mandibular premolars removed, and the sockets were left to heal for 6 months. Dogs were randomly divided into three groups (n = 16): group 1—0.2 mg/kg nicotine was injected twice daily; group 2—0.2 mg/kg nicotine was injected twice daily in addition to 200 mg/kg l-arginine capsules taken orally; and group 3—placebo. Forty-eight dental implants were inserted into the healed sockets of the dog’s mandible and were assessed by implant stability quotient (ISQ) using resonance frequency analysis (RFA) during 4 weeks and insertion and removal torque value analysis. Results No implant failure occurred during the study period. The change in torque value between insertion and removal was similar in the placebo and nicotine+arginine consumer dogs (p = 0.276), which shows a positive effect of arginine supplementation in nicotine consumers. There was a significant difference in torque value change between nicotine+arginine vs. nicotine consumers (p = 0.049) and placebo vs. nicotine (p = 0.003). After 4 weeks, the placebo had the most significant improvement in torque value (47.0 ± 16.9), followed by nicotine+arginine (25.1 ± 37.8), and the worst torque value was for the nicotine group (− 5.7 ± 24.0) pound per inch. The results show that except in the first week, there are significant differences in ISQ between the groups in different periods. ISQ in all of the groups has reduced at first but then increased over time. At the time of implant placement, insertion torque was significantly higher in the nicotine consumer group than the nicotine+arginine consumer group and placebo group (p = 0.020). Conclusion Arginine supplementation promotes bone healing and implant primary stability by improving dental implant osseointegration biomechanical characteristics.