Journal of Dental Medicine

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Normal 0 false false false EN-US X-NONE AR-SA Mumps is a contagious, acute, self limiting, benign disease with very low mortality rate. By classic clinical view, Mumps is increased volume of parotid glands. The disease was known specific disease of parotid glands for many years. Hence, it was named as epidemic parotitis with local and limited site of affecting area. As well as parotid glands, it can affect testicles, ovaries, central nervous system, pancreas, heart, kidneys, thyroid gland, etc.  Researchers showed that the disease is not limited to parotid glands but can provoke generalized reactions in the body and parotitis is just the most prevalent clinical feature of it. 21 cases recruited from Imam hospital were observed in this study. The results were similar to the previous international ones except about the frequency rate of the disease which is due to incomplete vaccination in Iran.

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Recently. Minalux alloy, a base metal free from Be, has been presented on the market while no special soldering has been recommended for it. On the other hand, based on the manufacturer's claim, this alloy is similar to Verabond2. The aim of this study was to investigate the tensile strength of Minalux and Verabond2, soldered by Verasolder. Twelve standard dambble shape samples, with the length of 18 mm and the diameter of 3mm, were prepared from each alloy. Six samples of each alloy were divided into two pieces with carboradom disk. Soldering gap distance was 0.3mm, measured by a special jig and they were soldered by Verasolder alloy. Six other samples, of both Iranian and foreign unsoldered alloys were considered as control group. Then samples were examined under tensile force and their tensile strength was recorded. Two- way variance analysis showed that the tensile strength of Minalux alloy and Verabond2 were not statistically significant (Verasoler 686, Minalux 723), but after soldering, such difference became significant (Minalux 308, Verabond2 432). Verabond2 showed higher tensile strength after soldering.

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Waxes have a lot of applications in dentistry. Such materials are of thermoplastic type that undergoes deformation in different temperatures. Two important properties of base plate waxes are flow and their coefficient of linear thermal expansion. Recently, different institutions, inside the country, produce dentistry waxes, while they have not been standardized. Consequently, consumers' dissatisfaction are observed. In this research, the two above- mentioned factors were compared between three kinds of Iranian waxes with Cavex that is foreign production, based on test number 24 of ADA. To measure the flow rate in the temperatures of 23, 37 and 45°c, Wilcoxon statistical analysis was used. The results showed that in 23°c, the flow rate of Cavex and Azardent waxes met ADA standards however, it was not true for two others types. In 37°c, the flow of none of the waxes was standardized and in 45°c their flow was acceptable, moreover, thermal expansion coefficient, for Cavex and Azardent types, was based on ADA standard.

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Statement of Problem: Root canal cleaning and shaping are important steps in endodontic therapy. In order to develop better techniques, new instruments are constantly designed and delivered to the market.
Purpose: The aim of the present study was to compare the effectiveness of one manual with three rotary root canal instrumentations techniques.
Materials and Methods: In this in-vitro study, 80 mesial roots of freshly extracted human mandibular molars were divided in to four groups equally and prepared by one of the following instrumentation methods profile NiTi rotary system, Protaper NiTi rotary system, Flex Master NiTi rotary system and hand NiTi K-file instrumentation. In each root one of the canals was instrumented and the other was used as control.After decalcification, cross sections at 3mm and 5mm of apical portion were prepared and examined for remaining debris, predentin and smooth walls under light microscope. The data were analyzed by Kxuskal-Wallis test.
Results: Significantly less debris was found at 3mm cross- section using protaper and Flex Master techniques (P<0.05). No significant differences were found at 5mm cross section. Also no significant differences were observed for remaining predentin at all regions. Significantly more smooth walls were found at both regions using protaper technique (P<0.05).
Conclusion: The protaper technique employed in this study resulted in cleaner root cana! walls than the
other techniques.

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Statement of Problem: Total removal of tissues and remnant microorganisms as well as canal shaping are the essential objectives of endodontic therapy. A successful endodontic treatment is obtained through Shilder’s principals, however complete observation of this technique using stainless steel files manually is problematic and time-consuming. Modern technology, in order to eliminate such problems, has presented new facilities such as Nickel-Titanium (NiTi) files and engine driven instruments.

Purpose: The aim of this in-vitro study was to compare the canal debridement efficiency of three engine driven instruments: Rotary, Reciprocal and Vertical.

Materials and Methods: In this experimental study, 60 mesial roots of human first and second mandibular molars were divided into three groups randomly. In each sample, one canal was considered as case, the other one as control. Files used in Reciprocal and vertical groups were of handy Ni-Ti type and in rotary group, rotary Ni-Ti files were used. After debridement, the roots were sectioned at 3mm and 5mm from anatomic apex, stained and examined under light microscope. Comparison criteria between case and control groups were based on residual debris and predentin and the level of root canal preparation and shaping after debridement. Data were subjected to kruskal-Wallis non-parametric test.

Results: There was no significant difference between the efficiency of debridement at 3mm and 5mm sections between all groups. But difference in time consumption was significant ranked from the shortest to the longest as rotary, reciprocal and vertical.

Conclusion: The efficiency of debridement between the three automated instruments was approximately equal, however the instrumentation time was different between three groups. Rotary system was the fastest one, as compared with reciprocal (second) and vertical (last). It may be concluded that rotary system has a superiority over the other two groups in conventional root canal therapies.

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Background and Aim: Many methods and techniques of canal preparation work well in large and relatively straight canals. However, in severely curved canals, the complexity increases markedly, and techniques rendering good results in usual cases may be unsuccessful. The aim of this study was to compare the effect of five root canal preparation techniques on original canal anatomy in simulated severely curved canals.

Materials and Methods: In this experimental in vitro study, 100 simulated canal blocks with similar hardness were made from polyester. The degree of curvature was 45º with a radius of 2.55 mm and a straight part of 8mm. The blocks were prepared with five different techniques (20 canals in each group) as follows: 1-Stepback 2- Passive step back 3- Balanced force using flex-R files 4- Balanced force using Ni-Ti hand instruments 5- Hybrid using a rotary Ni-Ti system (XtremRace). Digital photographs were taken from pre- and post instrumentation colored canals. Then images were superimposed and analyzed by an image editing software. The amount of removed material from the inner and outer canal walls was measured at five levels: 1-The canal orifice (O) 2-The halfway between the orifice and the beginning of the curve (HO) 3-The beginning of the curve (BC) 4-The apex of the curve (AC) and 5-The endpoint of preparation (EP). Additionally, the time of instrumentation, instrument failure and changes in working length were recorded. Data were analyzed by ANOVA and Kruskall-Wallis tests with p<0.05 as the limit of significance.

Results: Mean transportation was towards the outer aspect of the curve at the EP in all canals but there were no significant differences between the studied groups. At the BC point, all of the canals were transported towards the inner aspect of the curve and there were significant differences for both transportation values & direction among different groups. The highest amount of transportation was in step back and the lowest, in hybrid group. The highest transportation value was in step back and the lowest in balanced force group. Fractured and deformed instruments were observed in Flex-R files. The shortest canal preparation time was seen in XtremRace and the slowest, in Passive step back groups (P<0.001).

Conclusion: Based on the results of this study, changes in canal curvature were less with techniques using nickel titanium instruments and the fastest technique with least transportation was XtremRace.

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Background and Aim: Qigong is a type of Chinese psychosomatic exercise that integrates meditation, slow physical movements, and breathing. Numerous physical and mental benefits have been classically ascribed to qigong. On the other hand, unstimulated saliva is thought to play an important role in oral immunity, enamel stability and moisturizing the oral mucous membrane. Impaired salivary secretion leads to dental caries, mucosal deterioration and mouth dryness. The aim of the present study was to analyze the effect of a qigong program on various parameters of saliva such as quantity of unstimulated saliva, pH and SIgA.

Materials and Methods: Twenty three subjects participated in this clinical trial study. The experimental subjects underwent a qigong training program, conducted by a qualified instructor. The program consisted of half an hour daily practice for 6 months (spring and winter). Saliva was collected in two periods: once during the spring before the experiment commencement and the second, in the following spring. During each period saliva collection was done on tuesday of each week. pH and quantity of salvia measurements were taken simultaneously. SIgA measurements were also taken based on the values obtained in the last phase of the experiment at the end of each spring. The results were analyzed using paired sample T test, one way repeated measure and Bon Ferroni multiple comparison. P<0.05 was the level of significance. Results: Based on our findings, the change in the amount of unstimulated salvia as well as SIgA was statistically significant (P<0.001) however, there was no significant difference in pH values before and after experiment.

Conclusion: These findings demonstrate that after 6 months of practicing qigong, significant changes in amount of unstimulated saliva and SIgA occurred in participants. The authors suggest that qigong may be a beneficial adjunctive treatment that enhances amount of unstimulated saliva and SIgA.

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Background and Aim: Complete obturation of the prepared root canal is an essential step in endodontic treatment. Combination of gutta-percha and a sealer is widely used in clinical practice for root canal obturation, thus microleakage studies on sealing properties of these materials constitute an important part of endodontic researches. The aim of this study was to evaluate the microleakage of three root canal sealers: Apexit, AH26 and Dorifill by electrochemical method.

Materials and Methods: In this experimental study, 55 extracted human maxillary and mandibular cuspids were used. The coronal part of teeth were removed and the root canals were prepared using the step-back technique. The specimens were randomly divided into 3 groups of 17 samples each. Teeth in each group were filled with one of the sealers and gutta-percha by lateral condensation technique. 4 specimens served as positive and negative controls. An electrochemical method was used for evaluation of apical leakage with the electrical source potential of 10 V. Measurements of current flow through the test system were recorded every 72 hours. Data were analyzed by Kruskall Wallis and Mann Whitney tests. P<0.05 was considered as the level of significance.

Results: All specimens of the three groups showed low initial leakage that increased during the test period. The mean leakage in Apexit group was higher than AH26 and Dorifill groups. The lowest mean leakage was related to Dorifill group. Although no statistically significant difference was observed between this sealer and AH26.

Conclusion: The results of this study revealed that the best apical seal was obtained using Dorifill and AH26 sealers. The poorest result was observed in Apexit.

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Background and Aim: Elimination of microorganisms and their byproducts from root canal system is one of important aims of root canal therapy. This object is gained by using of many chemomechanical techniques but with noncertain success. A new method is used of nonpathogenic bacteria for growth inhibition of pathogenic bacteria, Antibiosis, in root canal therapy.The aim of this study was in vitro evaluation of antimicrobial effect of probiotics, such as Lactic Acid Bacteria (LAB) on the infected root canal bacteria.

Materials and Methods: Isolated bacteria from infected root canal were grown and then scattered onto the muller Hinton agar plates which contain wells, LAB, extracted from dairy products, were added into these wells, Inhibition effected of LAB was determined. Furthermore the sample taken from the inhibition zone and possible resistant monoclonal bacteria also were identified, then 6 sensitive and 14 resistant samples were selected and E. faecalis species were added to them Then antimicrobial effects of LAB on these samples was reevaluated.

Results: The results showed that 66.7% of the samples were sensitive at least to one type of LAB, and 33% were resistant to all kind of LAB. Meanwhile the outgrowing anaerobic bacteria inside the inhibition zone were from the low frequency oral bacterial flora. Furthermore, adding E. faecalis to the samples caused more sensitivity of them to LAB. Mc-Neamar test recognized the difference significant.

Conclusion: This study showed that the LAB inhibit growth of the pathogenic root canal bacteriae. Furthermore, presence of E. faecalis reinforces the antimicrobial effect of LAB. It seemed that LAB maybe have potential to use in endodontic practice for elimination of root canal infections.

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Background and Aim: One of the unique properties of MTA is its setting ability in presence of moisture. The sealing ability of MTA used as a root-end filling was shown to be unaffected by the presence of blood, in vitro. It has been recommended that, because of MTA ability to set in the presence of blood, there is no need to dry the perforation site before MTA placement. On the other hand, based on an in vitro study, it is recommended that hemorrhage be controlled at the perforation site and blood be removed from the perforation walls before placement of tooth-colored MTA. Blood contamination may also affect the crystalline structure of MTA. The microhardness of a material is influenced substantially by some fundamental properties of the material such as crystal structure stability. Thus, it can be used as an indicator of the setting process. It can also indicate the effect of various setting conditions on the overall strength of a material. The aim of this study was to evaluate the effect of blood contamination on microhardness of white and gray MTA as an indicator of their setting process.

Materials and Methods: In groups 1 and 2 each material has been mixed with distilled water according to manufacturer^,s instruction (No contamination groups). In groups 3 and 4 samples were prepared like groups 1 and 2 but the surface of material placed in contact with blood (Surface blood contamination groups). Samples of groups 5 and 6 were mixed with blood instead of distilled water and also the surfaces of the materials were placed in contact with blood (Mixed with blood groups). All samples were stored in 37⁰C and 100% humidity for 96 hours. The microhardness of the samples was measured with Vickers test.

Results: White MTA samples which have not contaminated with blood had the highest microharness (59.9±11.4 N/mm²) while gray MTA mixed with blood had the lowest hardness (18.45±7.8 N/mm²). One-way ANOVA test showed that contamination with blood significantly reduces the microhardness of both white and gray MTA (p<0.001). The difference between white MTA and gray MTA was significant in groups of no contamination (p<0.001), surface blood contamination (p=0.043), and mixed with blood (p<0.001) according to T-Test analysis. In all of them white MTA had higher hardness than gray MTA.

Conclusion: According to results of our study we recommend that hemorrhage should be controlled and any blood contamination should be removed before placement of both white and gray MTA.

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Endodontic treatment of immature permanent teeth accompanies with several issues. The primary goal when treating such teeth is to maintain pulp vitality so that root development can occur normally. Indications and requirements for vital pulp therapy include asymptomatic and reversible pulpitis. Also there are controversial opinions regarding the ultimate clinical treatment of the vital pulp therapy techniques. In this manuscript we report 3 cases of immature symptomatic permanent molars with irreversible pulpitis caused by caries exposure of the pulp that have been undergone vital pulp therapy successfully.

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Background and Aims: Teaching of clinical skills is one of the most important aspects in training medical students. The aim of this study was to compare the effectiveness of videotaped and live demonstrations for applying fissure sealant on permanent molar teeth at Zahedan University of Medical Sciences (2010-2011).

Materials and Methods: Thirty 8th-semester dental students were randomly assigned in two groups (n = 15). In group 1, fissure sealant placement was taught using live demonstration while, in group 2, education was performed by videotaped demonstration. Then, each student applied fissure sealant on the patient's permanent molar tooth. The procedure of fissure sealant placement was assessed and scored by a pedodontist. The students were subsequently asked to rate how helpful the videotape or live demonstration had been. The data were analyzed using T-test and Chi-square test.

Results: The mean students' scores for videotaped and live demonstration were 16.5 and 16.53, respectively. There was no significant difference between the teaching methods according to students' scores (P>0.05). 33% of students rated videotaped demonstration as "good" for its helpfulness and 66% as "very good". However, live demonstration was rated as "good" and "very good" by 66% and 33% of students, respectively. There was no significant difference between two groups (P>0.05).

Conclusion: Both teaching methods were equally effective. Therefore, videotaped demonstration can be used in combination with live demonstration or as an alternative for it.

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Background and Aims: Composite restorative materials and dental adhesives are usually cured with light sources. The light direction may influence the bond strength of dental adhesives. The aim of this study was to evaluate the effect of light direction on the microtensile bond strength of fifth and sixth generation dental adhesives.

Materials and Methods: Prime & Bond NT and Clearfil SE bond were used with different light directions. Sixty human incisor teeth were divided into 4 groups (n=15). In groups A and C, Clearfil SE bond with light curing direction from buccal was used for bonding a composite resin to dentin. In groups B and D, Prime & Bond NT with light curing direction from composite was used. After thermocycling the specimens were subjected to tensile force until debonding occurred and values for microtensile bond strength were recorded. The data were analyzed using two-way ANOVA and Tukey post hoc test.

Results: The findings showed that the bond strength of Clearfil SE bond was significantly higher than that of Prime&Bond NT (P<0.001). There was no significant difference between light curing directions (P=0.132).

Conclusion: Light curing direction did not have significant effect on the bond strength. Sixth generation adhesives was more successful than fifth generation in terms of bond strength to dentin.

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Background and Aims: The present study aimed to evaluate the barriers to the production of scientific dental articles in dental schools in Iran based on the opinions of dental postgraduate students.

Materials and Methods: A self-administered questionnaire was distributed among postgraduate students of all Iranian dental schools in June 2010. The respondents rated their agreement with eight sentences about what hinder them from producing scientific dental articles based on a 5-grade Likert scale. The data were analyzed using Chi-square test.

Results: Totally, 270 filled questionnaires from 14 dental schools were received. Of all respondents, 53% were male, the mean age were 29.6 ± 3.8. About half of the respondents reported at least one published article. Less than half of the respondents reported producing an article from undergraduate thesis more women than men and more younger than older students (P<0.03). About two-third of the respondents rated absence of an English editing center, no financial incentives, no appropriate environment, and no competency for scientific writing as most prevalent barriers to the production of scientific dental articles.

Conclusion: To expand the share of Iran in the production of scientific dental documents, the potential of postgraduate dental students must be regarded and suitable condition for scientific writing must be provided. Specifically, based on the findings of the present study, provision of an English editing facility, establishing financial incentives, and providing the students with appropriate environment and efficient scientific writing education are of utmost importance.

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Background and Aims: The aim of the present study was to investigate self-perceived need to learn practice management and self reported knowledge in this regard among dentists.

Materials and Methods: A group of five academic staff members of Community Oral Health Department (Tehran Dental School) and four dentists formed an expert panel to develop the content of the course. This group developed a list of topics related to principles of successful dental practice. To investigate the necessity of educating the topics and self-assessed knowledge of the topics, a questionnaire was designed and administered to 55 volunteer dentists. Forty six dentists completed the questionnaire. T-test and Chi-square test were used for statistical analyses.

Results: Totally more than two-third of the dentists believed that a huge need exists for education of all the topics. The corresponded figure for such topics as ergonomics and medical emergencies was about 90%. About 80% of the dentists felt that they had a vast knowledge of safety and infection control. On the other hand, 54.3% of them reported weak knowledge regarding professional rules and regulations. Self-reported educational need and knowledge of the dentists did not show significant association with their age, gender, and work experience
(P>0.05).

Conclusion: The dentists believed in the necessity of educating such topics and evaluated their knowledge as deficient in these areas. This shows the necessity of developing courses on these topics.

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Background and Aims: When composite resin polymerizes, shrinkage stresses tend to produce gaps at the tooth/ restoration interfaces. Surface sealants may reduce or avoid problems related to the marginal interface. The aim of this study was to evaluate the effect of two different surface sealants (Fortify and Optiguard) on the microleakage of class V resin composite restorations.

Materials and Methods: Twenty three sound noncarious molars were collected. Totally, 45 Class V cavities with the occlusal margins in enamel and cervical margins in cementum were prepared in both buccal and lingual surfaces. The specimens were randomly assigned in three groups (15 cavities in each group) and then restored with a resin composite. After the finishing and polishing procedures, the restorations in each group were covered with a specific surface sealant, except for the control samples, which were not sealed. After placing restorations, the specimens were thermocycled and then immersed in a 50% silver nitrate solution (tracer agent) for four hours, sectioned longitudinally and analyzed for leakage using a stereomicroscope in a blind manner. The marginal microleakage was evaluated at the occlusal and cervical interfaces and compared among the three groups using the Kruskall-Wallis and the Mann-Whitney U tests.

Results: Microleakage was found in all groups at both occlusal and cervical margins. Significantly greater leakage was observed at the cervical margins compared to the enamel margins of the material groups (P=0.005). There was no statistically significant difference among the groups at occlusal margins (P=0.66). In the cervical region, Fortify showed improved results and statistically presented the lowest degree of microleakage (P=0.003).

Conclusion: The used sealant materials presented different rates of effectiveness and Fortify decreased marginal microleakage significantly.

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Background and Aims: Working length determination and remaining this length is of great importance in root canal therapy. Recently, electronic apex locators are being used to determine working length and decrease the number of radiographs. The purpose of this study was to compare the sensitivity of Root ZX and Novapex electronic apex locators with radiography in a clinical study.

Materials and Methods: In this study, 73 single-canalled teeth of the patients referred to the endodontic department of the Yazd Dental School were evaluated. The access cavity was prepared and working length of the root canals were measured by using the apex locators: Root ZX and Novapex. The file was placed in the root canal and a periapical radiograph was taken using parallel technique. The working lengths obtained by apex locators were recorded and compared with those of radiographs. The data were analyzed by Pearson's correlation coefficient, Wilcoxon test and paired t-test.

Results: The exact measurement without any fault was 46.6% for Root ZX and 20.5% for Novapex compared to radiography. In the range of 0.5 mm fault, the results were 91.8% for Root ZX and 64.4% for Novapex compared to radiographic measurements. The difference between the average of the measured lengths by Root ZX and radiography was not significant (P=0.17). On the other hand, the results showed significant difference between the average of the measured lengths by Novapex and radiography (P=0.017). The difference between two apex locators was not significant (P=0.061).

Conclusion: Root ZX and Novapex with high accuracy are useful for determining working length of the root canals in pregnant patients with special anatomic conditions and patients with muscle disharmony. Therefore, the use of these apex locators combined with radiography is recommended in root canal treatment.

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Background and Aims: Various methods are used for treatment of open bite. The objective of this study was to investigate the effects of Lower Anterior High Pull Headgear (LAHPH) appliance in Class I subjects with moderate open bite and high lower lip line.

Materials and Methods: The study group was composed of 10 subjects with a mean age of 15.8±2.5 years and 3.05 ± 0.07 mm moderate open bite. All the patients rejected orthognathic surgery. The treatment included extraction of upper and lower second premolars followed by leveling, banding, bonding, posterior space closure, and anterior retraction. After these procedures, the open bite was reduced to 2.04±1.17 mm. Afterwards, LAHPH was applied for 18 hours per day for 8±2 months. LAHPH appliance was composed of High Pull Headgear and two hooks mounted on its inner bow. Two elastics (1.8, light, Dentaurum) connected the upper hooks on the inner bow to the lower hooks on the mandibular canines vertically. The forces produced by the prescribed elastics were 10 and 60 g during mouth closing and opening, respectively. Paired T-test was used to evaluate pre-and post-treatment outcomes.

Results: The pre-and post-treatment cephalometric evaluations showed that the LAHPH reduced effectively the open bite of the patients to 0.15±1.7 mm (P<0.001).

Conclusion: This appliance can be used as an acceptable method for closing the open bite in Class I subjects.

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Background and Aims: Using the conservative adhesive resin restoration (CAR) in uncooperative children lead to numerous problems because of being time consuming. The purpose of this study was to compare the microleakage of conservative adhesive resin restoration under separate curing and co-curing.

Materials and Methods: In this experimental study, 120 intact premolar teeth were collected and 120 vertical grooves were prepared on them. Then the teeth were divided into four groups: group 1, separated curing of bonding agent, flowable composite and sealant group 2, co-curing of all materials for 60 seconds group 3,
co-curing of all materials for 40 seconds and group 4, co-curing of all materials for 20 seconds. Then the specimens were thermocycled and immersed in basic fuchsin solution. The teeth were sectioned horizontally and dye penetration was evaluated with stereomicroscope. Date were analyzed using one-way ANOVA and Scheffe test.

Results: Mean value of dye penetration in groups 1, 2, 3, and 4 was 1.53±0.6, 2.06±0.6, 2.5±0.7 and 3.53±0.6, respectively. There was a statistically significant difference between group 1 and the other groups (P=0.0001).

Conclusion: Considering the problems caused by microleakage in conservative resin adhesive restorations, co-curing method should not be used. In the case of using co-curing method, 60 second curing time is suggested for sufficient polymerization.

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Background and Aims: Electric pulp testing is used for diagnosis of the pulp status. This test is technique sensitive and hence may elicit positive or negative false response in case of inaccurate use. The optimal site for placement of the probe tip has not been determined. The aim of this study was to evaluate the effect of pulp tester probe placement site on the response of maxillary teeth.
Materials and Methods: A total of 378 teeth (126 central incisors, 126 lateral incisors and 126 canines) in 67 voluntary 20-35 year-old patients were selected. Three sites on each tooth (incisal edge, labial and lingual surfaces) were tested with an electrical pulp tester and responses were recorded. Data were analyzed by Repeated Measure ANOVA test.
Results: The central teeth showed significantly lower sensation threshold than lateral and canine teeth (P<0.001). The incisal edge of tooth were significantly more sensitive compared to labial and lingual surfaces (P=0.008).
Conclusion: This study showed that the optimum site for placement of pulp tester probe was incisal edge.