Objective: Novel fast-setting calcium silicate cement with fluoride (Protooth) has been developed for potential applications in tooth crowns. The aim of this study was to evaluate the success rate of direct pulp capping in primary molars using two-layer mineral trioxide aggregate (MTA) and overlying glass ionomer cement versus one-layer novel calcium silicate cement with 4 to 10 minutes setting time. Materials and methods: Ninety bilaterally symmetrical primary molars in the same jaw in 45 patients aged 5 to 7 years were included. Exposed pulps following caries removal were randomly capped with one-layer novel calcium silicate cement or two-layer MTA and glass ionomer cement. All cavities were filled with amalgam. Clinical and radiographic evaluations were performed after six and twelve months. 41 patients were available for the evaluations at the end of the 12-month follow-up. Results: The overall success rate of direct pulp capping, in a split-mouth design, using MTA covered with glass ionomer cement or one-layer novel calcium silicate cement after 12 months were 90% (37 out of 41 cases) and 85% (35 out of 41 cases), respectively, without statistically significant differences after 6 and 12 months. Conclusion: Within the limitations of this study, clinical and radiographic evaluations suggested one-layer novel calcium silicate cement would be successfully used in direct pulp capping of primary molars as a practical alternative to two-layer MTA and overlying glass ionomer cement.

Aim Achieving a satisfactory facial esthetics is of utmost importance in the practice of orthodontics. Cl II div 1 patients often suffer from numerous adverse facial characteristics which may impair their social well-being. The objective of the current study was to evaluate the esthetic changes in such patients by using a modified twin block appliance. Materials and methods Seventy adolescent patients with mandibular deficiency consecutively underwent treatment with a modified twin block appliance for a mean period of 13 months. Soft tissue analyzes of Burstone and Mcnamara were applied to evaluate the changes before and after the treatment. The esthetic changes before and after the therapy were compared using parametric paired t tests analysis. p values less than 0.05 were considered significant. Results Facial convexity, lip incompetence, upper lip protrusion, and columellar inclination significantly decreased ( p < 0.05) while Merrifield's Z -angle nasolabial angle, lower lip length, and mentolabial angle significantly increased ( p < 0.05). Vertical facial height ratio, lower lip protrusion, upper lip length as well as nasal projection and inclination, did not change significantly ( p > 0.05) Conclusion Our findings indicated that a modified form of the twin block appliance can be substantially effective in the improvement of several aspects of patients’ facial balance with minimum untoward effects. Clinical significance Adolescents suffering from mandibular deficiency can gain substantial facial balance with the twin block appliance. The whole face attractiveness, however, is another subject and should not be conflicted with the facial balance. How to cite this article Shahamfar M, Atashi MHA, Azima N. Soft Tissue Esthetic Changes Following a Modified Twin Block Appliance Therapy: A Prospective Study. Int J Clin Pediatr Dent 2020;13(3):255–260.

A bstract Aims and objectives This study was done to compare the success rate of a novel fast-setting calcium silicate cement (protooth) with mineral trioxide aggregate (MTA) in direct pulp capping (DPC) of primary molars. Materials and methods Forty-five patients with an age range of 5–7 years with 90 bilaterally symmetrical primary molars that had deep carious lesions were incorporated into a randomized split mouth clinical trial. Initially, the caries was removed. Afterward, the teeth randomly underwent DPC with either MTA or protooth. Restoration of the teeth was done by amalgam fillings. Clinical and radiographic examinations were performed after 6 months. To analyze the data, Chi-square statistical test was used. Values < 0.05 were considered statistically significant. Results After 6 months of follow-up, 88 teeth on 44 patients were available for evaluation. The MTA-treated teeth showed a success rate of 95.5%, while the same outcome for the protooth-treated teeth was 93.2%. The difference did not yield a statistically significant difference ( p value > 0.05). Conclusion The findings of this study showed favorable results for the novel calcium silicate cement “protooth” when compared to the outcomes of MTA in the DPC of primary molars. Clinical significance The constant need for the development of more effective materials in the modern pediatric dentistry makes this novel cement of particular interest for pedodontists. The new cement is biocompatible, hydrophilic, and has fast-setting time and adequate tensile strength with favorable clinical results in the DPC of primary molars which can benefit pedodontists in their clinical practice. How to cite this article Shahamfar M, Azima N, Erfanparast L. A Randomized Split Mouth Clinical Trial Comparing Mineral Trioxide Aggregate with a New Fast-setting Calcium Silicate Cement in Direct Pulp Capping of Primary Molars: A Preliminary Report from a Long-term Follow-up. Int J Clin Pediatr Dent 2020;13(4):390–394.