JOURNAL OF ISFAHAN DENTAL SCHOOL
Year:2016 | Volume:12 | Issue:2|Papers Count:13

Introduction: Receiving hemodialysis therapy may affect oral candidal colonization. The aim of this study was to determine presence of Candida species in the oral cavity and evaluate their prevalence and severity in patients with renal insufficiency.Materials& Methods: Fifty end-stage renal disease (ESRD) patients who initiated their hemodialysis (HD) therapy at least 6 months prior to this research and 50 patients with chronic kidney disease (CKD) not requiring HD (control group) were invited to participate in this case-control study. Oral samples were collected by swab technique from posterior-dorsal surface of the tongue and cultured on Sabouraud dextrose agar plus chloramphenicol (SC), CHROMagar Candida® (CMA) and cornmeal agar plus 1% Tween 80 (CTA) to assess the growth of yeasts, determine degree of colonization and identify species. Data analysis was performed using SPSS 18 with Pearson, chi-squared, Wilcoxon and Mann-Whitney tests and Spearman's rho (a=0.05).Results: Based on the results, 48% of HD subjects and 38% of CKD subjects carried Candidal yeasts, with no significant difference (p value=0.54). Candida albicans was the most predominant species isolated in both HD and CKD groups (66.6% and 84.2% respectively). Statistical analysis showed that colonization increased with age (p value=0.017, r=0.23), with no significant relationship between colonization severity and gender or time on dialysis (p value>0.05).Conclusion: Under the limitations of this investigation, no difference was observed in oral Candidal colonization percentages between two study groups.

Introduction: The main objective of root canal therapy is to eliminate the contents and internal irritants from the root canal and achieve a complete seal of the root canal system.Despite mechanical preparation, always some organic tissues and bacteria remain in the root canal. The aim of this study was to compare the amount of residual Enterococcus faecalis after root canal preparation with hand files and rotary Flexmaster files with 4% taper.Materials& Methods: Thirty-four extracted human anterior teeth were divided into two experimental (n=12) and two control (positive and negative) (n=5) groups in this in vitro study.All the samples were initially prepared with #30 K-files, rinsed and sterilized in an autoclave. The root canals were contaminated with Enterococcus faecalis. The root canals in groups 1 and 2 were prepared with rotary Flexmaster and hand files, respectively; in the positive control group the bacteria were cultured without filing and in the negative control group the bacteria were not cultured. Then the root canal debris was transferred into microtubes and incubated. The residual bacterial CFUs were determined after 24 hours of growth in bile esculin agar medium. Data were analyzed with one-way ANOVA at a=0.05.Results: The difference between groups 1 (K-files) and 2 (rotary Flexmaster) was significant (p value=0.001); the differences between groups 1 and 2 on one hand and the positive and negative control groups on the other hand were significant, too (p value=0.001).Conclusion: Intra-canal Enterococcus faecalis counts decreased significantly after preparation of the root canals with rotary files.

Introduction: Considering the importance of pain as a main complication after mandibular third molar surgery, the effect of oral hygiene on the outcome of treatment and lack of sufficient information on the effect of preoperative plaque index on the severity of pain after mandibular third molar surgery, this study was undertaken to evaluate the influence of preoperative plaque index on pain after surgical removal of impacted mandibular third molars.Materials& Methods: This study was designed as a cohort study. Plaque index of the patients admitted into the Islamic Azad University, School of Dentistry, Tehran in 2014, who required surgery for the removal of impacted wisdom teeth, was determined by the O' Leary method. Thirty patients were selected; 15 subjects had a plaque index over 40% (case group) and 15 had a plaque index below 40% (control group). A 40% criterion was selected based on articles in the field of periodontology. The two groups were matched in relation to age, gender and the type of the impacted tooth. All the surgeries were carried out by one surgeon. The postoperative pain severity in both groups was recorded by VAS (visual analogue scale) on the first, third and seventh days after surgery and assessed by Man-Whitney U and Friedman tests at each time interval (a=0.05).Results: The group with plaque indexes over 40% (the case group) reported higher postoperative pain levels than the control group with plaque indexes under 40% and this difference was statistically significant (p value=0.01). However, in both groups, patients who had a longer duration of surgery reported more severe postoperative pain during the first week.Conclusion: Poor preoperative oral hygiene correlated with more severe postoperative pain after surgical removal of impacted mandibular third molars.

Introduction: Geographic and racial factors affect the incidence of salivary gland lesions. This study surveyed the prevalence of salivary gland lesions in Zahedan and compared them with other epidemiological studies.Materials& Methods: In this cross-sectional and retrospective study, of a total of 1112 biopsies taken from oral and maxillofacial lesions during an 11-year period (2002–2012) that were available in the Pathology Department archives of medical centers of Zahedan University of Medical Sciences, 95 biopsies (8.54%) were found to be related to salivary gland lesions. Lesion types and demographic data of patients such as age, gender and location of lesions were obtained from patient records and analyzed using Fisher's exact test and Student’s t-test (a=0.05).Results: The mean age of the patients was 31.6±15.6 years and male-to-female ratio was 1: 1.1. The incidence of neoplastic lesions in women was twice that in men, while most of the non-neoplastic lesions were found in the men. The most affected locations were the submandibular gland (27.7%) and lip (27.7%). Mucocele (30.6%) was the most common non-neoplastic lesion; pleomorphic adenoma (21%) and mucoepidermoid carcinoma (7.3%) were the most common benign and malignant neoplastic lesions of salivary glands, respectively.Conclusion: Generally, non-neoplastic lesions were more prevalent than neoplastic lesions and most lesions had occurred in the minor salivary glands. There were small differences in the frequency and distribution of salivary gland lesions between the population in this study and other populations.

Introduction: Salivary gland lesions comprise a wide group of lesions, including infectious and obstructive lesions and salivary gland tumors. Fine needle aspiration (FNA) is used primarily to identify these lesions; application of this method results in identification of cytologic features of the majority of salivary gland neoplasms and infectious lesions. The present study was undertaken to determine the accuracy of fine needle aspiration cytology in the diagnosis of parotid salivary gland lesions.Materials& Methods: In the present descriptive/cross-sectional study, 170 parotid salivary gland specimen were included, which had been examined by FNA initially and then treated by surgical techniques and histopathologically evaluated. The results of both sampling techniques were compared and analyzed with SPSS 22. Chisquared test, t-test, and sensitivity and specificity statistical tests were used for statistical analyses (a=0.05).Results: Based on the results of chi-squared test and t-test, agreement rate between FNA and biopsy results was 87.64%, with sensitivity and specificity of FNA being 97% and 81.37%, respectively. False positive and false negative rates of FNA were 18.62% and 2.94%, respectively.Conclusion: FNA can be applied primarily as an adjunctive technique for patient evaluation; subsequent steps should be taken based on the patient’s condition and the physician’s judgment.

Introduction: The impaction of third molars is very common. Due to the possible damages due to impaction and the effect of its angulation on treatment, it is important to study this pattern. The aim of this study was to determine the frequency of impacted mandibular third molars separately for each angulation on panoramic radiographs of patients referred to the Department of Maxillofacial Radiology, Esfahan Faculty of Dentistry.Materials& Methods: This retrospective descriptive study was performed on 1000 panoramic radiographs available in the Department of Maxillofacial Radiology, Esfahan Faculty of Dentistry in 2013‒2014. The patients’ data, including gender and angulation of the impacted teeth, were recorded. Data were analyzed with chisquared test, using SPSS 17 (a=0.05).Results: The majority of impacted third molars were found in female patients with 228 cases (58.91%), followed by male patients with 159 (41.08%) of 387 unilateral and bilateral cases of impacted third molars. The most frequent angulation was vertical with 247 cases (40.8%) and the least frequent angulation was buccolingual with 22 cases (3.62%). There were 218 bilateral impactions (59.09%). Chi-squared test showed significant relationships between the frequency of impaction of third molars and dentitions with no extracted teeth and those with one or more extractions (p value<0.001). In addition, there were no significant differences in the complete dentitions and those with extracted teeth between males and females (p value=0.953).Conclusion: This study showed that the most common angulation of impaction of mandibular third molars was vertical and the buccolingual angulation exhibited lowest rate of impaction. Bilateral impaction was the most common mode and wisdom tooth impaction was more frequent in female patients.

Introduction: Sensitivity is one of the most common complications of vital tooth bleaching anddifferent materials such as fluoride can be used to reduce such tooth sensitivity.The aim of this study was to evaluate the effect of fluoride on tooth color changesbefore and after using bleaching materials.Materials& Methods: In this clinical trial, 24 students aged 18‒25 years were selected. Initially, thecolor of 6 sound anterior maxillary and mandibular teeth was recorded under thesame environmental condition and then photographic records were provided. Thesubjects were randomly divided into 3 groups. The subjects in group 1 usedcarbamide peroxide (CP) for at least 6 hours every night during sleep; the subjectsin group 2 used phosphate fluoride (PF) before using CP and subjects in group 3used phosphate fluoride (PF) gel after having used CP. After the tooth bleachingperiod, the tooth colors were recorded using Vita shade guide and the digital RGB(red, green, blue) method to evaluate the effect of the time of fluoride use on toothcolor changes. Data were analyzed with paired t-test and ANOVA (a=0.05).Results: Statistically there was no significant difference between groups in term of colorchanges using vita (p value=0.154) and the RGB method (p value=0.147).Conclusion: The results of this study showed that use of PF gel before and after toothbleaching did not affect the color change process.

Introduction: Dentistry is associated with high levels of stress as a result of financial issues, non-cooperative patients, stressful procedures, etc. Root canal therapy can potentially lead to high stress levels in dental students. Therefore, this study aimed to evaluate and compare factors causing stress during both the pre-clinic and clinical courses.Materials& Methods: In this comparative-descriptive study, all the fifth- and sixth-year dental students in 2011-2012, a total of 125 students, were selected using the cluster sampling technique. In order to evaluate stress levels, a Likert scale questionnaire was designed. Data were analyzed with different descriptive methods using SPSS 19 (a=0.05).Results: The maximum endodontics-related stress level was 58%. Improper behavior of professors in both the clinic (85%) and pre-clinic (92%) was the most important factor causing stress in students. insufficient lack of sufficient time for fulfilling the requirements was the most important factor causing stress in the pre-clinic, while the type and location of teeth were not as important.Conclusion: Based on the results of the present study, professors’ poor behavior in the clinic and pre-clinic, cutting the power supply of the dental unit at a certain time and lack of sufficient time for finishing the job in the pre-clinic affected students’stress levels.

Introduction: Enamel surface roughness affects its visual properties, plaque retention, abrasion and bond strength. The aim of this study was to determine surface roughness of enamel lesions treated with Casein Phosphopeptide-Amorphus Calcium Phosphate (CPP-ACP), fluoride and a combination of these two.Materials& Methods: In this experimental study, 24 sound bovine anterior teeth were mounted in acrylic resin after decoronation. Then the samples were demineralized and divided into 4 groups: treatment with CPP-ACP, CPP-ACPF and fluoride mouthwash, fluoride mouthwash and control. After treatment, the surface roughness of each group was determined. Data were analyzed with one-way ANOVA, followed by Duncan post hoc tests (a=0.05).Results: The surface roughness of the control group was significantly higher than that in other treatment groups (p value=0.011).Conclusion: The results showed that treatment with all the three remineralizing agents significantly reduced surface roughness.

Introduction: After fixed orthodontic treatment, it is necessary to remove residual resin.Currently, no technique removes composite resin remnants without affecting the enamel surface. The aim of this study was to evaluate enamel surface roughness after removal of composite resin remnants with two different methods.Materials& Methods: A total of 12 premolars were embedded in acrylic resin with their buccal surface out of the acrylic resin. The baseline roughness of the buccal surface enamel was evaluated by a profilometer and the three surface parameters (Rt, Rq and Ra) were recorded. Composite resin was bonded on the mid-buccal enamel surface in two equal and distinct parts on the right (Tc) and left (Fg) sides. TC composite resin was removed with tungsten carbide bur in a low-speed handpiece and Fg composite resin was removed with fiberglass epoxy resin bur in a low-speed handpiece. The surface roughness was evaluated again and the three parameters were recorded. Data were analyzed with one-way ANOVA using SPSS 21 (a=0.05).Results: Analysis of parameters Ra (average roughness) and Rq (root mean square) indicated significant differences between Fg and pre-bonding surface with the least value (p value<0.001); in addition, there were significant differences between Tc and pre-bonding surfaces with the highest value (p value<0.001). In relation to Rt (maximum roughness depth), there were no significant differences between Fg and pre-bonding surfaces (p value>0.05); however, the differences were significant in relation to Tc surface (p value<0.001).Conclusion: Fiberglass and tungsten carbide burs created less and more enamel surface roughness, respectively, compared to pre-bonding conditions.

Introduction: Identification of factors affecting oral health behaviors is a key step for promotion of oral health in diabetic patients. The aim of the present study was to determine factors predicting oral health behaviors in diabetic patients, using the Pender' s Oral Health Promotion Model.Materials& Methods: A total of 256 diabetic patients were included in this cross-sectional study voluntarily using a continuous random sampling technique. A self-report researcher-designed questionnaire was used to collect data in order to measure the constructs related to Pender's Oral Health Promotion Model in diabetic patients.Data was analyzed with one-way ANOVA, Pearson’s correlation coefficient and linear regression (a=0.05).Results: The frequency of tooth brushing behavior in patients was 1.14 ± 0.73 times daily.Self-care behaviors related to oral health (r=0.118), perceived benefits (r= 0.107) and the commitment to action (r=0.130) increased with an increase in educational level. All the variables exhibited significant correlation with Pender’s Oral Health Promotion model, except for the correlations between interpersonal construct norms and interpersonal modeling and oral health, and correlations between self-efficacy and negative fillings and perceived benefits. The Model predicted 48.3% of the variance in oral health behaviors in diabetic patients.Conclusion: The emphasis is on identifying barriers and weaknesses of self-efficacy and strategies to promote it and maximize the role of structural commitment to actions in order to increase the efficacy of educational programs for diabetic patients.

Introduction: The aim was to review antibacterial agents incorporated into adhesives. In this context, bonding systems were compared and the effect of irradiation on the antibacterial properties of adhesives was evaluated.Description: Currently, composite resins are considered the principal materials to restore anterior and posterior cavities. Advances in the synthesis of polymers and fillers have improved composite resin properties; however, a major problem is the greater tendency for accumulation of plaque in their vicinity. Since composite resins are bonded to tooth surfaces, recently the antibacterial effects of adhesives have attracted attention. One of the new developments in the formulation of adhesives is introduction of chemical components to confer antibacterial activity.This article reviewed recent studies in this area to answer this question: Is the antibacterial activity of adhesives clinically important? Search was run in Pubmed database and Google Scholar using the key words "antibacterial adhesives", "adhesives+Methacryloyloxydodecylpyridinium bromide (MDPB) ", "adhesives +epigallocatechin-3-gallate (EGCG) ", "fluoride+adhesives", "quarterly ammoniums+adhesives" from 2005 on.Results: Some studies have reported that adhesive systems show significant antibacterial properties and this effect has been attributed to the presence of MDPB molecule.However, others believe that this effect is minor and temporary. No adhesive is able to completely prevent nanoleakage at resin–dentin interface. Adhesives without light activation have better antibacterial properties. However, after irradiation the afore-mentioned properties are still available to some extent.Recently, the use of substances such epigllocatechin-3-gallate (EGCG), dimethylaminododecyl methacrylate (DMADDM) and silver nanoparticles have been proposed in the adhesives and in vitro studies have yielded promising results. However, no accurate simulation of the oral cavityhas been carried out.Currently, definitive assessment of the clinical relevance is not possible and more extensive clinical studies are necessary.