JOURNAL OF ISFAHAN DENTAL SCHOOL
Year:2016 | Volume:12 | Issue:3|Papers Count:14

Introduction: Dentists can encourage their patients to give up smoking if they have adequate knowledge about scientific techniques used to stop smoking. This study was designed to evaluate the knowledge and attitudes of dentists in relation to techniques used to quit smoking and the relevant factors.Materials& Methods: This cross-sectional research was conducted on 400 dentists using continuous referral sampling technique. The questionnaire used to collect data included three sections: There were 12 questions on individual characteristics, 14 questions on dentists’ knowledge about smoking cessation methods, and 10 questions on dentists’ attitudes towards these methods. In the section on knowledge each question received a score of 1, with a maximum score of 14 and a minimum of 0 in this section. The score range of each attitude question was 0‒ 1, with a maximum score of 10 for attitude and a minimum score of 0. Data were analyzed with chi-squared test and regression analysis.Results: Of 400 dentists evaluated, 45.7% were female and 54.3% were male, with a mean age of 34.4±2.7 years. All the subjects (100%) had poor knowledge with no moderate and high knowledge levels. In relation to dentists’ attitudes towards smoking cessation methods, 32% had a positive, 50% had relatively positive and 18% had negative attitudes. There were no significant relationships between gender, the university, the dentist’s smoking habits, the presence of a smoker in the dentist’s family, education and studies on smoking cessation and dentists’knowledge and attitudes. A significant relationship was found between the dentists’ year of graduation and their knowledge scores (p value<0.013); there was a significant relationship between the dentists’ age and their attitudes (p value< 0.03).Conclusion: The knowledge and attitudes of dentists in relation to smoking cessation methods were less than the expected levels. It is necessary to design proper educational programs to improve dentists’ knowledge and attitudes in this field.

Introduction: Evidence indicates the role of mutans streptococci (especially Streptococcus mutans and Streptococcus sobrinus) and Lactobacilli in initiation and development of dental caries. The aim of this study was to investigate the effects of some natural compounds on biofilm formation and growth of Streptococcus mutans and Streptococcus sobrinus and compare their effects with three herbal mouthwash products.Materials& Methods: In this laboratory study, natural products (honey, vinegar and rosewater) and two strains of Streptococcus (S. mutans, S. sobrinus) were used. First the adherence and biofilm formation of the pathogenic strains were investigated and then the effects of natural products on adhesion of pathogens was evaluated. In both teats, microtiter plate assay was used. In addition, the inhibitory effects of these compounds on the growth of Streptococci were investigated. Finally, the effects of these compounds were compared with those of three herbal mouthwash products. Data were analyzed with SPSS 15 using independent-samples test and Excel software program. Statistical significance was defined at p value<0.05.Results: S. mutans and S. sobrinus expressed strong (OD=2.5) and moderate (OD=1.53) adherence, respectively. Vinegar, rosewater and honey reduced biofilm formation by Streptococcus mutans up to 66.45%, 66.18% and 66.43%, respectively.Comparison of natural compounds and herbal mouthwash products showed that the three mouthwashes did not have significant differences (p value<0.05) in reducing pathogen binding. Rosewater was less effective than the other compounds in the reduction of pathogen binding. The results indicated that vinegar and the three mouthwashes had inhibitory effects on the growth of Streptococci.Conclusion: Observations showed that these natural compounds, particularly vinegar and then honey, were able to reduce biofilm formation by cariogenic pathogens. Therefore, use of these compounds can be effective in preventing and controlling dental caries by reducing the binding of Streptococci.

Introduction: Educating mothers regarding oral health and early childhood caries can have a great effect on improving their knowledge, attitudes and performance. The aim of this study was to determine the knowledge, attitudes and performance of mothers of children aged 1 to 3 years in relation to oral health and early childhood caries in Shiraz.Materials& Methods: In this descriptive analytical cross-sectional study, 202 mothers of children aged 1 to 3 years were selected randomly from those visiting 4 health centers in Shiraz and a questionnaire whose reliability and validity had been confirmed was distributed among them. Questions of the questionnaire had been designed in relation to knowledge, attitudes and performance of mothers regarding oral health and early childhood caries. Statistical analyses were performed using SPSS 20, using descriptive statistics (means and standard deviations), Pearson’s and Spearman’s correlation coefficients and independent t-test.Results: The mean knowledge, attitude and performance scores of mothers were 41.8, 61.2 and 45.2 (of 100), respectively. There were direct and significant relationships between mothers’ knowledge and attitudes (p value=0.02) and practice (p value =0.005); in addition, there was a direct and significant relationship between mothers’ attitudes and performance (p value=0.04). There was no significant relationship between knowledge (p value=0.07) and attitude (p=0.92) and age but there was a significant relationship (p value<0.001) between performance and age. There was also a significant relationship (p value<0.05) between knowledge, attitude and performance on one hand and mothers’ educational level, economic status of the family and employment status of mothers on the other hand. However, there was no significant relationship (p value>0.05) with child birth rank.Conclusion: Since the means of mothers’ knowledge and practice scores were lower than moderate level and since mothers are responsible for infants’ oral hygiene, it is important to increase the mothers’ level of knowledge and improve their attitudes and practice in this context. Therefore, educational programs are necessary for them in this respect.

Introduction: Given the importance of angiogenesis and formation of new vessels and their relationship with the progression of malignant lesions and also CD105 sensitivity in determining newly formed vessels, the present study was undertaken to evaluate CD105 protein expression in dysplastic and malignant oral lesions.Materials& Methods: In this cross-sectional descriptive‒ analytical study 20 paraffin blocks from dysplastic oral lesions and 20 paraffin blocks from squamous cell carcinoma lesions based on histopathological criteria, from patients referring to the Department of Oral and Maxillofacial Pathology of the School of Dentistry in the last 10 years were selected using simple sampling technique. The samples were stained immunohistochemically for CD105 marker and evaluated by two pathologists simultaneously under a light microscope at ×400 magnification. The mean of stained areas was considered as the mean vessel density with CD105 expression in each sample. Data were analyzed with SPSS 20, using Mann-Whitney test (α=0.05).Results: The means of CD105 marker expression in dysplastic and squamous cell carcinoma lesions were 7.58±6.19 and 19.35±8.63, respectively. Mann-Whitney test showed significant differences between the two groups in CD105 expression (p value<0.001).Conclusion: Given the importance of CD105 marker expression in new vessels and its significant increase in malignant lesions, it can be concluded that the progression of dysplastic lesions toward malignancy is accompanied by neoangiogenesis and this marker can be useful for evaluation of the course of dysplastic lesions or as a therapeutic aim for malignant lesions.

Introduction: Oral health literacy (OHL) is one of the most important determinants of oral health. Given the importance of the subject in program planning for promotion of the oral health of the community, this study evaluated OHL among citizens in Isfahan, Iran.Materials& Methods: This cross-sectional study was conducted on 758 adults living in Isfahan, who were selected by simple random sampling technique. Data were collected with the use of a questionnaire which consisted of 17 questions on OHL in 4 sections of reading comprehension, perception of numbers, listening and decision making.There were 3 questions on oral health behaviors; a question on potential sources for oral health information, the self-assessment of oral health of participants as well as age, sex and education. The citizens were categorized into three groups with inadequate OHL (0‒9), borderline (10‒11) and adequate OHL (12‒17). Ttest, ANOVA, LSD tests, chi-squared, Spearman’s coefficient and multivariate linear regression were applied for statistical analyses verbal consents were achieved.Results: Of participants, 53% had adequate OHL. The mean (SD) of OHL was 11.1 (4.3) of a total of 17. Woman, older adults and those with higher education scored higher for OHL (p value<0.05). The score of OHL was higher among those who reported favorable oral health behaviors (p value=0.006). In addition, participants who believed they had a poor oral health status had low OHL scores compared to the other two groups. Dentists, radio and television, and the internet were the main sources of oral health information of citizens in Isfahan.Conclusion: The study showed insufficient OHL among Isfahan citizens. Health policy maker should have prepare oral health programs to promote OHL in the community.

Introduction: Dentists’ awareness about the rules of light and color makes it possible to deliver restorations coordinated with the patient's tooth color. The aim of this study was to evaluate the performance of dentists in relation to the principles of light and color to select the color of teeth.Materials& Methods: This descriptive/cross-sectional study was performed on a random sample of 200 dentists in Isfahan by using a questionnaire with 36 questions. The responses to the questions in the questionnaire were scored. The scores were analyzed statistically with Kolmogorov Smirnov and chi-squared tests (a=0.05).Results: The surrounding atmosphere color in most dental offices was bright. Dentists and assistants wore white uniforms in most cases. Most dentists used to select the teeth color under a light source, but increasing the number of light sources increased the success rate (p value<0.01). Most dentists selected the tooth colors in the afternoon, but the color selection was not correlated with success rate (p value=0.220). Most dentists chose the color in over one minute. In half of the cases, the dentist selected the color and in the other half it was selected in partnership with assistants. Most dentists chose the color after carrying out dental prophylaxis. Tooth color selection was carried out in most cases while the patient was standing near the window, with the teeth and the surrounding tissues being wet. Most dentists were not aware of the differences in lighting conditions between the dental office and the laboratory.Conclusion: Most dentists were in the moderate group in terms of following the rules of light and color selection. Although this is somewhat acceptable, color selection should be improved through continuous education programs.

Introduction: Conservative pulp therapy is an approach to maintain pulp vitality. Direct pulp capping and partial pulpotomy are two main approaches of this therapy. The aim of this study was histological comparison of direct pulp capping and partial pulpotomy with MTA in human premolar teeth.Materials& Methods: In this randomized clinical trial, 40 healthy premolar teeth were selected from patients who needed tooth extraction because of orthodontic treatment. After anesthesia, isolation and preparation of a Cl I cavity on the occlusal surface, an exposure was made in the buccal pulp horn using a #½ round bur with the whole bur entering the pulp chamber in half of the samples. In the remaining samples, a small exposure was made in the buccal pulp horn. The pulps in both groups were sealed with MTA (PRO Root, Dentsply, Switzerland). All the cavities were restored with glass-ionomer. After 60 days, all the teeth were extracted and after fixation and decalcification processes, 4-μ sections were obtained. H& E staining was carried out. The sections were analyzed by an oral pathologist who was blinded to the study procedures. Data were analyzed with Kruskal–Wallis test and Fisher's exact test (a<0.05).Results: There were no significant differences between direct pulp capping and partial pulpotomy in pulp reaction (p value=0.823). The calcified bridges formed were not significantly different between the two groups (p value=0.985).Conclusion: Direct pulp capping and partial pulpotomy are both useful for maintaining pulp vitality.

Introduction: The maxillary sinus septa are a major problem in sinus lift procedures, resulting in an increase in sinus membrane perforation. The aim of this study was to determine the frequency, location and size of maxillary sinus septa on CBCT images in an adult population.Materials& Methods: In this descriptive-analytical study, CBCT images of 75 patients>18 years of age were evaluated. Then the frequency, location and size of maxillary sinus septa were determined. The patients were divided into three groups (n=25) based on the number of teeth: posterior complete edentulism, posterior partial edentulism and posterior complete dentition. The images were evaluated in terms of the location of septa in three areas: the anterior (premolar region), middle (distal to the second premolar to distal to the second molar) and posterior (distal to the second molar).The septa sizes and locations were evaluated using Ondemand 3D software program. Data were analyzed with ANOVA and chi-squared, McNemar and Kruskal-Wallis tests (a=0.05).Results: In 150 maxillary sinuses, CBCT images showed 86 septa (57.3%). Most septa (53%) were located in the middle region of maxillary sinuses. Sinus septa were present in 30% of posterior totally edentulous subjects, 37% of posterior partially edentulous subjects and 33% of patients dentate in the posterior region, with no significant differences between the three groups (p value=0.37). The mean height of the septa was 5.9±3.6 mm.Conclusion: Most septa were located in the middle region of maxillary sinuses, with no statistically significant differences between the three groups. CBCT might provide useful information during sinus lift procedures, considering wide anatomic variations in the frequency, size, location and morphology of maxillary sinus septa.

Introduction: Overweight increases the likelihood of systemic involvement with one or several conditions and social problems, which might affect dental services and their management. Based on research, obesity is a major risk factor for periodontal diseases. The aim of this study was to compare periodontal findings in overweight and obese individuals with those with normal BMI.Materials& Methods: In this cross-sectional study, 160 subjects were examined for periodontal status, 80 of which were overweight and obese and 80 were normal. Body mass index was used for the diagnosis of overweight and obese individuals. The participants were clinically examined for plaque index, gingival index, BOP, probing depth, gingival recession and clinical attachment level. Data were collected from examinations and analyzed with t-test using SPSS.Results: The means of all the indexes were higher in overweight and obese subjects compared to normal subjects. T-test showed significant differences between the normal group and overweight and obese groups in the assessed indexes (p value< 0.05).Conclusion: The results of this research showed that overweight and obese individuals had worse periodontal status than subjects with normal BMI.

Introduction: Oral lichen planus (OLP) is a chronic oral immunological disease. Topical corticosteroids and low-level lasers are used in the treatment of erosive and erythematous forms of lichen planus. This study was performed to compare the combined application of low-level laser and topical corticosteroids and topical corticosteroids alone in the treatment of OLP.Materials& Methods: In a clinical trial, 11 patients with 15 regions of ulcerative and erythematous forms of oral lichen planus were selected for treatment with laser and 15 control areas were selected on the opposite side. In these areas, the lesion sizes, pain severity and erythematous changes were recorded. Topical corticosteroid therapy continued for the lesions. Low-level Azor-2K diode laser (660 nm, 2 J/cm2) beams were applied in 4 sessions for 2 weeks. Data were analyzed with SPSS by using independent t-test and Mann-Whitney U test and ANOVA (α=0.05).Results: The pain severity was not different between the two sides after laser irradiation (p value=0.954). Following laser irradiation, sign symptoms and signs were lower on laser therapy side (p value=0.019). The lesion sizes decreased on the laser side (p value=0.012) and remained small during the follow-up period (p value= 0.024). There was no decrease in lesion size on the topical corticosteroid side (p value=0.383). Erythematous intensity decreased to a greater degree on the laser irradiation side (p value=0.016).Conclusion: Application of 660-nm low-level diode laser combined with the use of topical corticosteroids was more effective than topical corticosteroid alone; therefore, it appears LLLT can be used to increase the efficacy of topical corticosteroid therapy in oral lichen planus.

Introduction: Although dental caries, periodontal diseases are the most prevalent conditions of oral health all over the world, it should be pointed out that temporomandibular disorders are the second leading cause of pain after odontogenic pain. Various tools are available for the diagnosis of temporomandibular disorders, including Fonseca questionnaire. The aim of this study was to evaluate the psychometric characteristics of Persian translation of Fonseca index in a sample of Persianspeaking people.Materials& Methods: The original English version of the Fonseca questionnaire was translated into Persian by a forward–backward translation method. Then reliability was tested on 400 subjects. Cohen’s kappa, a measure of agreement between observers that includes an adjustment for chance agreement, was likewise calculated.Results: The reliability coefficient (Cronbach's alpha) of the Fonseca questionnaire was calculated at 0.88, which increased to an acceptable level when each item under study was eliminated. The coefficient of test re-test reliability measured by ICC (Intra-class correlation coefficient) was 0.86 (95% CI: 0.82‒ 0.91).Conclusion: The Persian version of Fonseca questionnaire was shown to be valid tool for the evaluation of TMJ disorders by dentists. It should be pointed out that this questionnaire is a screening tool and should be used with clinical and control criteria in the paraclinic for determination of positive and negative cases and for the validity of tests with intervention if necessary.

Introduction: Stem cells which are capable of self-proliferation and differentiation into at least two different types of cells can play a major role in the treatment of various diseases. The aim of this study was to evaluate awareness, knowledge and attitudes of dental practitioners in Isfahan regarding stem cells and their applications in the dental field.Materials& Methods: This cross-sectional study was based on designing a structured self-functioning questionnaire, with close-ended questions. The questionnaire was distributed among 391 general dentists and specialists in Isfahan. Data were analyzed with SPSS 22 using Spearman’s test, t-test and chi-squared test (α=0.05).Results: Of 391 dental practitioners working in Isfahan, 245 general dentists and 63 specialists were familiar with the term "stem cells". The mean age of the subjects in this research was 41 years. Of these dentists, 86 (22.2%) had job experience less than 5 years and 105 (27.11%) had 5‒10 years of experience and 197 (50.8%) had job experience over 10 years. The mean awareness score was 3.92, with mean knowledge and attitude scores of 2.63 and 38.6, respectively. The correlation between mean awareness, knowledge and attitude scores showed a direct and significant correlation between awareness and knowledge (r=0.608, p value< 0.001). However, there was no significant correlation between awareness and attitude (r=0.099, p value=0.085). In addition, there was no significant correlation between knowledge and attitude (r=0.055, p value=0.332).Conclusion: The results showed that despite high level awareness and relatively positive attitude toward stem cells, knowledge on the application of stem cells was low.