Journal of Isfahan Dental School
Year:2011 | Volume:6 | Issue:5 (SPECIAL ISSUE)|Papers Count:71

Introduction: Oral health includes healthy mouth with healthy tissues, which provides for eating, speaking, and social encounters without active disease, discomfort, and dissatisfaction. The present study evaluated quality of life related to oral and dental health, effect of body and mind on oral health, and effect of oral and dental disabilities on daily life of 8-10 year-old children in Isfahan.Materials and Methods: In this descriptive, analytical, and cross-sectional study 138 children aged 8-10 were randomly selected from elementary schools in Isfahan. Children completed the Children Perception Questionnaire (CPQ). Then they were clinically examined and their DMFT (permanent teeth), dmft (deciduous teeth), MIH (molar-incisor hypoplasia), TDI (dental traumatic injuries) indexes and malocclusion were determined. To evaluate the reliability of CPQ, 70 of these children completed the questionnaire two weeks later without any dental interventions during the period. ANOVA, Spearman’s correlation coefficient, Cronbach's alpha and intra-class correlation coefficient (ICC) were used to determine the relationship between the indexes (a=0.05).Results: The mean score of CPQ was 14.68 with a standard deviation of 10.6, which was higher in girls than in boys. Cronbach's alpha and ICC were 0.86 and 0.82, respectively. Oral health-related quality of life did not exhibit any significant relationship with carious lesions in the deciduous and permanent teeth, molarincisor hypoplasia, dental traumatic injuries and malocclusion (p value<0.05).Conclusion: The Children Perception Questionnaire translated into Persian is valid and reliable for use in 8-10 year-old Persian children and can assess the effect of oral and dental disorders on quality of life.

Introduction: PFM crowns can restore esthetic and function to damaged teeth. In this research, the esthetic indexes of PFM crowns and overall patient satisfaction were evaluated.Materials and Methods: This study evaluated 41 patients with 45 PFM crowns in Isfahan Faculty of Dentistry, where the impressions had been taken and casts poured. Clinical crown length, crown width, faciolingual dimension of crown, contact point position and patients’ satisfaction were assessed. Finally the number and incidence rates of ideal and close-to-ideal crowns from esthetic viewpoint were determined. Data was analyzed by SPSS software and with paired t-test. (a=0.05).Results: The contact points of 24 crowns (53.3%) were similar to natural teeth. The shades of 41 crowns (91.1%) were similar to patients’ natural teeth. From the esthetic viewpoint 7 crowns (15.5%) were ideal and 11 (24.4%) were close-to-ideal. 95.1% of patients expressed complete satisfaction and 4.8% were partially satisfied with the esthetics of crowns. Compared to natural teeth, PFM crowns had longer clinical heights (0.005 mm) on average, with no statistically significant differences (p value=0.966). The mesiodistal widths of crowns were on average 0.282 mm larger than those of similar natural teeth, demonstrating a statistically significant difference (p value=0.01). In faciolingual dimension, the mean difference between crowns and similar natural teeth was 0.026 mm, which was not statistically significant.Conclusion: Considering the results, it is necessary that tooth preparation and the laboratory procedures be performed more accurately to fabricate crowns with better appearance and more similar to the natural teeth and to obtain patients’ full satisfaction.

Introduction: Recently, ferric sulfate has been introduced as an alternative to formocresol in primary teeth pulpotomies. The most common cause of failure in ferric sulfate pulpotomies is internal resorption, but the main reason for this side effect has not been elucidated. The aim of this study was to compare the clinical and radiographic success rates with the use of different base materials following ferric sulfate pulpotomy.Materials and Methods: Pulpotomies were performed in 105 primary mandibular molars in 35 patients under six years of age (3 teeth in each patient). After traditional ferric sulfate pulpotomy, one of the three test materials, ZOE, Ca (OH)2 or MTA, was randomly assigned to each tooth. The pulp chambers were filled with IRM and restored by SSCs. Clinical and radiographic evaluations were carried out at 6- and 12-month follow-up visits. Data was analyzed with chi-square and Fisher’s exact tests (a=0.05).Results: After 12 months, MTA group demonstrated higher overall success rate (100%) when compared with ZOE (86.67%) and Ca (OH)2 (80%) groups. There was a statistically significant difference between Ca (OH)2 and MTA groups (p value=0.024). Internal resorption was the principal cause of radiographic failure in Ca (OH)2 and ZOE groups.Conclusion: Given the limitations of the present study, Ca (OH) 2 cannot be recommended as a base material after ferric sulfate pulpotomy. It appears the base material has an important role in the success of ferric sulfate pulpotomy.

Introduction: Although chlorhexidine has better clinical and antimicrobial properties with less toxicity, it also has some side effects, limiting its application. The aim of the present study was to compare the side effects of two chlorhexidine mouthwashes made in Iran with two different concentrations of 0.12% and 0.2%.Materials and Methods: In this clinical trial, thirty patients with gingivitis or mild periodontitis were randomly selected. For all the subjects full prophylactic procedures were carried out, including the removal of plaque and germ and elimination of extrinsic stains. Then each subject in each group was asked to use 0.12% or 0.2% chlorhexidine twice a day for 14 days. Staining indexes, changes in taste, mucosal sensitivity and mouthwash taste were evaluated. The subjects did not use any mouthwashes for two weeks thereafter. This process was repeated with the other mouthwash after prophylaxis. Finally, data was analyzed with Wilcoxon and Mann-Whitney tests using SPSS software (α=0.05).Results: There were no statistically significant differences between staining indexes in terms of extent and intensity between the two concentrations of chlorhexidine (p value>0.05). Mucosal sensitivity and changes in taste were higher in 0.2% chlorhexidine compared to 0.12% chlorhexidine (p value<0.05). The taste of 0.12% chlorhexidine was more acceptable and better than 0.2% chlorhexidine (p value<0.05).Conclusion: Under the limitations of the present study, it was concluded that there are no significant differences in the side effects of the two mouthwashes under study.

Introduction: Implant surgery involves local anesthesia and drilling for implant placement, which might influence blood supply of the adjacent tooth. This study evaluated oxygen saturation changes of healthy adjacent tooth with pulse oximetry during implant surgery.Materials and Methods: Fifteen healthy adult patients, who were candidate for anterior implant sugary and had at least one healthy anterior adjacent tooth, were selected. Surgery was carried out after lidocaine/epinephrine local anesthesia. At four stages before local anesthesia injection and after injection, oxygen saturation of the healthy adjacent tooth and peripheral oxygen supply were measured. Data was analyzed with paired samples t-test.Results: The mean peripheral blood oxygen saturation before local anesthesia was 98.2%, with no changes during and after surgery. In the teeth the mean of oxygen saturation was 87.73% before local anesthesia, which decreased to 79.27% after surgery, demonstrating a statistically significant difference; at other intervals no significant differences were observed between oxygen saturation values before and after local anesthesia.Conclusion: After local anesthesia injection there was a transient decrease in oxygen saturation in the adjacent tooth. It is not clear whether this decrease in the blood supply of adjacent tooth is clinically important or not; therefore, more studies are necessary.

Introduction: Long-term clinical evaluation of dental implants and their surrounding structures is of utmost importance to acquire knowledge about reasons for implant success and failure.However, accurate and reproducible results are difficult to obtain. The aim of the present study was to examine bone height around endosseous implants on digital conventional radiographs (DCR) and direct digital subtraction images (DSI) prior to loading.Materials and methods: In this experimental study, bone height around 10 implants in 6 patients was assessed by 2 observers. Standardized digital radiographs were obtained just a week and 3 months postoperatively and subtracted by means of EMAGO software. Then the observers evaluated bone height on DCRs and DSIs. MINITAB software and paired t-test were used for statistical analysis (a=0.05).Results: Comparative evaluation of bone height indicated significantly higher values on DCR than on DSI (p value=0.002). The observers also had statistically significant variability in this assessment (p value=0.00003).Conclusion: DSI demonstrated lower values of linear measurement of bone height around endosseous implants compared with DCR. Interobserver variability should be considered when comparing values from follow-up studies.

Introduction: Many dental procedures such as intraoral radiography, impression-taking etc result in gag reflex. Various methods have been proposed for controlling this reflex but no practical and accurate technique has been found to date. The role of Eleagnus extract has been demonstrated in controlling this reflex. The aim of the present study was to evaluate the role of various concentrations of Eleagnus extract on controlling gag reflex.Materials and Methods: In this clinical trial the effect of 0.5%, 1%, 2%, and 3% aqueous concentrations of Eleagnus extract on gag reflex were evaluated in 168 subjects in 4 groups of 42. The subjects gargled 20 mL of Eleagnus aqueous solution in their mouth for one minute. Gag reflex was checked before and after the use of the solution by means of a tongue blade. The same procedure was repeated for all the concentrations. Data was analyzed by means of Freeman and Wilcoxon statistical tests using SPSS software (a=0.05).Results: Gag reflex decreased with an increase in Eleagnus concentration (p value<0.001).Conclusion: Under the limitations of the present study it was concluded that high concentrations of Eleagnus extract are effective in controlling gag reflex.

Introduction: Genes produce various organs of the body. Genes can be easily affected by different factors, resulting in mutations and structural changes, the effects of which appear as various diseases and abnormalities in individuals, particularly in their children. Anomalies and defects are more common in familial marriages compared to non-familial marriages. The aim of the present study was to evaluate the prevalence of dental anomalies in the children of familial and nonfamilial marriages.Materials and methods: In the present study, the records of 660 births related to 220 familial and 330 non-familial marriages were evaluated in Isfahan in relation to dental anomalies of microdontia, macrodontia, hypodontia, hyperdontia and missing teeth. Data was analyzed by chisquare test using SPSS software.Results: According to the results, the anomalies were distributed as follows: Hypodontia: 5% (78.5% in familial marriages); microdontia: 5.4% (63.9% in familial marriages); missing teeth: 8.1% (75.5% in familial marriages); macrodontia: 2.1% (57.1% in familial marriages); hyperdontia: 1.3% (55.6% in familial marriages); Total: 3.4% (68.2% in familial marriages).Conclusion: According to the results, there is a significant statistical relationship between familial marriage and the incidence of dental anomalies but there is no significant relationship between the anomalies and gender.

Introduction: Based on data available request for dental implants is ever-increasing in Iran parallel with that in other countries. Therefore, dentists are required to increase their awareness about this treatment modality. The aim of the present study was to evaluate Isfahan dentists’awareness to be able to program implant educational courses.Materials and methods: In this descriptive, cross-sectional study 300 dentists were evaluated in Isfahan. Questionnaires were distributed among dentists and collected in person, which were later coded. Average marks of questionnaires were determined between 0 and 60. ANOVA and t-test were used for statistical analysis (a=0.05).Results: A total of 67.7% of the subjects had not participated in any sort of implant courses. Total average mark of the questionnaires was 28.33 ± 16.9 (based on marks from 0 to 60). Average marks of general practitioners and specialists were 27.87±16 and 41±17.9, respectively, demonstrating a statistically significant difference (p value=0.03). Average marks of dentists participating in implant courses and those not participating in the courses were 38.72±13.74 and 23.4±16.12, respectively, with statistically significant differences (p value<0.001).Conclusion: Average marks of general practitioners and even specialists were much lower than the ideal. Regarding the need for knowledge in dental implants it is recommended that dental students’ curricula and dentists’ in-service training courses be tailored to accommodate this need.

Introduction: Complete blood count (CBC) is an important test, comprising several tests, considered a whole unit. The result of the test is important because it will help diagnose the systemic cause of some oral manifestations and eliminate the systemic etiologic factors involved in oral diseases. The aim of this study was to evaluate the knowledge of general dental practitioners in Isfahan about CBC test.Materials and Methods: In this descriptive cross-sectional study, a specially designed questionnaire was delivered to 100 dentists during continuous education programs or by directly referring to their offices. Data was gathered and analyzed by chi-squared test using SPSS software (a=0.05).Results: The mean overall score of the awareness of the dentists was 61%, which is optimal but not ideal.Conclusion: It is suggested that more continuous education programs be held to increase awareness of dental practitioners and greater emphasis be placed on basic sciences education in dental education.

Introduction: Erythema multiform (EM) is a mucocutaneous reaction to several factors, including infections, medications, foodstuffs, physical agents, malignancies and pregnancy. The oral cavity is commonly and painfully involved in this condition, with impairment of its function. The aim of the present study was to evaluate the prevalence of EM oral manifestations.Materials and Methods: This retrospective descriptive study evaluated 217 records of EM patients (F=113, M=104) from 1998 to 2008. Data regarding various forms of EM were extracted and recorded in special forms and analyzed with frequency tests using SPSS software (a=0.05).Results: Of 217 patients, 126 patients (58%) had oral lesions. Erosive, ulcerative and erythematous types were, in descending order, the most common lesions. Lip, tongue and the buccal mucosa were, in descending order, most commonly involved. No significant differences were observed between males and females.Conclusion: Considering the limitations of the present study, it was concluded that EM is quite prevalent and it should be included in the differential diagnosis by dental practitioners.

Introduction: Non-surgical treatment modalities, including scaling and root planing, have always been considered effective periodontal treatments. The purpose of subgingival instrumentation is complete elimination of calculi and other calcified deposits and creation of a smooth surface on the root. This study evaluated the effectiveness of conventional scaling methods on removal of subgingival deposits.Materials and Methods: In this clinical trial on 23 patients with moderate-to-severe periodontitis, 276 different sites with probing depths of >4 mm were selected. Initially, perfect SRP was performed for patients and its accuracy was approved by one experienced periodontist. In the surgical phase those sites were exposed and evaluated for presence and quantity of residual calculi and their relationship with pocket depth. Data was analyzed with Mann-Whitney, Kruskal-Wallis and correlation coefficient tests using SPSS software (a=0.05).Results: Of 276 different sites, 60.9% had residual calculi. The mean residual calculi in interproximal areas (63.1%) was more than that on radicular surfaces (50%) (p value=0.029). The mean of calculus index was higher in females than males (p value=0.039) and more on right sides than left sides (p value=0.001). There was a direct correlation between probing depth and calculus index: an increase in probing depth resulted in more residual calculi.Conclusion: Closed SRP method in deep pockets is not a reliable method for elimination of subgingival deposits, with 50% of calculi remaining, necessitating open scaling procedures in periodontal pockets with deep pockets.

Introduction: Usually osseointegration takes between three to six months after implant placement but patients are interested to have early loading. There are no definitive criteria for measuring bone mineral density (BMD), insertion torque (IT) (final torque force) and resonance frequency analysis (RFA) (primary implant stability) to determine exact loading time based on the relationship between the above-mentioned parameters. The aim of this study was to determine the relationship between IT, RFA and BMD in screw-type implants.Materials and Methods: This clinical trial was conducted on 18 patients who were candidates for ITI implant placement. Written consent was taken and jaw bone density was determined via a digital radiography technique before surgery. After implant placement, RFA and IT were measured. Fifty-five ITI implants of the total 62 implants placed were evaluated; the implants were 12 mm long with a diameter of 4.1 mm. Data was analyzed with Pearson’s test using SPSS.15 software (a=0.05).Results: There was a significant relationship between IT, RFA and BMD. Pearson’s test showed a correlation coefficient of 0.872 to 0.789 between the three parameters, indicating a strong relationship between them. The mean bone density was 1.468±0.042 g/cm2; the mean RFA was 66.01±2.2 ISQ and the mean IT was 34.62±3.33 N/cm2.Conclusion: Based on the results of the present study there is a significant relationship between, IT, RFA and BMD (p value=0.001).

Introduction: Cleft lip and palate is a common congenital and developmental anomaly. Several risk factors have been reported, some of which have been studied to some extent. The aim of this study was to evaluate risk factors involved in patients referring to Isfahan Faculty of Dentistry.Materials and Methods: This retrospective case-control study was conducted in 2009-2010 in the Cleft Lip and Palate Clinic in Isfahan University of Medical Sciences. The case group included 149 (91 boys and 45 girls) children with cleft lip and palate under three years of age, and the control group included 151 (90 boys, 61 girls) healthy children under three years of age. Family history, maternal age at pregnancy and any of these cases in the first trimester of pregnancy were evaluated: infectious diseases, trauma, exposure to x-ray, vaginal bleeding, tobacco smoking, alcohol, drugs, stress and pre-pregnancy BMI. Data was analyzed by the descriptive statistical methods, including frequency, mean, t-test, X2 and logistic regression (a=0.05).Results: The mean ages of children in the case and control groups were 1.89±0.84 and 1.77±0.93 years, respectively. The family history of cleft lip and palate (case=26.9%, control=1.3%) (p value< 0.001), use of antibiotics during the first trimester of pregnancy (case=26.2%, control=7.9%) (p value<0.001), BMI before pregnancy (case mean=23.57±0.46, control mean=22.28±0.40) (p value=0.036) and stress in the first trimester of pregnancy (case mean=27.02±2.78, control mean=14.49±2.18) (p value=0.048) were significantly different.Conclusion: In the present study four risk factors of family history, antibiotics, stress, and BMI before pregnancy were positively associated with the incidence of cleft lip and palate.

Introduction: Noncarious cervical lesions appear in 3 forms: abrasion, erosion and abfraction. The aim of this study was to evaluate the prevalence and etiology of noncarious cervical lesions in Dental Faculty patients of Isfahan Medical Sciences University in 2007.Materials and Methods: In this retrospective, descriptive, cross-sectional study a total of 120 teeth in 41 patients were evaluated. Special forms were filled out in 36 patients, which contained the clinical characteristics of the lesions and medical history of the patients. The diagnosis was based on the information in the forms and the etiology and prevalence of these noncarious cervical lesions were evaluated. Data was analyzed with descriptive tests (a=0.05).Results: The results showed that 75.7% of the subjects had abrasion lesions as a result of incorrect methods of brushing, use of non-standard toothbrushes or the application of non-standard toothpastes or dentifrices. A total of 50.7% of the subjects had abfraction lesions. The major etiologic factors for this lesion were missing of teeth, parafunctional habits, premature contacts and dental tilting. Finally, 28.2% of the subjects had dental erosions. The main causes of these lesions were gastrointestinal problems, consumption of saliva-reducing medications and smoking.Conclusion: Under the limitations of the present study it was concluded that the prevalence of noncarious cervical lesions in our subjects were, in descending order, abrasion, abfraction and erosion, respectively.

Introduction: The occurrence of emergency cases is one of the most important events during a dentist’s professional work time. Awareness of conditions which can bring about these events and the way to deal with and prevent these situations can play an effective role in controlling these events. The purpose of this research was to analyze awareness and performance of senior dental students of Isfahan universities about essential policies to deal with cardiovascular diseases.Materials and Methods: By completing a questionnaire containing 18 questions (9 questions about awareness and 9 questions about performance) in a descriptive study 86 senior dental students of Isfahan universities were evaluated regarding essential polices about cardiovascular diseases. SPSS software was used for data analysis (a=0.05).Results: In this study the awareness score average of the subjects for essential policies about cardiovascular diseases was 61%. Students’ performance about essential polices for cardiovascular diseases was at a moderate level.Conclusion: It appears additional instruction and explanation about the importance of emergency cases will increase the dental students’ awareness and optimize their performance in emergency cases.

Introduction: Determination and registration of orthodontic treatment needs in the general population is useful for planning orthodontic services. Self-perception of dental attractiveness is an important factor affecting orthodontic treatment need. This study investigated orthodontic treatment needs based on clinical dental aesthetic index (DAI) and the aesthetic component (AC) of self-perceived indices of orthodontic treatment need (IOTN).Materials and Methods: This cross-sectional study evaluated 728 students (52% boys, 48% girls) aged 12-18 in Isfahan. A stratified multistage sampling procedure was used to select subjects and the students wearing an orthodontic appliance or reporting a history of orthodontic treatment were excluded. Clinical examinations were carried out using dental aesthetic index (DAI). The subjective need was assessed using aesthetic component (AC) of index of orthodontic treatment need (IOTN). Statistical analysis was undertaken by SPSS software using chi-squared test and Spearman’s correlation coefficient.Results: The mean DAI and AC scores were 26.1±7.6 and 2.4±1.5, respectively. The most common orthodontic problems were crowding in the anterior segments, non-Class I molar relationship and tooth spacing. The subjects with no need or minor need, moderate need, definite need and severe need for orthodontic treatment comprised 54.5%, 19.5%, 15.1% and 10.9% of the population under study, respectively. There was a statistically significant correlation between DAI and AC scores (r=0.26, p value=0.00).Conclusion: According to the results, 26% of the subjects needed orthodontic treatment based on DAI and significant correlation between DAI and AC shows that DAI score might reflect a self-perceived need for orthodontic treatment.

Introduction: There is an ever-increasing demand for esthetic plastic surgeries, especially for rhinoplasty. Rhinoplasty influences the results of orthodontic treatment. Therefore, the aim of the present study was to evaluate this influence and compare esthetic facial parameters before and after rhinoplasty.Materials and Methods: In this clinical trial the pre-operative and post-operative photographs of thirty-five 20-30 year-old female candidates for rhinoplasty, which had been taken in a standard manner, were evaluated with AutoCAD 2008 software in relation to pre-determined angles and dimensions after written consent forms were signed. Data was analyzed with paired t-test and McNemar’s test (a=0.05).Results: Before rhinoplasty the median canthus-alar cartilage line crossed through both spots in 20% of the subjects, which changed to 80% post-operatively. The mean of clinical nasal index exhibited a difference of 4; lobular index difference was 2. No significant changes were observed in mean of nasofrontal angle. Nasolabial and nasofacial angles exhibited mean differences of 7 and 1 degrees, respectively.Conclusion: Based on median canthus-alar cartilage line position, rhinoplasty is successful in establishing facial golden proportions. Regarding nasolabial angle and lobular index, the changes were significant post-operatively (p value >0.001), which means that rhinoplasty successfully establishes normal proportions of these parameters in the face. Changes in other angles and indices after rhinoplasty were all in the standard range and were not statistically significant.

Introduction: To accomplish treatment successfully, dentists should use a variety of techniques to control the behavior of children. The aim of this study was to examine the effect of educational films and theoretical education of conventional behavior control methods on the attitudes of dental students toward behavior management techniques.Materials and Methods: In this experimental-interventional study, first, the operator explained every technique and the students filled out a questionnaire that included questions about behavior management techniques and demographic data. Then a videotape that explained and implemented the techniques was presented to them. Then the students filled out the questionnaire again. Theoretical education about behavior management techniques included four 2-hour meetings. After these meetings the students filled out the questionnaire again. Finally, means of scores for every technique were compared in the three intervals (before film, after film and after education). Data was analyzed with SPSS software and one-way ANOVA, and Tukey HSD (a=0.05).Results: The most acceptable technique in the three periods was tell-show-do and voice control. Watching the film did not result in any significant differences in any methods. The effect of education on voice control, passive restraint and general anesthesia techniques was significant and resulted in their acceptance.Conclusion: According to the results of this study, educational films prepared students to accept education. Theoretical education can increase acceptance of some techniques.

Introduction: Chronic sinusitis results from micro-anatomic disturbances, especially from narrow airways and mucous contact areas in the nose and sinuses. One of the predisposing factors is the nasal septum deviation. Therefore, the aim of the present study was to determine the relative frequency of sinusitis severity in patients with nasal septum deviation, the effect of age in patients with nasal septum deviation on the severity of sinusitis, and the effect of nasal septum deviation severity on sinusitis severity.Materials and Methods: In this descriptive, cross-sectional study 109 adult subjects with chronic sinusitis, who had Water’s radiographic views and CT scans were evaluated. These patients had nasal septum deviation with no other predisposing factors for sinusitis. Data was analyzed with Spearman’s correlation coefficient test (a=0.05).Results: All the subjects with sinusitis had nasal septum deviation, which demonstrates a strong correlation between chronic sinusitis and nasal septum deviation. The highest and lowest frequencies were observed in the 20-29 and >50 age groups, respectively. There was no significant relationship between sinusitis severity and nasal septum deviation severity on one hand and aging on the other.Conclusion: Under the limitations of the present study it was concluded that there was a significant correlation between nasal septum deviation severity and sinusitis severity.

Introduction: Mothers have a great role in the oro-dental health of their children and prevention of related diseases and dental traumas. The aim of this study was to assess awareness of mothers about individual and environmental risk factors of dental trauma and prevention in 8-12 year-old children and their relationship with children’s daily life.Materials and Methods: Five hundred fifty-six mothers of 8-12 year-old elementary schoolchildren in Isfahan completed a questionnaire on awareness about environmental risk factors and prevention of dental traumas, how to preserve and transfer avulsed teeth, and first aid in dental traumas. One hundred of these students were examined for oral health status, oral traumas and their effect on daily routines. Data was analyzed by chi-squared test, ANOVA, and t-test using SPSS 11.5 software (a=0.05).Results: Means and standard deviations of awareness of mothers was 8.9±3.13. There was a statistically significant relationships between mothers’ dental trauma awareness and educational level and sources of dental trauma information (p value=0.016 and p value=0.001, respectively). There was no significant relationship between mothers’ knowledge and occupational status and dental trauma reaction speed (p value=0.154 and p value=0.636, respectively). Furthermore, the relationship between the effect of oro-dental health on children’s daily routines and mothers’ awareness was significant (p value=0.001).Conclusion: Awareness of mothers about dental trauma and individual and environmental risk factors and preventive modalities was poor. Oro-dental health had a significant effect on children’s daily routines, including schooling, eating, social relations, rest, sleep and tooth brushing.

Introduction: Impaction displaces the maxilla in the vertical dimension, increasing the distance from the mandible; autorotation compensates this distance in the articulator and the mouth. The aim of the present study was to compare two thin (with the mandibular autorotation) and thick (without autorotation) splints.Materials and Methods: In this clinical trial, 19 patients (6 males and 13 females) were evaluated. The casts were trimmed and transferred to an articulator with the use of a Gnathus facebow. Jaw relationship was recorded in CR position. A model maxillary surgery was carried out in the direction of impaction and depending on the incisal pin of the articulator two intermediate splints were produced: 1. a situation with no incisal pin displacement (thick splint); 2. a situation with incisal pin displacement (thin splint). After maxillary osteotomy, at first the maxillary position was determined using the thin splint and reference lines were drawn on the maxillary sinus wall perpendicular to the osteotomy line. Then the thin splint was replaced by the thick one and the position of reference lines was evaluated and recorded. Data was analyzed with ANOVA (a=0.05).Results: The reference lines changed in 6 patients (31%) (mean=1.3 mm) and in 13 patients (69%) they remained constant. In 13 patients the mean of impaction and incisal pin movement were 4.3 mm (3-6 mm) and 4.9 mm (2-8 mm) respectively; in 6 cases they were 7.5 mm (5-9 mm) and 9.8 mm (7-15 mm). The probability of displacement of reference lines after splint replacement was calculated 10.7-52.5% by probability test.Conclusion: There is a possibility that thin and thick splints will not place the maxilla in the same position; the probability increases as impactions increases. Changes in reference lines are under the influence of articulator incisal pin displacement rather than the extent of impaction.

Introduction: Mechanical plaque control is the main method for prevention of dental caries and periodontal disease. Among mechanical methods, daily brushing is the basic method to achieve oral and dental health. Toothbrush design and shape are important for brushing efficacy. The aim of this study was to compare the efficacy of three toothbrush designs, i.e. Classic, Cross-action and Pulsar, in Bass plaque control method.Materials and Methods: In this clinical trial, 30 volunteers were enrolled and prophylactic procedures were carried out for all of them. Bass method of toothbrushing was explained to them. Then each subject randomly received one of the three toothbrush designs to brush with for 7 days. The volunteers were asked not to brush for 24 hours before recall. The plaque index was recorded for all the subjects by O’Leary plaque index on recall visit. Then the volunteers brushed under the control of the investigator using the Bass technique, and the plaque index was measured again by the same procedure. This process was repeated for the two other toothbrushes. Data was analyzed by sample t-test and repeated measure ANOVA (a=0.05).Results: In this study the plaque removal level was 21.5% for Classic, 26.77% for Cross-action and 24.03% for Pulsar designs. All the three toothbrushes decreased plaque significantly (p value < 0.05), with no significant differences (p value >0.05).Conclusion: Classic, Cross-action and Pulsar toothbrushes are effective in Bass method of plaque control, with no significant differences.

Introduction: Collecting data on the prevalence of dental caries in a community has a great role in planning for oral health. The aim of this study was to determine the prevalence of dental caries in 12-19 year-old schoolchildren in Isfahan.Materials and Methods: A descriptive cross-sectional study was undertaken on 810 students aged 12-19, divided into three age groups: 12-14 year-olds (n=257), 14-17 year-olds (n=279) and 17- 19 year-olds (n=274). A stratified two-stage sampling procedure was used to select subjects from student lists in different districts of Isfahan. All the students were examined to determine DMFT index using the WHO criteria by calibrated examiners. Demographic data was recorded. Data was analyzed with Kruskal-Wallis and Mann-Whitney tests, and Spearman’s correlation coefficient (a= 0.05).Results: Mean DMFT values in the 12-14, 14-17, and 17-19 age groups were 2.84±2.4, 4.88±3.4 and 6.28±3.9, respectively. There were significant differences in mean DT, FT and DMFT values between the different age groups (p value<0.001). However, there were no significant differences in missing teeth means between the groups (p value=0.11). There was a significant association between FT means and the parents’ job and educational status.Conclusion: The results of the present study showed that DMFT scores of adolescents are higher than global goal set for the year 2000. To achieve these standards, it is vital to establish comprehensive oral health promotion programs in children and adolescents and revise the oral health care delivery system in Isfahan.

Introduction: In addition to color, translucency is one of the primary factors influencing the esthetics of a dental prosthesis. The aim of this study was to determine the effect of water storage on translucency of reinforced composite resins.Materials and Methods: In this experimental study, six C1-shade dentin samples from Belleglass and Gradia reinforced composite resins were prepared and divided into two groups: The samples in one group were stored in 37oC distilled water and the samples in the other group were kept in a dry environment. The samples in both groups were stored at 37oC in an incubator for one month. Then, sample translucency was calculated using the contrast ratio. Statistical analysis was performed by two-way ANOVA and Mann-Whitney test (a=0.05).Results: No significant differences were observed in contrast ratios between the wet and dry storage conditions of Belleglass samples or Gradia samples (p value=0.827). However, significant differences were observed between contrast ratios of Belleglass and Gradia in wet and dry storage conditions (p value=0.05), revealing that in both dry and wet storage conditions Belleglass was more translucent than Gradia.Conclusion: Within the limitations of this study, both Belleglass and Gradia were stable in translucency after water storage. However, Belleglass was more translucent than Gradia in both dry and wet storage conditions.

Introduction: The aim of the present study was to determine and compare the accuracy of measurements of CEJ-to-alveolar crest (AC) distance in periapical conventional and digital radiographs corrected for attenuation and visual response.Materials and Methods: Sixty-three interproximal bone sites adjacent to posterior teeth with different amounts of horizontal bone loss in dried human mandibles were selected in the present experimental study. The CEJ-AC distances in the mandibles were assessed and employed as gold standard. Periapical and digital radiographs (parallel technique) were exposed with the CCD sensor and E-speed films. Digital radiographs were processed with Dental Eye program to correct for attenuation and visual response. The CEJ-AC distances were assessed on conventional and corrected digital radiographs. The results of the two radiographic measurements were compared with gold standard by paired t-test. Pearson’s correlation coefficient for the two radiographic measurements was calculated with gold standard (a=0.05).Results: The accuracy of CEJ-AC distance measurements on conventional and digital radiographs was estimated to be 86%. Pearson’s correlation coefficient between the gold standard and measurements on conventional (r=0.90) and digital radiographs (r=0.92) indicated strong correlation between the gold standard and the two radiographic measurements (p value >0.001).Conclusion: Digital radiographs corrected for x-ray attenuation and visual response are comparable to conventional radiographs in accuracy for measurements of CEJ-AC distance.

Introduction: Considering the relationship between different measurements of facial skeleton, it is possible to use cephalometric and anthropometric indexes to classify different facial types, which is very important in orthodontic treatment. The aim of this study was to determine the relationship between dental arch width and vertical facial dimension in 8-17 year-old students in Isfahan.Materials and Methods: This cross-sectional, descriptive-analytical study was carried out on 96 casts and lateral cephalograms, which had been selected under specific conditions. The following measurements were carried out: inter-canine, inter-premolar, and inter-molar distances in both arches at three points: cusp tips, the most buccal aspect of each tooth and at the central fossa in molars. Data was analyzed with descriptive statistical tests, Pearson’s correlation coefficient and regression analysis using SPSS software (a=0.05).Results: Of all the variables evaluated only the inter-molar distances at central fossa and the most buccal aspect in the mandible had a significant relationship with the lower and total facial heights (p value <0.05). Furthermore, a significant relationship was observed between dental arch width and age.Conclusion: Under the limitations of the present study, it was concluded that as the lower and anterior facial heights increase, the mandibular inter-molar widths at the central fossa and the most buccal aspect of the teeth decrease. Therefore, it is possible to predict, to some extent, the proper mandibular inter-molar widths by these vertical measurements.

Introduction: Decreasing injection pain will make the patient more comfortable during dental procedures, giving a positive feeling towards dentistry. The most recently developed product for topical anesthesia is Denti Patch. The aim of this study was to study the effectiveness of Denti Patch as a topical anesthetic agent before palatal infiltration injection.Materials and Methods: Fifty-four 9-12 year-old subjects, 23 boys and 31 girls, were examined. Before the study, VAS was explained to the participants. First, the area was dried by air spray for 5 seconds; then both patches, the placebo and lidocaine, were placed 5-10 mm from the free gingival margin of the palate on the injection site for 12 minutes. A total of 0.2 mL of 2% lidocaine was injected. After 1-2 minutes the second injection was made on the contra-lateral side. Data was analyzed by paired t-test and Willcoxon test (a=0.05).Results: Means from CPS test in the non-anxious children for placebo and Denti Patch were 8.5 and 8.4, respectively, with no significant differences (p value=0.88). The results from VAS test in non-anxious children for placebo and Denti Patch were 75.2 and the 70.2, respectively, demonstrating a statistically significant difference (p value=0.006).Conclusion: According to this study, Denti Patch is effective in reducing the pain of palatal infiltration injection. The differences between CPS and VAS test results might be attributed to the cooperation of subjects, their friendly relationship with the dentist, and their abstinence from exhibiting false alarm reactions in the CPS test.

Introduction: Interaction between periodontal cells and bone graft materials is important for the regeneration of periodontal lesions. The aim of this study was to compare the genotoxicity and cytotoxicity of Iranian Nano-hydroxyapatite and foreign Algipore hydroxyapatite on periodontal fibroblasts.Materials and Methods: In this in vitro study, gingival C502 fibroblasts were captured in their logarithmic phase, cultured and grown. Genotoxicity and cytotoxicity of Nano-hydroxyapatite and Algipore hydroxyapatite were evaluated on these cultured cells at 100%, 75%, 50% and 25% concentrations. Comet test was used in order to study the toxicity of the materials on the chromosomes in the nucleus. Multiple regression was used to compare the effect of the two materials at a significance level of a=0.05, by considering the percentage of the lysed cells at baseline and after incorporating the two materials.Results: No significant differences were observed between the two materials (p value >0.05). Multiple regression showed that there was a significant relationship between the cytotoxicity and the concentration of these two materials (p value <0.05). There was no case of Comet, which indicates that the materials had no genotoxicity.Conclusion: The results of this study demonstrated that Nano-hydroxyapatite is an appropriate alternative to hydroxyapatite, especially in regeneration and repair of periodontal lesions. Further studies are recommended in this regard.

Introduction: Tumors and cysts comprise a complicated group of lesions characterize histologically and manifested clinically in a wide variety of ways. As far as dental origin is concerned, some cysts and tumors are odontogenic and still some others are non- odontogenic. On the whole, maxillary cysts are more common than other bone cysts, and actually rank first in prevalence. It must noted that cysts and tumors give rise to maxillary fractures. The aim of this study was Assessment prevalence and frequencies of non- odontogenic and odontogenic cysts & tumors in 15 years ago In the isfahan dental school and Alzahra hospital.Materials and Methods: The necessary data was collected on odontogenic and non odontogenic tumors and cysts cases filed in the Surgery ward, and Disease and Pathology ward, Dentistry College and also those cases filed at Maxillofacial Surgery ward, Alzahra Hospital, Isfahan, Iran. Also, the patients, gender, age, disease recurrence and the time of pathological analysis were recorded for more detailed evaluation.Results: Of the cases filed from 1994 to 2008, there were 187 cases of odontogenic, 9 cases of non– odontogenic cysts, and also 47 odontogenic and 3 cases of non- odontogenic tumors. While odontogenic cysts were more commonly observed in men of 16 to 30, non – Odontogenic cysts were equally dispersed between men and women and across all age ranges. Moreover, the odontogenic tumors were also seen to belong to men of 16 to 30. In contrast, the non- odontogenic tumors were more prevalent in women in their mid life.Conclusion: Odontogenic cysts compared with odontogenic tumors were significantly more common (Pvalue 0.048). Next in terms of prevalence are odontogenic tumors, followed by non– odontogenic cysts and finally non– odontogenic tumors. The concluding point in the present research is that odontogenic cysts and tumors arc more in comparison with non– odontogenic ones.

Introduction: Analysis of smile is one of the esthetic evaluations in dentistry. In the present study, GLA, LID, the long axis position and the oblique axial angle of each tooth were evaluated.Materials and Methods: In this cross-sectional analytical study, 80 subjects with properly-aligned teeth and healthy periodontium were selected. A digital camera was to take photos of lip areas in uniform conditions. The zenith (the margin tip) of the gingiva of maxillary incisors was determined in the photographs. The line connecting the zenith of canine to that of central was called the gingival line. The angle between this line and tooth midline (GLA) and the distance between the Zenith of the later and that line (LID) was calculated. Then the long axis and the oblique axial angles of maxillary anterior teeth were determined. Data was analyzed with t-test and McNemar’s test (a=0.05).Results: No significant differences were observed in GLA and LID between the left and right sides (p value <0.05). The overall GLA and LID averages were 90.01±6.10o and 0.55±0.52 mm. There was no significant difference in long axis position of maxillary anterior teeth between the left and right sides (p value >0.05). There were significant differences in the overall oblique axial angles of anterior teeth between the right and left sides (p value <0.05).Conclusion: The zenith of centrals and canines were mostly on the same level and LID was 0-1 mm coronal to the gingival line. The mean oblique axial angle of canine was higher than that of lateral, which in turn was higher than that of central.

Introduction: Herpes labialis is important in dentistry because of its high prevalence. Herpes simplex virus (HSV) is responsive to treatment and infection control methods help protect patients and dental personnel. Due to high levels of stress in the flight crew this study evaluated the prevalence of recurrent herpes labialis in the personnel of an airline company.Materials and Methods: In this cross-sectional descriptive analytical study, 63 personnel of an airline company referring to the company’s dental facility in 2008 were selected. Questionnaire forms containing demographic data (age, sex, etc) and clinical evaluations were arranged. Then the relevant data was gathered with the questionnaires and clinical examinations. Data was analyzed with chi-squared test and t-test (a=0.05).Results: Overall prevalence of recurrent herpes labialis was 39.68% in the two groups under study. Of 63 questionnaires filled out 31 were related to the office staff and 32 to the flight crew. The highest prevalence of recurrent herpes labialis was observed in the flight crew (68%). Only 32% of the office staff had recurrent herpes labialis. Therefore, there was a statistically significant relationship between the two groups (p value <0.05). The results of the chi-squared test showed that the flight crew who had higher stress levels had higher prevalence rates of recurrent herpes labialis.Discussion: Under the limits of this study, it was concluded that flight crew had higher prevalence rates of recurrent herpes labialis compared to the office staff.

Introduction: Severe gagging in some patients during dental procedures can complicate the procedure. In this study, the effect of oral ondansetron and placebo, as antiemetic medications, on gag reflex was evaluated with the stimulation of soft palate and palatine tonsil areas to simulate the clinical situation during dental procedures.Materials and methods: In this clinical trial, 88 healthy adult individuals were randomly divided into two equal groups of ondansetron and placebo, which were administered orally. Gag reflexes were checked using a tongue depressor and recorded before and 90 minutes after intervention in the soft palate and palatine tonsil areas. Data was analyzed and compared with SPSS software, using Mann-Whitney and Wilcoxon tests (a=0.05).Results: In the ondansetron group a statistically significant decrease in gag reflex was noted after intervention in both soft palate and tonsil areas (p value<0.05); however, no significant decrease was observed in the placebo group in the two areas after intervention.Conclusion: The results of the present study showed the efficacy of ondansetron in reducing the severity of gag reflex in both the soft palate and tonsil areas; therefore, its administration can be considered in clinical procedures in those areas.

Introduction: Isolation of various microorganisms from pockets, dental plaque or saliva in periodontal patients is very important. Among the isolated microorganisms, Helicobacter pylori is usually present in the oral cavity, either in saliva or in dental plaque. The aim of the present study was to evaluate the relationship between H. pylori and periodontal disease.Materials and Methods: In this case-control study in 2009-2010, 50 periodontal patients, as diagnosed by a periodontist, who referred to the Department of Periodontics in Isfahan Faculty of Dentistry, were included. The subjects had not received any treatment for their disease during the previous month. The subjects were asked to submit a sample of their saliva by spitting into a sterile test tube. The samples were sent to the laboratory in a sterile environment to be analyzed with PCR test, which is now the best test for the evaluation of intraoral microorganisms. The same procedure was repeated for another 50 healthy individuals as the control group. The results were analyzed by chi-square test using SPSS software.Results: No significant differences were observed between the two groups in relation to the presence of H. pylori in the saliva (p value >0.05). In addition, no significant differences were observed between H. pylori presence and gender and periodontal disease severity (p values >0.05).Conclusion: Under the limitations of the present study no relationship was established between H.pylori and periodontal disease.

Introduction: At present various materials, such as Coe-pak, are used for wound healing and pain relief following periodontal surgery. Despite widespread use of Coe-pak, recently its value and efficacy in wound healing have been questioned. This study evaluated and compared the clinical effects of Coe-pak after modified Widman flap (MWF) surgery.Materials and Methods: In this clinical trial, 23 patients who needed MWF in at least two quadrants were selected. At first, the surgery site was dressed with Coe-pak and during the first week post-operatively, the patients were recommended to use 0.2% chlorhexidine mouthwash. After 3 weeks to one month, the second surgery was performed on the contra-lateral side without any dressing. Again, the patients were recommended to use 0.2% chlorhexidine mouthwash during the first week post-operatively. The patients were given questionnaires about their pain intensity and satisfaction about using or not using Coe-pak. The plaque index was determined using Mombelli Index one week post-operatively. Data was analyzed using SPSS and Wilcoxon, t-test and chisquared tests.Results: Significantly less plaque had formed in the absence of Coe-pak (p value=0.001); 56.5% of the patients preferred Coe-pak, 34.8% were not satisfied with it, and 8.7% had no special comment, with no statistically significant differences (p value=0.275). Pain intensity, with or without Coe-pak, was not significantly different between the two groups at 1-, 3-, 6- and 12-hour and 1-week intervals post-operatively.Conclusion: Use of Coe-pak after MWF influenced plaque formation, with no effect on pain and patient satisfaction.

Introduction: Knowledge of the position of the mental foramen is important in administering local anesthesia for routine dental procedures and in performing surgery in the mandible. Because of this anatomical structure's importance on one hand and the variations seen in its position in different ethnic groups on the other, this study was designed to evaluate its horizontal position in panoramic radiographs.Materials and Methods: In this cross-sectional, analytical, descriptive study 150 panoramic radiographs of 25-45 year-old patients referring to the Department of Radiology in Isfahan Faculty of Dentistry were evaluated and the position of mental foramen was recorded. The horizontal position of mental foramen on eligible radiographs was recorded in relation to mandibular first and second premolars. Data was analyzed with ANOVA, chi-squared test, and kappa agreement coefficient using SPSS software (a=0.05).Results: Panoramic radiographs of 64 males and 87 females were assessed. The most frequent position for the foramen was the apex of the second mandibular premolar with an approximate frequency of 56%.Conclusion: Under the limits of the present study, it was concluded that the most frequent position for the mental foramen in Iranian ethnic groups is the apex of the second premolar. The current finding, consistent with the results of other studies, showed that patient’s gender and age do not have any effect on the foramen's position.

Introduction: Managing the anxiety of pediatric dental patients is a daily routine for all dental practitioners. Various techniques have been used to control patient anxiety during dental treatment. The aim of this study was to evaluate the effect of audiovisual distraction on children’s anxiety during dental treatment.Materials and Methods: This experimental study was carried out on twenty-six 5-7 year-old children suffering from tooth decay in two groups. In group 1, during the first dental visit restorations were carried out on 13 subjects after local anesthesia without audiovisual distraction; during the second visit, audiovisual distraction was used with video glasses. In group 2, the order was reversed. Child anxiety level in each visit was assessed using a combination of two measures: saliva cortisol and pulse rate. Data was analyzed by t-test and paired t-test (a=0.05).Results: Use of video glasses did not significantly decrease salivary cortisol (p value=0.625) and pulse rate (p value=0.636).Discussion: In this study audiovisual distraction with video glasses could not decrease child anxiety to a significant level. However, children did enjoy wearing video glasses during dental treatment and preferred to wear them during the next treatment session.

Introduction: Neurotic war veterans have numerous oro-dental problems because of several factors, including the use of psychotropic drugs, peculiar mood, lack of attention to appearance and various other reasons. The aim of this study was to compare the oro-dental health in these veterans with a group among themselves.Materials and Methods: This cross-sectional retrospective study was carried out on 110 neurotic war veterans referring to Amir-Al-Momenin Hospital in Isfahan, who were on psychotropic drugs and 110 veterans who did not take psychotropic drugs. For both groups DMFT, plaque index, CPITN and saliva pH were recorded. Data was analyzed by t-test and Mann-Whitney and chisqured tests at 95% confidence interval.Results: The mean age of the subjects in the case and control groups were 44.5 and 41 years, respectively. DMFT means in the case and control groups were 11.02 and 10.1, respectively (p value <0.001). Means of plaque index in the case and control groups were 1.25 and 1.09, respectively (p value=0.005). In relation to CPITN the number of sextants with scores 0 and 1 were higher in the control group and scores 2, 3, and 4 were more numerous in the study group; regarding scores 0, 1, 2, and 3 a significant difference was observed between the groups (p values of 0.16, 0.05, 0.03, 0.047, respectively). Means of saliva pH were 6.11 and 6.34 in the case and control groups, respectively (p value <0.001).Conclusion: Neurotic war veterans are high risk patiants for oral and dental complacations. Therefore, more attention should be paid to their oro-dental health.

Introduction: Few research studies have evaluated cariogenicity and cariogenic bacteria in adults. Furthermore, there is limited and conflicting data on the effect of dental care level (restorative index) on salivary counts of Streptococcus mutans and Lactobacilli. The purpose of this study was to investigate the association between Streptococcus mutans, Lactobacilli and caries experience in adults with a high dental care level.Materials and Methods: Eighty adult volunteers who had not used Xylitol chewing gums, probiotic products, systemic antibiotics and local fluoride for a period of four weeks before saliva sampling participated in the present study. The subjects filled out a questionnaire about demographic information, educational level, occupation and oral health habits. D1,2MFT Index was recorded by clinical examinations. Saliva sampling was performed to determine bacterial counts.Results: A statistically significant relationship was noted between salivary Streptococcus mutans Lactobacilli counts and caries experience (p value<0.05).Conclusion: Under the limits of the present study, it was concluded that there is a relationship between salivary Streptococcus mutans, Lactobacilli counts and D1,2MFT index in adults with a high dental care level. It seemed that although the highest D1,2MFT component was related to the F component, the salivary bacterial flora counts are high.

Introduction: An important disadvantage of acrylic resin artificial teeth is their wear, which poses problems for patients. This study compared wear resistance of three Iranian brands of acrylic resin teeth with Ivoclar foreign brand, approved by ADA.Materials and Methods: In this experimental study, one foreign brand, Ivoclar, and three Iranian brands, Surperberelian, Yaghoot and Naturaldent, were comparatively evaluated. Seven samples from each brand were prepared. All the wear tests were performed in an environment with natural saliva by the use of porcelain abrading surfaces under the vertical force of 3 pounds. Each sample’s height was measured before and after 5000 and 10000 wear cycles with a micrometer with 0.002-mm accuracy. Statistical analyses by SPSS soft ware and were carried out with one-way ANOVA, Tukey test, and paired samples t-test.Results: There were no significant differences between the average wear rates of Superberelian and Ivoclar (p value=0.899), and between Yaghoot and Naturaldent teeth (p value=0.728) in 5000 wear cycles; however, in 10000 wear cycles average wear rates of all the brands increased, with the least and most increases in Yaghoot and Naturaldent, respectively. There were no significant differences between Superberelian and Ivoclar teeth in this cycle (p value=0.784); however, there were significant differences between other brands (p value<0.05). Among the Iranian brands, Superberelian and Naturaldent showed the least and the highest wear rates, respectively.Conclusion: The results showed that wear resistance of Superberelian teeth is similar to that of Ivoclar (approved by ADA).

Introduction: Emergence agitation is a common clinical phenomenon in children undergoing general anesthesia. A possible predisposing factor is the type of general anesthetic technique used. The aim of the present study was to evaluate the effect of two intravenous and inhalational general anesthetic methods on emergence agitation of children in the recovery room.Materials and Methods: In this prospective single-blind clinical trial, 56 children aged less than 6 years were randomly divided into two groups of 28. The first group received IV general anesthesia with propofol and alfentanyl and the second group received inhalation anesthesia with isoflorance and nitrous oxide. After awakening in the recovery room the children's emergence agitation was measured every ten minutes for 60 minutes by PAED scale. Data was analyzed with t-test, chisquared test and ANOVA with SPSS software (a=0.05).Results: Emergence agitation in the intravenous and inhalational groups at 10-minute interval were 12.85 and 10.51 on PAED scale, respectively, demonstrating a significantly higher rate in the intravenous group. However, in general, there were no significant differences between the two groups (p value=0.241). There was an inverse relationship between age and agitation, with higher rates in younger children.Conclusion: Based on the results it was concluded that decision-making on the type of anesthesia should not be based on emergence agitation. Other factors involved in emergence agitation should be considered.

Introduction: Measuring the antero-posterior jaw relationship has an important role in the diagnosis and treatment planning in orthodontics. Common linear and angular measurements to evaluate sagittal jaw relationship, including ANB angle and Wits index are not very accurate because various factors influence them. The aim of this study was to evaluateβ angle range in 6-17 year-old students with normal occlusal relationships referring to Isfahan Faculty of Dentistry.Materials and Methods: In this descriptive-analytical study, the files in the archives of the Orthodontics Department, Isfahan Faculty of Dentistry, were evaluated and 235 cephalometric radiographs from the files of patients with no orthodontic treatment were selected; the subjects were considered to have normal occlusal relationships based on 13 criteria. The specimens were divided into 5 age groups. After tracing the cephalometric radiographs, ANB angle, Wits index and b angle (the angle produced by the AB line intersecting the line perpendicular from A to line CB) were measured. Thirty-six specimens were excluded from the study during measurements. Data was analyzed by t-test, ANOVA and Pearson’s correlation coefficient using SPSS software (a=0.05).Results: The results showed a mean of 31.7±3.31o for b angle with a range of 21.5-39o. No significant differences were observed between males and females. This angle had a direct and significant relationship with age (r=0.435) and an inverse and significant relationship with AB angle and Wits index.Conclusion: It was concluded that b angle is accurate in evaluating antero-posterior jaw relationship and can be used as a valuable index in evaluations.

Introduction: Early childhood caries (ECC) is a common dental disease, with various risk factors involved. It has heavy negative consequences for the child, family and society. The aim of this study was to determine the relationship between ECC and weight, height, body mass index (BMI) and head circumference (HC) anthropometric characteristics.Materials and Methods: Two hundred 3-5 year-old healthy children attending the primary health care centers of Kazeroun city in Fars Province were recruited. One hundred children with ECC were selected using simple random sampling method; one hundred healthy and caries-free children were placed in the control group. The subjects in the two groups were subjected to the same clinical examinations. Data was analyzed by descriptive statistical tests using SPSS 11.5 software.Results: Of the indexes evaluated, only height and BMI exhibited statistically significant relationships with ECC. The means of height and BMI in the ECC and caries-free groups were 102, 103, 14.7, and 15.3, respectively.Conclusion: Subsequent to early childhood caries, complications such as pain, inflammation, premature loss of deciduous teeth, and speech and masticatory problems result in deleterious effects on child growth and development and quality of life. Therefore, the relationship between dental caries and height and BMI can be justified. Oral hygiene procedures and regular periodic examinations are recommended to prevent dental caries.

Introduction: In complete denture fabrication, it is very important to locate the best place for tooth arrangement. Studies have made attempts in this respect, but limited studies have evaluated the posterior region to this end. The aim of the present study was to determine the relationship between inter-condylar width (ICW) and lower and upper arch widths in the canine and molar areas.Materials and Methods: In this descriptive, cross-sectional study, 61 dental students were selected from Isfahan Faculty of Dentistry. A facebow was used to measure inter-condylar distance. A digital caliper was used to measure the distances between canine cusp tips and first molar mesiobuccal cusp tips. Data was analyzed with t-test and Pearson’s correlation coefficient (a=0.05).Results: There were statistically significant differences in inter-condylar distances between males and females. Based on the analyses carried out specific equations were extracted to predict each of the above-mentioned parameters with the use of inter-condylar distance.Conclusion: In this study, ICW was used as an extraoral anatomical landmark which does not change in time and with ridge resorption. The proposed technique in this study can be useful for dentists with less clinical experience.

Introduction: Intravenous sedation is one of methods to control anxiety in dentistry. However, due to intravenous use of potent drugs, the odds of hypoxia increases. In this study the prevalence of this complication between the two intravenous sedation methods was investigated.Materials and Methods: In this double-blind prospective clinical trial a total of 73 implant patients were evaluated in two groups. Conscious sedation was administered with a combination of midazolam/fentanyl in one group and with midazolam/ketamine in the other. SPO2 was measured in 6 stages and results were analyzed with t-test using SPSS software (a=0.05).Results: Mean of SPO2 five minutes after drug injection decreased in both groups. In midazolam/fentanyl group it decreased to 93.2% and in midazolam/ketamine group to 94.9% which indicates that the decrease in SPO2 in the first group (midazolam/fentanyl) was significantly more than other group.Conclusion: Use of intravenous sedation resulted in a decrease in SPO2 five minutes after sedation. In the midazolam/fentanyl group, it decreased to 93.2% and in the midazolam/ketamine group it decreased to 94.9%, with a significantly higher decrease in the former.

Introduction: Er: YAG lasers are effective in removing dental tissues and in tooth surface preparations for adhesive procedures. The aim of the present study was to evaluate the efficacy of Er: YAG lasers in improving the bond strength of composite resins to coronal and radicular dentin with the use of two self-etch and total-etch adhesive systems.Materials and Methods: In this in vitro study, 60 sound human premolars were randomly divided into 5 groups of 12. The teeth were cut at CEJ using diamond disks to yield two subgroups of coronal and radicular sections. Surface preparations were carried out by Er: YAG laser (4 Hz, 160 mJ). A total-etch adhesive was used with or without phosphoric acid, and a self-etch adhesive was used on the surface. Two other groups were used as controls, in which diamond burs and bonding systems were used for surface preparation. Composite resin cylinders (Z250, 3M ESPE) were bonded to the samples and stored in distilled water at 37oC for 24 hours. Means of shear bond strength values were measured in a universal testing machine. Data was analyzed with t-test (a=0.05).Results: There were no significant differences in the means of shear bond strength of coronal and radicular sections between the subgroups (p value >0.05). Self-etch adhesive system had the highest means of bond strength in both the laser and bur groups, with a significantly higher bond strength compared to the total-etch adhesive system (p value <0.05). In the total-etch system, surface conditioning with laser was less efficacious than acid etching (p value <0.05).Conclusion: Dentin surface preparation with Er: YAG laser is effective on the bond strength of composite resin to dentin, depending on the type of the bonding system used; with the laser application, self-etch adhesive system exhibits more bond strength decrease compared to the totaletch system. In addition, acid etching of the laser-treated dentin significantly improves the efficacy of total-etch adhesive systems.

Introduction: It is possible to estimate an individual’s chronological age by evaluating their somatic development, including osseous maturation, menses, body size, height and tooth calcification. Of the methods available, Demirjian's method is the most reliable. The purpose of this study was to evaluate the accuracy of Demirjian's dental age estimation in 3-9 year-old children in Isfahan.Materials and Methods: In this cross-sectional and analytical study, Demirjian's method and radiography were used. Based on Demirjian's method mineralization of seven permanent left mandibular teeth was assessed by two radiologists and the scores were compared with those of Demirjian. The final score was calculated for each subject and was converted to dental age using standard maturation curves. Data was analyzed with Spearman’s correlation coefficient using SPSS software (a=0.05).Results: The correlation coefficient between the true and estimated age was 0.83 in boys and 0.71 in girls. Demirjian's method was highly accurate in the subjects (p value <0.001).Conclusion: Under the limits of the present study, it was concluded that Demirjian’s method can be used in estimating the age of children in Isfahan.

Introduction: Tooth decay is one of the most common diseases of the oral cavity, with many factors as etiologic agents. The aim of the present study was to compare DMFT, salivary pH and salivary buffering capacity in two group of individuals with and without dental calculus.Materials and Methods: This case-control in vitro study was carried out on 88 patients referring to Isfahan Faculty of Dentistry. DMFT, salivary pH and salivary buffering capacities were measured in two groups of 44 (with and without dental calculus). Clinical examination was used for calculus measurements and clinical examination along with bite-wing radiographs were used for DMFT and proximal caries. Data was analyzed with t-test using SPSS software (a=0.05).Results: The case group consisted of 20 females (45.5%) and 24 males (54.5%); the control group consisted of 14 females (32%) and 30 males (68%). Means of DMFT, salivary pH and salivary buffering capacity values were 8.0455, 7.1661 and 1841 percent in the case and 6.9318, 7.0877 and 1559 percent in the control groups, respectively. The results did not demonstrate any significant differences between the two groups regarding the indexes evaluated (p value <0.05).Conclusion: Under the limits of the present study, it was concluded that the amount of dental calculus is not associated with DMFT, salivary pH and salivary buffering capacity.

Introduction: Considering the ever-increasing importance of dental materials’ esthetics, color, and translucency in cosmetic dentistry, the purpose of this study was to compare the translucency of two reinforced composite resins of BelleGlass and Gradia.Materials and Methods: In this in vitro study three disc specimens, 27 mm in diameter and 1.5 mm in thickness, were fabricated from each material under study. Translucent dentin C2 shades of BelleGlass and Gradia were used. The specimens were produced based on manufacturers’ instructions. Translucencies of BelleGlass and Gradia composite resins were compared using contrast ratio method. A spectrophotometer was used for sending reflected light rays. Data was analyzed by t-test using SPSS software (a=0.05).Results: Mean contrast ratios of BelleGlass and Gradia composite resins were 0.89±0.02 and 0.89±0.01, respectively (p value=0.009).Conclusion: The results of the present study showed that BelleGlass is more translucent than Gradia. Therefore, in patients with natural tooth translucency, BelleGlass is preferable. In patients who use composite resin restorations to camouflage their tooth discolorations Gradia is preferable.

Introduction: Awareness of the status of the root canal has an important role in the success of endodontic treatment. Radiography is the most important tool for root canal evaluation. Internal resorption is one of the problems of the root canal. The aim of the present study was to evaluate the extent of internal resorption by using direct digital radiography with software programs and compare it with pathologic diagnosis.Materials and Methods: In this in vitro study, 100 extracted human mandibular premolars were stored in formalin. Digital radiographs were taken and the extent of internal resorption was evaluated by Cygnus Media software with the use of Enhancement and Embossed tools by two experienced radiologists. Then the samples were stained with H & E and evaluated by a pathologist. Data was analyzed with McNemar’s test at 95% confidence level.Results: The observer 1 reported 22 cases of internal resorption and 78 sound teeth in the first observation; in the second observation, 25 cases of internal resorption and 75 sound teeth were reported. The observer 2 reported 13 cases of internal resorption and 87 sound teeth in the first observation; in the second observation, 17 cases of internal resorption and 83 sound teeth were reported. In the histopathologic evaluation, 18 cases of internal resorption and 82 sound teeth were reported. No significant differences were observed between the two methods.Conclusion: Digital radiography with the use of Embossed and Enhancement tools has a high degree of accuracy in the diagnosis of internal resorption.

Introduction: High attention of modern society to beauty and beauty surgery specially orthognathic surgery shows the importance of assessment of the ability of this surgery in changing parameters and soft tissue proportion and finally changing in attraction and beauty. Because of the ability of soft tissue in beauty and masking the defects of hard tissue, assessment of the changes during the orthognathic surgery seems important.Materials and Methods: In Ghaedi clinic (that is for Isfahan university) the patients are among the candidates of maxillary osteotomy (only lefort I osteotomy or Bimax surgery). With coordination of surgeon, the standard cephalometrices are prepared before and six months after the surgery and then soft tissue selected analysis are done. The cephalometrices, that are prepared before and after the surgery, are compared and according to paired T-test are analysed. The changes in parameters between two groups of surgery (one group with ANS-cut and another without ANS-cut) are compared, too. The data of two groups according to independent T-test are analysed. The total samples were sixteen (eight samples in each group). A sincere statistics adviser helped me in this way.Results: According to the results, after the surgery, we see some changes in all of the parameters and proportions. We have statistical significant difference between the means of upper lip length before and after the surgery in uncut group (p value <0.05). We didn't have statistical significant differences in other parameters in different situations (before and after the surgery or the difference between two groups). The differences might be so little that these are not significant with the samples. Also the nasolabial angle with the most differences, isn't significant. It's because of the high standard deviation.Conclusion: As a result, we can assert that the maxillary osteotomy has the most changes on nasolabial angle. During of the follow (6 months), we observed a decrease in upper lip vermilion and increase of upper lip length & also nasolabial angle. Despite of the numerical differences that almost were not statistically significant, clinical changes of soft tissue following the maxillary lefort I osteotomy are noticable. Also we can nearly predict the changes.

Introduction: Decreasing pain elicited by injections in children results in patient comfort during dental procedures and produces a positive experience towards dental procedures. The aim of the present study was to compare the effect of Dentipatch and 20% benzocaine gel in decreasing injection pain in children referring to Isfahan Faculty of Dentistry.Materials and Methods: Simple sampling method was used in the present clinical trial to select fifty-four 9-12 year-old children (24 males and 30 females). The injection site was dried with air spray for 5 seconds; then Dentipatch was placed by a dentist on the palate for 12 minutes at a distance of 5-10 mm from the gingival margin. A total of 1.8 mL of 2% lidocaine was injected; 10 minutes after the injection the same procedure was repeated on the contra-lateral side with the use of benzocaine gel. Data was collected and analyzed with pained t-test and Wilcoxon test using CPS and VAS scales (a=0.05).Results: Means of CPS in non-anxious children in the benzocaine and Dentipatch groups were 6.4 and 5.8, respectively, with no statistically significant differences (p value=0.081). Means of VAS in non-anxious children in the benzocaine and Dentipatch groups were 39.2 and 32.5, respectively, with no statistically significant differences (p value=0.068).Conclusion: Under the limits of the present study, it was concluded that there is no difference between the two methods regarding children’s reaction. Further evaluations are recommended with different application times, especially with the new Dentipatech method.

Introduction: An important factor in the esthetics of artificial teeth is their color match with natural teeth; correct color vision has a great role in the match. Any disorder in color vision of the dental practitioner will result in improper color matching, inappropriate treatment, and patient dissatisfaction. The aim of the present study was to evaluate the frequency of color vision disorder among undergraduate and post-graduate dental students in Isfahan Faculty of Dentistry.Materials and Methods: Simple sampling method was used in this descriptive-analytical study to select 252 undergraduate and post-graduate students in Isfahan Faculty of Dentistry. Data was collected by using the Ishihara standard color blindness checklist, which consists of 11 pages and diagnoses color vision disorders. Data was analyzed by SPSS softwar and with chi-squared and Fisher’s exact tests (a=0.05).Results: Color vision disorder was diagnosed in 10 subjects (4%), with a prevalence of 3.6% in males and 0.4% in females. Nineteen subjects (7.5%) had color vision disorder in one of their firstdegree relatives. Sixty subjects (23.8%) were near-sighted and 51 (20.2) were far-sighted and 3 (1.2%) suffered from night blindness.Conclusion: Under the limits of the present study, it was concluded that color vision disorder is relatively common. Therefore, the color vision disorder test is necessary for dental practitioners and those who are involved in color selection.

Introduction: One of the most important factors in survival rate of implant - supported crowns is the adaptation of crown and abutment. In this study the color matching and aesthetic evolution of anterior maxillary crowns was evaluated.Materials and Methods: For this in vitro investigation 20 CAD/CAM crowns (group 1), 20 IPS e. max crowns (group 2) and 20 metal ceramic crowns were made for the maxillary central incisor of a phantom head. The silicon replica technique was used for the measurement of marginal and internal gaps. For color matching A2 shade tab was chosen of classical VITA shade guide as a reference shade. Visual and instrumental color evaluation were done for abutment - supported crowns and those crowns without abutment support. ANOVA, Tukey HSD and Pairedt test were used for data analysis (a=0.05).Results: The smallest marginal gap was for CAD/CAM crowns (86/07m). Mean marginal gap for other groups had no statistically significant difference (p value=0/916). All groups had no statistically significant difference for internal gap (p value=0/1). For abutment supported crowns the best color matching result (visual & instrumental) was for CAD/CAM crowns. Color matching in other groups had no statistically significant difference (p value=0/239, p value=0/872). Color matching evaluation approved the effect of titanium abutment on the color of group 1 & 2 crowns.Conclusion: All result for all groups were clinically acceptable. The CAD/CAM crowns had the best result in both two factors.