Journal of Isfahan Dental School
Year:2018 | Volume:14 | Issue:3 |Papers Count:16

Introduction: Carcinomas are the most common head and neck cancers. Adequate resection of the margins is critical for the management and predicting the prognosis of patients with head and carcinomas. The aim of this study was to determine clinicopathological factors influencing final tumor margins in resected carcinomas. Materials& Methods: In this cross-sectional study, the records of all the patients with oral and maxillofacial carcinomas of soft tissue in 2006-2016, who had undergone surgical resection, were analyzed. Data on clinicopathological factors, including sex, age, type of tumor, tumor size and location, lymph node metastasis, the number of margins involved, tumor histological grade, tumor clinical stage, and the results of frozen section were collected and analyzed with descriptive statistics and chi-squared test. Results: A total of 53. 5% of the subjects had positive pathological margins (p value = 0. 5), 12. 7% had close margins and 0. 8% had tumor-free margins. Positive margins exhibited a significant relationship with tumor size (p value = 0. 01) and location (p value = 0. 03). There were no significant relationships between sex, age, type of tumor, lymph node metastasis, histopathological tumor grade, clinical stage and frozen section with final margin (p value > 0. 05). Conclusion: In the present study, 66. 2% of oral carcinomas showed final positive margins and the status of the final margin was associated with the tumor size and location.

Introduction: Given the importance of theoretical and clinical geriatric education in dental schools, this study aimed to evaluate the sufficiency of geriatric education in Isfahan DentalSchool. Materials& Methods: In this descriptive cross-sectional study, all the departments of Isfahan Dental School, except for pediatric department, were included. The checklist of the study developedin four sections, including the frequency and content of courses, clinical educationand recommendations, were submitted to the department heads. In addition, thesyllabus of each department was evaluated for special geriatric titles and topics. Datawere analyzed with descriptive statistics. Results: Geriatric dentistry as an independent course was presented in only two departments ofpublic oral health and restorative dentistry. Departments of public oral health, restorative dentistry and periodontology presented specific geriatric topics in theircourse plans but in other departments (except for orthodontics) geriatric topics wereintegrated into other topics. The highest coverage of geriatric dentistry was seen in thesyllabi of maxillofacial pathology and surgery departments. There were no topics orcontents about geriatric dentistry in the department of orthodontics. Conclusion: According to the results, it seems the proportion of geriatric dentistry in courses andtopics of undergraduate education is not sufficient and there should be policies toincrease the amount of theoretical and clinical education in geriatric dentistry inIsfahan Dental School.

Introduction: Oral manifestations of endocrine disorders may lead to early diagnosis and proper treatment of these disorders. In addition, many of these patients need special care in dental office; therefore, it is mandatory for dentists to be familiar with oral manifestations of these disorders regarding diagnosis and observing the special care they require. To date no study has been performed on the knowledge of dentists about oral manifestations of endocrine disorders. The aim of this study was to evaluate the knowledge of dentists in Esfahan about oral manifestations of endocrine disorders. Materials& Methods: This descriptive‒ analytical study was performed on 94 general dental practitioners in Esfahan in 2015‒ 2016. A 20-score self-made questioner with a Cronbach's alpha value of 2 was used. Data were analyzed with t-test using SPSS (α = 0. 05). Results: The mean knowledge score of the subjects was 11. 138 ± 3. 23, which was significantly less than the maximum score (p value < 0. 05). The highest and lowest knowledge scores were respectively related to pancreas and pituitary glands (p value < 0. 05). Conclusion: The knowledge of dentists about the oral manifestations of endocrine disorders was significantly less than what was expected. It seems it is necessary to include oral manifestations of endocrine disorders in the syllabus of dental schools and in continuous dental education programs.

Introduction: Knowledge of patients’ satisfaction and evaluation of factors affecting patients' dissatisfaction after dental implant treatments can result in increasing our knowledge about dental implant treatments and help render better implant tratment. Therefore the aim of this study was to evaluate patients' satisfaction with dental implant treatments. Materials& Methods: In this descriptive/cross-sectional study, 176 patients treated with dental implants, with at least one year after prosthesis treatment, were randomly selected and their satisfaction with dental implant treatment was evaluated with a standard questionaire. Data were analyzed with SPSS, using one-way ANOVA and t-test (α = 0. 05). Results: The overall patients' satisfaction score was 37. 52 ± 4. 24, indicating high satisfaction level. There was no significant difference in the mean satisfaction scores between male and female subjects (p value = 0. 832). A total of 70. 1% had a positive idea about the effect of dental implants on aesthetics; 48. 9% reported that surgical problems were much anticipated. A total of 53. 1% believed that cleaning of dental implants was more difiicult than cleaning natural teeth. Conclusion: Patients treated with dental implants had high satisfaction level. Considering the fact that in each treatment, problems, the high level of patients’ expectations and failure to achieve their goals can result in dissatisfaction, this level of satisfaction appears to be successful and helps us investigate factors leading to dissatisfaction; therefore, we can take steps toward better implant teratments.

Introduction: Attention deficit-hyperactivity disorder (ADHD) is a persistent form of attention deficiency, hyperactivity and impulsivity, which is one of the most frequent mental health problems, affecting 12‒ 15 of children all over the world. The aim of this study was to investigate the rate of dental caries in children with symptoms of ADHD and to compare it with healthy children in order to emphasize the importance of prevention in preserving children's oral health. Materials& Methods: In this case-control cross-sectional study, 33 children diagnosed with ADHD and medicated, 32 children diagnosed with ADHD but non-medicated and 37 healthy children, 7‒ 12 years of age, were investigated using DMF/dmft and PI parameters. The subjects were matched in terms of age and gender. Data were analyzed with SPSS 18 at a significance level of p value < 0. 05. Results: The mean PI (p value = 0. 48) and DMFT (p value = 0. 97) indexes in children with ADHD were not significantly different from the healthy subjects; however, the mean dmft index in the control group was significantly lower than those in the two groups with ADHD (p value = 0. 04). Conclusion: Children with ADHD are not able to carry out regular activities properly such as brushing their teeth due to attention deficiency and impulsivity. Therefore, the deciduous teeth of such children are more prone to dental caries compared to healthy children. In the age range evaluated in the present study, there were no differences in DMFT between the case and control groups. Moreover, dental plaque (PI) was the same in the healthy and hyperactive childre

Introduction: The compliance of an adolescent patient and his/her parents is a critical issue inachieving optimal treatment results. If the patient's compliance can be predictedbefore the initiation of treatment, the orthodontist can improve the outcomes byvarious means and prevent any unpleasant complications such as immaturetermination of treatment. The aim of this study was to evaluate the relationshipbetween patients' psychosocial factors and cooperation in orthodontic treatment andtheir predictive value in adolescents. Materials& Methods: In this descriptive– analytical study, 30 factors were extracted from the literature, 24of the most important of which were determined based on the opinions of experiencedorthodontists using statistical methods. Then, a questionnaire was designed forevaluating each factor. Then 60 adolescent patients, 11‒ 18 years of age, wereselected randomly to fill out the questionnaire before the beginning of their treatment. At least 4 months after the initiation of treatment, their compliance was evaluated. Finally, the relationship between each factor and compliance was calculated usingPearson's correlation coefficient (α = 0. 05). Results: Factors such as age, economic status of the family, patient’ s performance in school, patient’ s perceived need for orthodontic treatment and his/her conscientiousness hadstatistically significant relationship with compliance (p value < 0. 05). Conclusion: The compliance of patients (especially those >14 years of age) is predictable beforeorthodontic treatment. There 5 factors of gender, family economic status, educationalstatus, the patient's need for treatment, and the patient's conscientiousness weresignificantly related with compliance.

Introduction: The preventive role of pit and fissure sealants against dental caries has clearly been shown. Two new categories of self-etching (Itena) and hydrophilic (Smartseal & Loc F) fissure sealants have recently been marketed. The aim of this study was to investigate and compare microleakage of these innovative fissure sealants with a conventional sealant material (3M). Materials& Methods: Seventy-five sound extracted third molars from both jaws with no caries or cracks were selected for the purpose of this in vitro study and assigned to three groups. The teeth were cleaned with pumice powder and water, rinsed, dried and prepared. The occlusal pits and fissures were etched using a 37% phosphoric acid ethant gel (3M) for 20 s, rinsed for 15 s and dried. In each group, the assigned sealant material was applied over the pits and fissures and cured for 20 s: self-etching (Itena), hydrophilic (Smartseal & Loc F) and conventional sealant material (3M). The samples were then stored in 0. 5% volatile fuchsine solution for 48 hours. The samples were then rinsed and sectioned in the buccolingual direction. The samples were then investigated at ×24 magnification under a stereomicroscope for depth of dye penetration. Data were analyzed with using Kruskal-Wallis and Mann-Whitney tests at a significance level of p value < 0. 05. Results: Comparison of the means showed the highest degree of microleakage in self-etching sealant (mean = 3), which was significantly different from the hydrophilic (mean = 2) and conventional (G = 0. 84) fissure sealants (p value < 0. 001). However, there was no statistically significant difference between conventional and hydrophilic fissure sealants (p value = 0. 21). Conclusion: The results of the present study showed that the microleakage of self-etching sealant was higher than the two other fissure sealants.

Introduction: Recently efforts have increased to diagnose premalignant lesions. One of thesetechniques is brush cytology. The aim of this study was to compare changes in thecytology samples taken from passive smokers and nonsmoking healthy patients usingstaining Papanicolaou technique. Materials& Methods: In this descriptive/analytical cross-sectional study, in two groups with 23 subjects(case and control), brush cytology samples were taken from the buccal mucosa andlateral border of the tongue from passive smokers with records of the duration ofexposure to cigarette smoke (hours/day), using a sterilized brush. Then samples whichwere already fixed by a specific spray were stained with Papanicolaou technique inthe laboratory. Then the samples were evaluated for the frequency of granular cells, binuclear cells, clear nucleolus, rough chromatin, nuclear vacuoles, apoptotic cells, and nuclear and cytoplasmic polymorphism. Data were analyzed with chi-squared testand t-test (α = 0. 05). Results: There were no meaningful differences in the buccal mucosa and lateral border of thetongue between the passive smokers (p value = 0. 31) and healthy control nonsmokers(p value = 0. 26) in the frequency of micronucleus, clear nucleus, polymorphism, inflammation, and keratin overproduction. The mean years of cigarette consumptionin the two groups of passive smokers with and without binuclear cells weresignificantly different (p value = 0. 004). Conclusion: The risk of cytologic changes might increase in passive smokers with an increase inexposure to cigarette smoke. However, cigarette was not a potential risk for mucosalchanges in passive smokers.

Introduction: To expedite the process of treatment, recovery of patients and prevention of medical adverse effects, dentists should be aware of prescription errors. This study aimed to investigate prescription behavior of dentists and common prescription errors by dentists in Razavi Khorasan Province. Materials& Methods: In this study, 1108 prescriptions by dentists in Razavi Khorasan Province from Fenruary 2016 to July 2016, from Social Security and Therapeutic Services insurance organizations were evaluated. To collect data, a list was prepared, consisting of drug forms, drug names, drug doses, intervals of administration, route of administration, drug interferences and the number of items in each prescription. Furthermore, the lack of date, dentist’ s signature or seal, and illegibility of the prescription were recorded in the error list of the prescription. Data were analyzed using chi-squared and Fisher’ s exact tests. Results: Most errors were related to incorrect drug form (17. 3%), incorrect route of administration (10. 9%) and incorrect dose (10. 4%). The mean number of medications prescribed per patient was 2. 36. Antibiotics (50. 7%) and antiinflammatory drugs (33. 5%) were respectively the most commonly prescribed medications. Conclusion: The results of the present study demonstrated that the performance of dentists in Razavi Khorasan Province was appropriate in terms of the number of drugs prescribed per patient; however, the number of prescribed antibiotics and nonsteroidal antiinflammatory drugs was higher than the reports in other countries. Given the high percentage of errors in prescriptions, it is highly recommended that the prescription behavior be included in the curricula of dentistry and be emphasized in continuous education programs for dentists.

Introduction: Glypican-3 is a cell surface protein, a member of glypican family and belongs to agroup of heparin sulfate proteoglycan bound to the cell membrane through a glycosylphosphatidylinositol anchor. GPC3 is involved in the regulation of cell proliferationand morphogenesis. Considering the distinct clinical behavior of odontogenic lesions, the aim of the present study was to investigate the immunohistochemical expressionof GPC3 in dentigerous cyst, odontogenic keratocyst and radicular cyst. Materials& Methods: In this descriptive, retrospective, cross-sectional study, 60 tissue samples ofodontogenic cysts consist of 20 radicular cysts (RC), 20 odontogenic keratocysts(OKC) and 20 dentigerous cysts (DC) were reviewed by immunohistochemistrystaining for GPC3 marker. Results: In this study, both membranous and cytoplasmic expression of glypican-3 wasobserved. GPC3 expression was seen in 60% of OKCs (12/20). No GPC3immunoreactivity was seen in DCs and RCs. Conclusion: A high expression rate of GPC3 was detected in OKC, which might be related to theaggressive behavior and high recurrence rate of OKC; however, further studies arenecessary to confirm this hypothesis.

Introduction: Rete ridges are epithelial extensions toward the underlying connective tissue in skinand mucous membranes. Given the advances in tissue engineering in recent years, rete ridges have become the center of attention. Therefore, the aim of the presentstudy was to evaluate the shape of rete ridges (RR) in different oral mucosal lesionsfor possible histological differential diagnosis and their possible relation withinflammation for better understanding of their histogenesis. Materials& Methods: This retrospective, descriptive, analytical study was performed on 154 oral lesionsclassified as epithelial (E), connective tissue (Ct) and mucocutaneous (Mc) lesions. RRs were evaluated under a light microscope at ×100 as flat or hyperplastic. Inflammation at epithelium‒ connective tissue interface was evaluated in 5 consecutivehigh-power fields (×400). Data were analyzed with chi-squared test (α = 0. 05). Results: In 87%, 80% and 58% of Ct, E and Mc lesions, hyperplastic RRs were seen, respectively (p value < 0. 001). RR forms Mc lesions were significantly different fromthe two other groups (p value < 0. 001). However, no statistically significant differencewas observed in RRs between E and CT lesions (p value = 0. 48). Hyperplastic RRs inreactive Ct lesions was seen more frequently than other Ct lesions; however, inflammation in different intensities was not related to RR shape (p value < 0. 05). Conclusion: The results of the present study showed that rete ridges in oral mucosal lesions werehyperplastic predominantly, indicating that inflammation is not the reason for thehyperplastic nature of rete ridges. Further studies are recommended.

Introduction: To assess dental caries from an epidemiologic viewpoint, it is necessary to use anexact, valid, and reliable index. This study aimed to assess dental status of senior andjunior dental students of Isfahan University of Medical Sciences and students ofIsfahan University using the International Caries Detection and Assessment System(ICDASII) index. Materials& Methods: In this study, 70 senior dental students, 70 junior dental students, and 70 studentsfrom Isfahan University (a total of 210 students) were randomly selected. Oralexaminations were conducted in the dental clinic on a dental chair using dentalexplorers and mirrors. Tooth surfaces were evaluated in both dry and wet conditionsand ICDASII codes were recorded. Chi-squar, Mann-Whitney and Kruskal-Wallistests, Pearson’ s correlation coefficient and GLM analyses were used for the analysisof data (α = 0. 05). Results: None of the students had all tooth surfaces with no caries. Only 19 students had codes00 to 02 (primary enamel caries). The most frequent code was 01 on occlusalsurfaces. Buccal and lingual surfaces of the teeth showed the lowest caries rate. Themost frequent code for dentinal caries was 04. GLM analysis showed the highestdental caries rate in Isfahan University students, followed by junior students thansenior dental students (p value = 0. 001). University students with highly educatedmothers exhibited less dental caries (p value < 0. 001). Conclusion: Assessment of dental caries with ICDASII index can provide detailed information forprevention and treatment. Enamel caries was the most prevalent dental caries amongthe students. Dental caries was more severe among the students of Isfahan University, while the senior dental students exhibiting the lowest caries rate. Educational or extracurricularprograms are suggested to be prepared to improve oral health of universitystudents.