Journal of Isfahan Dental School
Year:2020 | Volume:16 | Issue:1 |Papers Count:16

Introduction: Since Oral cavity is considered the main source of pulmonary pathogens and Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent diseases and one of the most important causes of mortality, aim of this study was to determine the relation between periodontal status and COPD. Materials & Methods: This Cross-Sectional study was performed in April to September 2018 on 30 patients with COPD as a case group and 30 respiratory healthy person as control group. In both groups, periodontal indices such as Gingival Recession(R), Probing Depth (PD), plaque Index (PI), Gingival Index (GI), Clinical Attachment loss (CAL) and Bleeding on Probing (BOP) were evaluated. The number of Missing Teeth (MT) was also recorded. Data were analyzed by the use of SPSS 22 with t-test, Chi-square, and Mann-Whitney statistical tests (α = 0. 05). Results: Periodontal indices and MT in the COPD group were significantly more than control (p value < 0. 001). The mean of smoking in COPD group was higher than control group T, but after neutralization of the effect of smoking, the mean periodontal indices in the COPD group was still more than control, also in non-smokers of COPD group, mean periodontal indices are more than non-smokers of control and the periodontal status was significantly associated with an increase in the grade of COPD (p value < 0. 001). Conclusion: This study showed periodontal diseases have considerable correlation with COPD and patients with COPD even after the control of cigarette smoking and oral hygiene as confounder factors, show worse periodontal conditions.

Introduction: This study aimed to evaluate the effect of oral hygiene instruction programs on the knowledge, attitude, performance, and DMFT index in pregnant women. Materials & Methods: In this clinical trial, 120 pregnant women in Fereydoun Shahr (Isfahan Province) were selected by cluster sampling method. The subjects were randomly divided into intervention and control groups. Educational intervention was conducted through four 2-hour sessions in the field of oral health in four groups with 11 subjects and two groups with eight subjects in the intervention group. The data of both groups were collected before, four weeks and three months after the intervention. The data were analyzed with SPSS 21, using independent-samples t-test, chi-squared test, and repeated measurements (α = 0. 05). Results: Of 120 subjects, 60 were in the control group, with the remaining 60 in the intervention group. After the educational intervention, after three months, the means of knowledge scores in the control and intervention groups were 8. 02 ± 1. 70 and 14. 15 ± 1. 05, respectively. The mean attitude scores were 30. 45 ± 3. 76 and 36. 00 ± 2. 33, and the mean performance scores were 35. 17 ± 3. 53 and 41. 43 ± 2. 40 in the control and intervention groups, respectively. Furthermore, the means of PI were 3. 28 ± 0. 81 and 2. 95 ± 0. 75 in the control and intervention groups, respectively. A repeated measure design was used to study the effect of time, group, interaction between the groups, and time on knowledge, attitude, performance, and DMFT index. The results showed a significant increase in the knowledge, attitude and performance of mothers in the intervention group compared to the control group. Evaluation of the DMFT index showed that time and group interaction was significant concerning decayed and filled teeth. Conclusion: The results showed that the educational program had a significant effect on improving the knowledge, attitude, and oral health parameters of pregnant women.

Introduction: To evaluate and compare salivary IL6 level in children with early childhood caries, before and 3 months after treatment. Materials & Methods: In this study totally 32 children aged 3 to 6 years (12 without any caries, 10 with mild caries: 1 < dmft < 4, 10 with severe caries: dmft > 5) were included. Salivary samples were taken from all children at least 1 hour after eating food. The group with severe ECC were treated as a full-mouth rehabilitation under general anesthesia. The group with mild ECC were treated in clinic. Group with no ECC followed with no treatment. 3 months after full-mouth rehabalitation, salivary samples gathered again. Data analysis was performed using Kolmogorov-Smirnov, Wilcoxon, Kruskal Wallis tests with SPSS version 22 software. Results: Baseline IL6 was higher in patients with severe ECC (p value = 0. 007 and P = 0. 001) but there was no statistically significant difference in baseline levels between first two groups. (p value = 0. 059). After treatment only severe ECC group had statistically significant difference of salivary IL6 after treatment. (p value = 0. 007). Conclusion: Our findings show that salivary IL6 level could be a partial predictor of ECC lesions. Treatment in sever ECC caused statistically significant decrease in IL6 but IL6 change was not significant in mild group.

Introduction: One of the aspects of health is oral and dental health. The purpose of the present study was to determine the efficacy of acceptance and commitment therapy on oral health quality of referrals to Isfahan dental centers. Materials & Methods: This pretest-posttest clinical trial, with a control group and a three-month follow-up, was conducted on the patients with dental anxiety. In this study, 32 patients with dental anxiety were selected from among the patients with the criteria of the research and randomly assigned to two groups of experimental and control. The case group received 10 weekly sessions of ACT for 90 min and the control group received no intervention. Data were collected using DAI anxiety inventory (DAI), Oral Health Quality of Life Questionnaire (OHIP-14), SCL-90-R questionnaire, and pulse oximeter. The findings were analyzed using repeated measure ANOVA in 0. 05 p-value using SPSS. 22 software. Results: The results showed that the mean (SD) of mental disability in the pre-test of the experimental group was 6. 5 (0. 9), which was 7. 4 (1. 2) and 7. 5 (1. 2) in the post-test and follow-up respectively, which was statistically significant (p value < 0. 001). Also, the mean (SD) of disability in the pretest group was 3. 1 (0. 9), which was 2. 9 (0. 9) and 3. 0 (0. 9) in post-test and follow-up respectively and it is statistically significant (p value < 0. 0001). The mean (SD) of quality of life in the pre-test of the experimental group was 23. 1 (2. 1), which was 25. 2 (2. 3) and 22 (1. 8) in post-test and follow-up, which was statistically significant (p value < 0. 001). Conclusion: It seems that acceptance and commitment therapy is effective on the quality of life of people with dental anxiety. Despite the limitations mentioned above, it seems that the findings of this study can be a useful step in the psychological treatment of dental anxiety patients.

Introduction: Cicatricial pemphigoid is a type of immunobullous disease. A number of ocular manifestations can occur in these patients. Early diagnosis can be effective in preventing ocular complications. This study investigated the frequency of pemphigoid and its mucosal manifestations in patients with immunobullous lesions referring to Isfahan Dental School and Alzahra Hospital over 8 years. Materials & Methods: In this cross-sectional descriptive/analytical study, 127 patient files of pemphigoid disease were evaluated in the Archives of the Department of Oral Diseases in Isfahan Dental School and Alzahra Hospital. The data on the age and sex of the patients were recorded. The patients were recalled and questioned about the location of the oral, cutaneous and ocular lesions, the treatment of these lesions, and the time of recovery of the lesions. All the relevant data were provided as a checklist and analyzed with SPSS 22, using ANOVA and descriptive statistical methods, including frequency distribution tables, calculation of percentages and relationships, and use of circular and bar diagrams (α = 0. 05). Results: The mean age of the patients was 64 years. There was a female predilection (2: 1). Eye symptoms were more frequent in patients < 60 years of age, and ocular manifestations in patients with oral manifestations were four folds more frequent compared to patients without oral manifestations. Conclusion: The frequency of the pemphigoid disease was 18. 814%. The frequency of ocular involvement in these patients was 12. 3%, with blurred vision (4. 1%) being the most common problem. The relationships between ocular and oral involvement, ocular and cutaneous involvement, and the ocular involvement and age and sex were not significant.

Introduction: Implants angles relative to each other might result in inaccurate impressions, resulting in inaccurate master casts. This study aimed to evaluate the dimensional accuracy of master casts in angulated dental implants. Materials & Methods: In this in vitro study, a unilateral partially edentulous acrylic model was prepared with two implants in the second premolar and second molar areas. Impressions were taken in nine different positions of the implant positions (0° , +15° ,-15° ), using two impression techniques (closed tray, open tray) (n = 3) with polyvinylsiloxane impression material. The master casts were scanned by a laser scanner, and the data were transferred to Materialise Magics software to measure the angulation between the implants. The dimensional accuracy of the impressions was calculated in different implant angulations (i. e., parallelism, divergence and convergence of two implants). Data were analyzed using independent t-test and two-way ANOVA (α = 0. 05). Results: With a 0° angle between the implants (parallelism), there was no significant difference between the two impression techniques (p value = 0. 102). However, when there was a >15º angle between the two implants, the open tray technique was significantly more accurate than the closed tray technique (p value ˂ 0. 05). Conclusion: The implant angulation and impression techniques affected the accuracy of the master casts. When implant angulation increased from 0° to 30° , the distortion of the impressions increased, too.

Introduction: BIS (bispectral index) indicates brain activity, and therefore, the depth of general anesthesia. Mentally challenged patients have different degrees of brain impairment and different levels of intelligence; as a result, it is expected that the BIS score of these patients will be different from that of healthy patients during general anesthesia. This study aimed to determine the relationship between the BIS score and the severity of mental disability during general anesthesia for dental procedures. Materials & Methods: Forty-four mentally challenged patients were selected and included in this cross-sectional descriptive/analytical study. After giving the Raven’ s Standard Progressive Matrices test to the patients, they were classified into different groups in terms of the severity of mental disability. After giving and maintaining the same general anesthesia level to the patients, BIS scores were calculated at 5-, 15-, 30-and 45-minute intervals after induction of anesthesia. BIS scores were compared at various degrees of mental deficiency, and possible correlations were evaluated. Statistical analysis was performed using t-test and Spearman’ s correlation test with SPSS 22 (α = 0. 05). Results: There were no statistically significant differences in BIS scores between various degrees of mental deficiency except for the 30-minute interval after the induction of general anesthesia (p value = 0. 025). Conclusion: In this study, the severity of mental deficiency did not affect the depth of general anesthesia except for the 30-minute interval after its induction.

Introduction: Delirium is a clinical syndrome characterized by acute changes in awareness and consciousness, and disturbances and fluctuations in attention. This study evaluated the frequency of postoperative delirium in patients undergoing general anesthesia for dental procedures and the relevant risk factors. Materials & Methods: In this cross-sectional study, 103 patients who were candidates for dental procedures under general anesthesia in Isfahan Dental School were randomly selected. General anesthesia was induced with thiopental sodium-fentanyl-atracurium in all the patients and maintained with propofol. Dental anxiety was evaluated in all the patients using the DAS-R (Dental Anxiety Score-Revised) questionnaire before the procedure. In addition, the MMSE (Mini Mental State Examination) questionnaire was completed 48 hours after the procedure. Statistical analysis was performed with SPSS 25, using independent t-test and regression analysis (α = 0. 05). Results: The results showed that the incidence of delirium in 103 patients undergoing general anesthesia was 22 cases (21. 4%). The results of linear regression analysis indicated that age was an important and influential factor in the mental status, and orientation to place (p value = 0. 002) and time (p value = 0. 001) after general anesthesia. The severity of anxiety before anesthesia significantly affected the duration of general anesthesia (p value = 0. 01) and orientation to place after general anesthesia (p value = 0. 005). Anxiety itself was affected by the age of the patient (p value = 0. 01). Conclusion: Delirium is highly prevalent in patients undergoing general anesthesia for dental procedures. It is critical to identify the risk factors associated with this disorder in order to reduce the incidence of delirium.

Introduction: Due to the importance of the administration of antibiotics in eliminating pulp and periapical microorganisms, this study aimed to evaluate dentists' knowledge about antibiotic administration in root canal treatment in Gorgan, Iran. Materials & Methods: In this cross-sectional descriptive/analytical study, 115 questionnaires with confirmed validity and reliability were distributed among dentists in Gorgan. The questionnaires included demographic data and antibiotic administration habits of dentists in different types of endodontic therapy. Finally, 103 completed questionnaires were analyzed statistically with SPSS 16. 0, using chi-squared test (α = 0. 05). Results: The awareness of dentists about antibiotic administration in patients with acute pulpitis, acute apical abscess, and chronic periodontitis was 81. 6%, 56. 3%, and 64. 4%, respectively. None of the dentists believed in routine antibiotic prophylaxis in root canal therapy, and 80. 4% prescribed 2 g of amoxicillin as their preferred antibiotic prophylaxis, if needed. Conclusion: According to the results, despite the favorable level of dentists' awareness of antibiotic administration, there is still some tendency for indiscriminate use of antibiotics by dentists in Gorgan compared to the standard indications for antibiotic administration, indicating the need for increasing the awareness of dentists in continuous education programs.

Introduction: Vital pulpotomy is performed in primary teeth to preserve the tooth until normal exfoliation. Different materials, such as formocresol, zinc oxide-eugenol, MTA, and Biodentine, are used in this procedure. This study aimed to compare the clinical and radiographic success of pulpotomy treatment in primary molars using formocresol or Biodentine. Materials & Methods: In this clinical study, pulpotomy procedures were performed on 66 mandibular primary second molars teeth in 4– 7-year-old children, referring to the Department of Pedodontics, Khorasghan Faculty of Dentistry, Isfahan Azad University, with indications for pulpotomy treatment. In each patient, one tooth was randomly assigned to the formocresol pulpotomy group, and one tooth was assigned to the Biodentine group. The teeth underwent pulpotomy treatments with either formocresol or Biodentine and restored with a stainless steel crown. The clinical and radiographic outcomes were recorded at 6 and 12 months. Data were analyzed with Fisher’ s exact test using SPSS 22 (α = 0. 05). Results: Both groups demonstrated 100% clinical success rate at 6-and 12-month follow-ups. However, at 6 months, the radiographic success of formocresol was 84. 8% compared to 93. 9% in the Biodentine group (p value = 0. 21). The radiographic success rates of formocresol and Biodentine were 81. 8% and 93. 9%, respectively at 12 months (p value = 0. 13). Conclusion: The teeth treated with Biodentine exhibited higher clinical and radiographic success rates as compared to formocresol at 6-and 12-month follow-up, with no statistically significant difference between the two groups. It seems Biodentine can be a proper alternative to formocresol in primary molar pulpotomy procedures.

Introduction: Formocresol has been used for the pulpotomy procedures of primary molar teeth in the past century; however, new alternatives have been introduced because of the potential carcinogenesis of formocresol. Some natural materials from the field of traditional medicine, such as propolis, have also been introduced as medicaments for vital pulp therapy procedures. This study compared the clinical and radiographic success of pulpotomy treatment in primary molars, using formocresol or propolis. Materials & Methods: In this clinical study, pulpotomy procedures were performed on 60 mandibular second primary molar teeth in 4-7-year-old children, referring to the Department of Pedodontics, Khorasghan Faculty of Dentistry, Isfahan Azad University, with indications for pulpotomy treatment. In each patient, one tooth was randomly assigned to the formocresol pulpotomy group, and one tooth was assigned to the propolis group. The teeth underwent pulpotomy treatments with either formocresol or propolis after achieving anesthesia and removing caries, followed by restoration with a stainless steel crown. The clinical and radiographic outcomes were recorded at 6 and 12 months. Data were analyzed with Fisher’ s exact test using SPSS 22 (α = 0. 05). Results: The formocresol group demonstrated 100% clinical success rate at 6-and 12-month postoperative intervals. The clinical success rates of propolis were 96. 7% and 100%, respectively at 6-and 12-month intervals, respectively. The 6-month radiographic success in the formocresol group was 83. 8% compared to 90% in the propolis group (p value = 0. 35). Radiographic success rates of formocresol and propolis were 80% and 76. 7%, respectively, at 12 months (p value = 0. 75). Conclusion: The results of this study revealed no significant differences in the success rates of primary molar pulpotomy procedures between propolis and formocresol. Propolis can be used for pulpotomy procedures as a substitute for formocresol.

Introduction: Oral pyogenic granuloma (PG) is a benign lesion that can occur due to chronic mild irritation, a traumatic surgical procedure, hormonal changes, certain medications, after bone marrow grafting, a response to a graft, etc. Two histopathological type of PG are lobular and non-lobular. This aimed to assess and compare the clinical, microscopic, and etiologic factors in the two type of PG. Materials & Methods: In this cross-sectional descriptive/analytical study, 214 samples of PG were selected from the Archives of the Pathology Department, Isfahan Dental School. Demographic, clinical, and microscopic data were collected by reviewing the files and slides. Data were analyzed with SPSS 24, using descriptive statistics, chi-squared test, Mann-Whitney test, Fisher‘ s exact test, and t-test (α = 0. 05). Results: There were 47 lobular cases, with 167 non-lobular samples. Lesion sizes (p value = 0. 035), location of lesions (p value < 0. 001), mean vascular density (p value < 0. 001), concentration of large endothelial cells (p value < 0. 001), edema (p value = 0. 007), inflammatory infiltration intensity (p value < 0. 001), and vascular canalization (p value = 0. 005) were significantly different between the two groups. Conclusion: The present study showed that some parameters between the two microscopic types of pyogenic granuloma were different significantly, accounting for the clinicopathological differences between two groups; this warrants further studies.

The treatment of an immature tooth with pulp necrosis and apical periodontitis is a major challenge for clinicians. The endodontic treatment of such teeth entails apexification, apical barriers, or more recently, revascularization. The current study reports an immature replanted tooth treated with calcium hydroxide medicament. A 13-year-old female patient with a history of abscess formation in tooth #45 was referred to the Department of Endodontics, Shiraz Dental School, Shiraz, Iran. The clinical and radiographic examinations revealed a necrotic pulp, a root with an open apex, and periradicular radiolucency. Case Presentation: The treatment was rendered under rubber dam isolation and local anesthesia. The root canal was irrigated with 2. 5% sodium hypochlorite solution and medicated with calcium hydroxide. The patient did not return for the completion of treatment in the next session. Twelve months later, she returned to the Department; she was asymptomatic and the root development was observed. The canal was then dried with paper points and obturated with thermoplastic injection technique.