Journal of Dental School
Year:2003 | Volume:21 | Issue:2|Papers Count:18

Background and Aim: The purpose of the study was isolation and characterization of the oral Actinomyces species believed to be the cause of the periapical abscesses.Methods and Materials: This epidemiological study was carried out on 32 patients with dento-alveolar abscesses, which have been referred to the Faculty of Dentistry, Tehran University of Medical Sciences. The specimens were collected during a period of 7 month, using aspiration method in the anaerobic condition.Samples were aseptically transferred to the individual screw bijoux bottles containing 1ml Career's Blair medium and sent to the laboratory within the next 30 minutes. Sample taking was performed from patients who had submandibular chronic dento-alveolar abscesses with no infectious diseases. An appropriate questionnaire was filled in for each case.Results: 32 specimens taken and one species of Actinomyces naeslundii were isolated from a patient with dentoalveolar abscess. Of the 32 patients with dento- alveolar abscesses, aged between 14-47 years, 19 were male (59.4 %) and 13 were female (40.6 %). The highest incidence of the dento-alveolar abscess (25 %) was seen in the group aged 31-35 with the lowest incidence (6.3 %) was seen in the group aged 15-19years. The cause of the dento-alveolar abscesses was found to be as follows: nineteen patients (59.4 %) with dental carries, seven patients (21.9 %) with a dental extraction and six patients (18.8 %) with d endodontic treatment.Conclusion: Results suggest that Actinomyces species may contribute to the etiology of the dento-alveolar abscesses.

Background and Aim: Halitosis or bad oral odor is a systemic and/or locally derived smell. There are many factors affecting oral odor. This study was designed to assess such factors.Methods and Materials: A group of 120 individuals were examined for plaque index, gingival index, caries, periodontal disease and halitosis. T - Test and odd's ratio were used for calculation of the data.Results: Crowding, pericoronitis, gingival and periodontal disease, caries, overhanged filling and bad oral hygiene were found to be significantly related to the presence of halitosis. Simple analysis showed that bad oral hygiene, periodontal problems, age, defective restoration and decays were significantly related to bad oral odor.Loosing teeth, crowding and dental prosthesis showed no relation with fetid odor.Conclusion: Multifactorial basis of halitosis was also seen in this study having the most effective role in this regard.

Background and Aim: Hodjkin's disease is an involvement of lymphatic system characterized by nontender enlargement of one or a group of lymph nodes associated with systemic signs and symptoms such as fever, night sweat, weight loss, itching and anemia. The objective of this study was to determine the epidemiologic features of Hodjkin' s disease in a group of Iranian children.Method and Materials: This retrospective and descriptive study was performed on children referred to Mofid Children's Hospital, Tehran, at Oncology Ward. Medical records of the selected patients were assessed for a period of ten years. A total of 82 casenotes of Hodjkin cases were overviewed and the data were then analyzed using SPSS software with a Chi - square test.Results: Findings of this study were as follows: 39% of children were in stage III at the time of diagnosis.Meanwhile, it was shown that the higher the stages of the disease, the more frequent the systemic symptoms (42.7%). There was a significant correlation between the stage of the disease and the systematic symptoms's rate (P<0.0005). The most frequent this topathologic type was mixed- cellularity (45.1%), and the mostcommon site of involvement was cervical lymphadenopathy (91.5%). Splenomegaly and lymphopenia were 39% caused commonly following chemotherapy, and the survival rate was at 73%. Conclusion: The pattern of Hodjkin's disease was found to be higher in this group of Iranian children compare to earlier reports.

Aim: The aim of this study was to evaluate the level of contamination in toothbrushes used by a group of personnels at Kerman Dental School and also their families during the year 1380.Method and Materials: This study contained four stages with its first and second stage sterility or contamination of new and unapplicated toothbrushes and toothpaste were evaluated and during third and fourth stages microbial contamination of toothbrushes and toothpastes which had been used.Results: Assessing the collected data suggest that:1. New and unused toothbrush had no microbial contamination.2. All applied toothbrushes had microbial contan1inationwith a sin1iliarityin number and kind of microorganism between members of the same fan1ily.3. Staphylococoes and streptococoes and neisseria were found to be dominant in comparison to other microorganisms.Conclusion: The used toothbrushes were contaminated as they illustrated microorganisms in them.

Background and Aim: Dentistry is a job with high risk to develop musculoskeletal pain and disorders, mainly due to the repeated bad and unsafe positions during work. The results of conducted studies showed that Low Back Pain had a high prevalence before 1960, while neck, shoulder, wrist and hand showed a higher percent of pain and disorders but after introduction of sitting position. The aim of present study was to evaluate the rate of musculoskeletal pain in a sample of Iranian dentists.Methods and Materials: A total of 99 general dentists (66 men and 33 women) aged from 24-68 years participated in this study by completing a modified NORDIC questionnaire. All subjects who had a work history of 1- 40 years and 3-16 hours day work were included in this investigation. Only 44.4% of participants had resting time between their patients' visits (1- 15 minutes).Results: Findings of this study showed a 59.5% neck pain, 54.5% back pain, 41.4% shoulder pain, 38.4% wrist pain and 28.3% headache sufferers among the total population. A significant difference was found between men and women in headache only, with the higher rate seen in women (p=0.008). X2 test revealed that those dentists who had break during work, the prevalence and history of musculoskeletal pain was significantly lower (p£0.05).Conclusion: More than half of the cases suffer from neck or back ache and a third from wrist and headache. So, a resting time between patients' visit has an important impact on preventing work related musculoskeletal pain and disorders in dentists.

Aim: Due to the importance of Hepatitis C and variations in correlation between HCV and oral lichen planus in different geographic areas, this investigation was conducted to determine the prevalence of oral lichen planus in HCV positive patients.Methods and materials: This cross sectional investigation has been carried out on 63 HCV positive patients in Hemodialysis center of Gilan province - north of Iran. The data was collected by patients examinations with prepared proforma to record the data. Specified details were also recorded including biographic information, liver enzymes variation, basic diseases and treatment with interferon.Results: From the total 63 cases, 33 were female and 30 male patients. The mean age of the male group was 43.8±17.4years, and females were 51.2±2.8 years. Only 3 of the cases had reticular of form of oral lichen planus. No significant difference was seen between the rate of oral lichen planus of hepatitis C positive and Negative patients.Conclusions: As the prevalence of lichen planus is lower in normal population (0.5-2%) the prevalence of 4.7% for hepatitis C positive patients could be considered as indicator for HCV infection.

Aim: The purpose of this study was to evaluate the frequency of idiopathic lichen planus among a group of patients with orallichenoid changes.Method and Materials: A group of 47 patients with orallichenoid lesions were evaluated in the department of oral medicine, Kerman dental school. Diagnosis of lichenoid tissue changes was confirmed by histologic examination of tissue biopsies in all cases. Carbohydrate metabolism status and liver function tests were evaluated in all patients. The diagnosis of idiopathic lichen planus was suggested after other causes of lichenoid tissue reactions had been ruled out. Statistical analysis was performed using a X2 and t - test.Results: The mean age of the study group was 41 years. Oral lichenoid lesions were somewhat more common in females than males of this population (55.3% vs 44.7%). The buccal mucosa and tongue were the most common sites of involvement. The present study showed that idiopatic lichen planus was the cause of oral lesions about in 87.2% of patients. Contact reaction to amalgam restorations was the second common cause of oral lichenoid lesions. Laboratory evaluation showed that 19.4% of lichen planus patients suffered from impaired glucose metabolism. Intrestingly, diabetes mellitus was also reported in 12.9% of lichen planus patients.Conclusion: This study suggests that oral lichenoid lesions are heterogenous, despite of their clinical and histological similarities and idiopathic lichen planus should be seen as the last diagnosis for a patient with oral lichenoid changes.

Background & Aim: Periodontal infection is the main cause for disease of the periodontium which is known as one of the most common of all diseases in human. Periodontal disease is broadly subdivided into two main categories: Gingivitis and Periodontitis. Periodontitis is generally associated with the age of its onset but also can be appeared by the effect of bacteria present in the pockets surrounding the teeth. The purpose of this study was to isolate capnophilic and periodontopathogenic bacteria and compare their sensitivity to some bacteriocide and bacteriostatic antibiotics.Materials & Methods: In this descriptive study, 513 capnophilic and periodontopathogenic bacteria were isolated from 405 specimens (206 cases in 1993 and 200 cases in 2001) of patients by culture method under capnophilic condition. Sensitivity of isolated bacteria to bacteriocide and bacteriostatic antibiotics were investigated by Kirby- Beuer method.Results: The Frequency of isolated capnophilic and periodontopathogenic bacteria in 1993 and 2001 were Actinobacillus actinomycetemcomitans 76 (31%), 96 (35.8%), Eikenella corrodens 71 (29%), 94 (35.1%) and Capnocytophaga 98 (40%), 78 (29.1%), respectively. Sensitivity of isolated periodontopathogenic bacteria to bacteriocide and bacteriostatic antibiotics including ampicillin, chloramphenicol, erythromycin oxitetracycline and penicillin G was found to be lower in 2001 than 1993.Conclusion: A resistance sign of assessed microorganisms are seen to some of bacteriocide and bacteriostatic antibiotics. It is therefore suggested to stop irrelevant antibiotic therapy.

Aim: This survey was designed to compare the efficiency of preventive methods on plaque index (PI) of 12 year old Tehranian pupils.Method and Materials: 16 secondary schooled were selected randomly and then divided into four groups:Group 1:the control group with no preventive program.Group II: the first trial group (Education G) who were introduced to oral hygiene through audio-visual training.Group III: the second trial group (Promotion G) who were persuaded practically.Group IV: The third trial group (Education and Promotion G) who were both trained and persuaded practically. PI was recorded both before and after intervention using Quigley - Hein plaque index, which is completed.Results: PI was increased from 30.8% (grade 3) to 48.3% (grade 4) in control group (P<0.05), while it's decrease was seen from 32.9% (grade 3) to 40.7% (grade 2) in group II (P<0.05). PI increased form 31.9% (grade 3) to 39.1% (grade 4) in group Ill. In group IV, PI decreased from 31.6% (grade 3) to 38.6 (grade 2) (P<0.05).Conclusion: Education and training has an obvious effect on increase of the level of oral hygiene.

Aim: This report of my own practice is presented to provide information on how to deal with such cases.Case Report: A 48 year old male is presented with diagnosis of pterygoid and masseteric space abscess of the left side of mandible after multiple extraction of upper and lower anterior teeth. Report included a history of injection of inferior alveolar nerve block with a possible infected needle. In spite of incision, drainage of abscess and antibiotic therapy complains from pus discharge were remained in the retromolar pad area associated with trismus.Results: After removing necrotic coronoid process under general anesthesia and antibiotic therapy, the pus discharge and trismus was resolved Conclusion: Pathologic examination of removed coronoid process proved its involvement to the osteomyelitis. So principle of sterilization in deep local anesthetic procedures like inferior alveolar and tuberosity block should be considered essential.

Background and Aim: Periodontitis encompasses a variety of infectious entities with various unique microbial and immune responses. Findings within the last decade have provided initial evidence that human hetpes viruse contributes to the periodontal disease development. This investigation studies the presence of herpes viruses in periodontal pockets and the corresponding gingival tissue from periodontally healthy and periodontitis sites.Methods and Materials: A nested - polymerase chain reaction was employed to identify the presence of HCMV, EBVI, EBV2, herpes simplex virus, human herpes virus HHV-6, HHV-7, HH-8 in each test sample.Results: Epstein - Barr virus type I (EBV-l), human cytomegalovirus (HCMV) and T- Iymphocytes are seen more frequently in periodontal lesions and acute necrotizing ulcerative gingivitis. It was also noted than periodontic lesions harbor elevated levels of bacterias including Actinobacillus Actinomycetemcomitans, Porphycomonas gingivalis, Bacteriodes forsythus, Prevotella intermedia, Prevotella nigreseens and Treponema denticola.Conclusion: The role of certain herpes viruses are clearly seen in the etiology and pathogenesis of human periodontal disease. Vaccination against herpes viruses could be considered as an important approach in periodontal prophylaxis and treatment.

Background and Aim: There has been an increased interest on the local application of antibiotics in the gingival crevice in order to obtain higher concentration of the drug at the target site and to minimize potential systemic adverse effects during the last two decades. Local delivery of antimicrobials has been investigated as a possible method for controlling and treating periodontal disease. This article will discuss details of clinical results obtained by topical application of metronidazole (Elyzol) in the treatment of periodontal disease.A treatment with local delivery of metronidazole seems to be as effective as scaling and root planning in untreated and recall subjects.Results: Calculating the collective data from the available studies was shown the mean probing depth reduction and clinical attachment gain for scaling/root planning (SRP) and Elyzol (SRP + Elyzol) group are 0.33 mm and 0.32 mm respectively, which is greater than SRP alone.Conclusion: It is concluded that the use of local metronidazole delivery devices should be reserved for sites in the patients who fail to respond to mechanical instrumentation. Furthermore, before using local metronidazole, it is prudent to use mechanical instrumentation on the root surfaces of teeth to disrupt the subgingival biofilms and remove calculus.

Aim: The aim of this study was to evaluate the role of Betadine mouthwash on reducing the dry socket appearing.Methods and Materials: A single blind study was conducted on 199 patients with 277 tooth sockets of extracted teeth. Cases were divided into two groups of control and study. They were selected from those referred to Oral and Maxillofacial Dept. in Tabriz Dental School.Results: The use of 1% Betadine mouthwash seems to have a significant effect on the prevention of dry socket formation (P=0.0195). Some predisposing factors for dry socket which were also evaluated such a smoking, oral hygiene, trauma, systemic disease with a clear effect on the formation of the dry socket.Conclusion: 1% Betadine mouthwash like other mouthwashes can reduce the incidence of dry socket.

Background and Aim: Fine Needle Aspiration Biopsy is an effective diagnostic method in the field of medical pathologies. Easiness, accuracy, validity and usefulness of this method have been verified frequently. This method is useful not only for soft tisse or even intraosseous lesions, but also recurrence of tumors (metastasis), resistence to treatment, verification of malignancy, differentiation between malignancy and benignment and determination of organisms causes infection. Unfortunately the use of this method is not common in dental pathology. So this study intendes to show the diagnostic value of FNA specially for intraosseous lesions causing jaw radiolucency.Methods and Materials: This investigation consisted of 80 patients who were referred to Taleghani General Hospital who were then referred to the pathology or surgery departments at Shahid Beheshti dental school.Cases consist of 29 females (36.25) % and 51 males (63.75%). Sampletaking was conducted using a 10 cc, gauge 19 syringe.Results: Results show 90% sensitivity and 75% specificity for jaw radiolucent lesions in FNA method. Correlation between FNA and jaw radiolucencies was significant (P<0.001) and it's power was at equal accepctable level according to cramer's V (phi - cramer's =0.623). Based on FNA cytology power, lesions with positive predictive value of 78.30 had a microscopic view compatible to the findings of other similar studies.Conclusion: FNA can be used as a reliable method for rapid, early and in expensive diagnosis, resulting in an on time, and appropriate treatment plan.

Following the growing influence of Evidence - Based Medicine on the critical evaluation of studies, this paper was prepared to put guidelines in dental research and reach the Best Evidence and preventing any possible bias.Evidence - Based Dentistry (BBD) is defined by the ADA as a skill in which the clinician will amalgamate information and apply to structure different forms of studies with Best Evidences without any bias.External validity of the results of in vivo and in vitro studies results highly depend on the strength of evidences. The only form of studies which can influence scientific and clinical decision making are considered as beings systematic reviews (Overview, Meta analysis). These studies criticize and evaluate multiple controlled randomized clinical trials (RCT). Appreciation of the Evidence - Based Dentistry principles can define the pathway of studies to reach a systematic review and to demonstrate the validity of results gained and their role on scientific and clinical decision making.

Background and Aim: Because respiratory infection can occur by aspiration of oropharyngeal flora into the lower respiratory tract, it has been suggested that periodontal microorganisms may act as a potential source for respiratory infection especially in patients with advanced periodontal diseases. The purpose of this study was to determine the role of periodontal diseases in the pneumonia.Method and Material: Samples of this investigation consists of 46 patients (23 cases and 23 controls). Samples were matched based on their age, gender, occupation and educational level. None of the patients had reported to have any smoking, alcohol drinking habit, or systemic disease.Results: The results indicated that 17.4% of the control group and 65.2% of the case group who had pneumonia, suffered from either moderate or severe periodontal diseases (P<0.001). This indicates chance 00.7 times exposure to pneumonia in case of periodontal diseases. The rate of attachment loss was 0.86±0.39 mm in control group, and 1.65±0.92mm in cases (P<0.001).The G.I moderate to severe in control group was 78.3% and in cases 95.7% (P<0.08).Conclusion: A definite relation was seen between pneumonia and periodontal disease with higher chance being evident in cases with a type of periodontal disease.

Aims: This investigation was designed to evaluate upper airway spaces in patients with skeletal anteroposterior and vertical malocclusions.Methods and Materials: Ninty lateral cephalograms of patients were traced with C1 I, C1 II and C1 III malocclusions having normal bite, openbite and deepbite were traced. Hypopharyngeal, nasopharyngeal and oropharyngeal depths were measured considering a magnification of 1.1. Chisquare and ANOYA tests were used to analyse the data.Results: Hypopharyngeal depth was found to be at 17.3±3.7mm in C1 I, 16.0: ±3 in C1 II and 16.7±4 in C1 III; 17.4±0.1 in normal bite, 16.4±3.2 in openbite and 17.1±3.5 in deepbite. The mean oropharyngeal depth was 10.4±2.4 in C1I, 9.8±2.4 in C1II, 11.3±3.3 mm in C1III; 10.9±3.1 in normal bite, 9.7±2 in openbite and 11±3.1 mm in deepbite cases. Nasopharyngeal depth was found to be at 23.8±3.3 in C1I, 22:7±3.3 in C1 II: 21±4 mm in C1 III: 23±4.7 in normal bite, 22.1±3.5 in openbite and 22.4±3.1 in deepbite cases.Conclusions: No significant difference was found between hypopharyngeal and oropharyngeal depths of three vertical and sagittal malocclusions. However, nasopharyngeal depth showed a significant difference between C1 II and C1 III malocclusions; and also between C1 I and C1 III malocclusions (P<0.05). No significant difference was found between different groups in vertical malocclusions too.