JOURNAL OF DENTISTRY (SHIRAZ UNIVERSITY OF MEDICAL SCIENCES)
Year:2019 | Volume:20 | Issue:3|Papers Count:13

Various treatment modalities have been reported for keratocystic odontogenic tumors (KOT), with different recurrence rates. Marsupialization and decompression are two different conservative surgical techniques for the treatment of KOTs. This study aimed at comparing the recurrence rate between marsupialization and decompression in the treatment of KOTs with or without adjunctive treatments. This is a systematic review study. The research sources utilized were PubMed (MEDLINE), Google scholar, Ovid MEDLINE and Cochrane Library. The keywords which were selected based on Medical Subject Heading (MeSH) terms and PICOS criteria were odontogenic keratocyst, keratocyst odontogenic tumor AND marsupialization OR decompression OR cystectomy OR enucleation OR curettage. Statistical analyses were performed to compare the recurrence rate between marsupialization and decompression with or without adjunctive treatments, regarding various follow-up times. The number of subjects that underwent marsupialization was 182. There was a significant difference for the recurrence rate between the marsupialization and decompression groups without considering adjunctive treatments (p= 0. 001). However, considering adjunctive treatments, there was no difference between marsupialization and the decompression groups (p= 0. 18). It appears that decompression without any adjuvant treatment may have a lower recurrence rate than marsupialization. The recurrence rate was not different when enucleation or cystectomy was performed after decompression and marsupialization.

Statement of the Problem: Several factors affect the success of pulp therapy of primary teeth, including cleaning and shaping of the root canals and the quality of obturation as the most important steps. Purpose: The aim of the present study was to compare the quality of different root canal obturation techniques in deciduous mandibular molars subsequent to preparation of the root canals with the rotary technique, using the photo stimulated phosphor (PSP) digital radiographic technique. Materials and Method: In this in vitro study, 221 root canals were selected in 80 extracted deciduous mandibular second molars. The root canals were prepared with a modified protocol for ProTaper NiTi rotary files and with only two instruments (SX and S2) and obturated using a lentulo spiral, condensation technique, an anesthetic syringe, and tuberculin syringe techniques with ZOE paste. The quality of the root canal obturation (obturation length and the number and sizes of the voids) was evaluated using PSP radiographic technique. Data were analyzed with SPSS 21, using chisquared, Kruskal-Wallis and Mann-Whitney tests. Results: There were no significant differences in the obturation length (p= 0. 285) and the number of voids (p= 0. 061) between the study groups; however, there were significant differences in void sizes between the study groups (p= 0. 001). The condensation and tuberculin syringe groups exhibited the best and worst results considering the obturation length, respectively. Lentulo and anesthetic syringe techniques have also exhibited acceptable results. The condensation and anesthetic syringe groups exhibited the minimum and maximum number of voids, respectively. The condensation and lentulo groups exhibited the maximum and minimum void sizes, respectively. Conclusion: If implemented correctly, there will be no significant difference among the experienced root canal obturation techniques considering obturation length and the number of voids.

Statement of the Problem: Currently, two major methods have been introduced for bone age assessment using left hand radiography. The first approach is Greulich and Pyle, which is very subjective. The second method is Tanner and Whitehouse, which is very time consuming and its morphological criteria are not quantitative, therefore it is hardly used. Purpose: The purpose of this study is to evaluate the relationship between skeletal age and bone size and joint space measurements among Asian children using hand radiographs and using this correlation as an aid in determining bone age. Materials and Method: In this analytic research, 304 hand radiographs from Asian children with normal development have been included in this study (155 female, 149 male). Two radiologists using Greulich and Pyle method assessed their bone ages. The 2nd-5th metacarpal bones length and width and 2nd-5th metacarpophalangeal joints width and length were manually measured by Adobe Photoshop and compared with subjects’ skeletal age. Pearson correlation was used to determine the relationship. Results: Pearson correlation between bone age and metacarpal bones length was 0. 902-0. 938; metacarpal bones width was 0. 452-0. 850; metacarpophalangeal joints width was 0. 656-0. 811, and metacarpophalangeal joints length was 0. 920-0. 947. Conclusion: Regarding Pearson correlation, metacarpophalangeal joints length, metacarpal bones length, metacarpophalangeal joints width, and metacarpal bones width showed significant relationship with bone age, respectively. These measurements can be used as accessory criteria for bone age assessment using left hand radiography, to reduce inter-observer reading differences.

Statement of the Problem: Various pathologic conditions can affect the thickness of the roof of glenoid fossa (RGF). The relationship between the RGF thickness and temporomandibular joint disorder (TMD) is not explicitly investigated. Considering the changes in RGF thickness, as a radiographic sign for TMD diagnosis, the phenomenon may necessitate specific treatment and may influence the treatment course and results. Purpose: This research was designed to examine the relationship between TMD and RGF thickness changes compared to non-TMD group. Materials and Method: In this cross sectional analytic research CBCT images of 70 TMD patients (140 joints) and 70 non-TMD individuals (140 joints) as control group were evaluated for thickness of RGF and presence of discontinuity in RGF. The distance between superior and inferior cortex of glenoid fossa was measured as RGF thickness. Inability to follow the course of cortex in any given image was considered as discontinuity. T-test, Chi-square and odds ratio (OR) were used for statistical analysis. In this study, p< 0. 05 was considered meaningful. Results: The mean thickness of RGF in our non-TMD samples was 1. 12 mm. RGF thickness was significantly increased in TMD patients compared non-TMD group (p= 0. 00). This value was also greater in males. On the other hand, TMD patient showed a higher incidence of discontinuity in RGF, in comparison with non-TMD patients (p= 0. 006). Conclusion: the increased thickness of RGF can be considered as a sign of TMD, which may help in diagnosis of TMD. It seems that there is a direct relationship between TMD and discontinuity of RGF.

Statement of the Problem: Due to growing concerns on complications of chemical drugs, the use of herbal extracts has been considered as denture cleaning solutions. Purpose: The aim of this study was to evaluate the in-vitro effects of Nigella sativa on the cleansing of the formation of Candida albicans plaque on the acrylic resin pieces. Materials and Method: In this experimental study, 30 pieces of acrylic resin were contaminated by Candida albicans suspension. Then, the acrylic pieces were randomly divided into six groups and treated with 0. 2, 0. 4, 20, and 200 mg/ml of Nigella sativa, 100, 000 units of nystatin (positive control), and distilled water (negative control) for 8 hours. At the end of the exposure period of the drugs, the rinse solution from acrylic pieces was cultured in Sabouraud Dextrose Agar and the average of the colonies from each group was compared. Results: The average number of colonies obtained at concentrations of 0. 2, 0. 4, 20, and 200 mg/ml of Nigella sativa were 122. 6, 117. 8, 73. 4, and 14. 4 colonies, respectively, as compared to distilled water (141. 6) and nystatin (0) that had a significant difference (p< 0. 001). Conclusion: Nigella sativa extract at definite concentration is capable of clearing dental prosthesis, but compared to nystatin, it is weaker. However, due to the indirect immuneregulatory effects of Nigella sativa, it is suggested that other studies be conducted to investigate the therapeutic properties of Nigella sativa from the aspects of antimicrobial, anti-inflammatory, and oral ulcer healing in candida oral lesions.

Statement of the Problem: Human tooth is clinically the most appropriate material that can be used for in-vitro dental research. However, there are limitations and drawbacks for using human teeth. Therefore, alternatives to samples of human teeth for dental studies are necessary. Purpose: This study purposed to evaluate and compare the microstructure and chemical composition of enamel and dentin of teeth in some lab animals. Materials and Method: In this experimental study, teeth of mouse, rabbit, guinea pig, dog, cat, and sheep were used. Scanning electron microscope observations and X-ray diffraction analysis were performed on samples. Results: This study revealed resemblance in general structure of dentin and enamel between mentioned animals and human. The minimum mean of dentinal tubules diameter is found in guinea pig (0. 5μ ), while the highest is in cat (1. 5μ ). Also the lowest and the highest mean intertubular distance was measured respectively in guinea pig (3μ ) and sheep (4. 8μ ) and the maximum and minimum mean diameter of rods was measured in rabbit (6. 6μ ) and guinea pig (1. 5μ ), respectively. Conclusion: The recorded details and the measured values indicate great resemblance between dog and human dentin and enamel. Cat is in the second place for dentinal studies; sheep and guinea pig have the least resemblance to human within the scope of the reviewed criteria.

Statement of the Problem: Recurrent aphthous stomatitis is a common oral lesion, and the use of herbal remedies containing tannin and flavonoid has been reported to be effective in treating aphthous stomatitis. Purpose: This study was aimed to evaluate the effect of Punica granatum muco-adhesive gel on controlling the oral recurrent aphthous stomatitis and its comparison with Triadent oral paste. Materials and Method: In this double-blind clinical trial, 60 patients with minor aphthous stomatitis were enrolled. These patients had no systemic diseases and were not on any medications. The patients were randomly treated with Punica granatum formulated gel, Triadent oral paste and placebo. The time of pain elimination and the time of complete healing were recorded and the pain degree was assessed and recorded by each patient. The data were analyzed using survival analysis and ANOVA test. Results: The Kaplan-Meier survival analysis demonstrated that pain relief time in Punica granatum group was lower than placebo group (p= 0. 002), even so, it caused no significant difference with the Triadent group in comparison with the placebo group (p= 0. 08). The survival analysis also indicated that the wound healing time in Punica granatum group was significantly lower than the other two groups (p< 0. 05). Conclusion: Punica granatum gel has a successful effect in controlling and treating recurrent aphthous stomatitis. It can be considered as an affordable and inexpensive treatment.

Statement of the Problem: Rheumatoid arthritis and periodontitis are chronic inflammatory diseases with a possible bidirectional relationship. This link may be affected by many factors like drug consumption. Purpose: This study was designed to evaluate the periodontal condition in patients with rheumatoid arthritis, considering the effect of disease modifying anti-rheumatic drugs. Materials and Method: This case-control study included 25 newly diagnosed rheumatoid arthritis patients with negative history of taking anti-rheumatic drugs, 25 patients who received anti-rheumatic drugs for more than three years and 50 healthy individuals as a control group. Periodontal indices, including plaque index, gingival index, probing depth, clinical attachment loss, and rheumatologic indices were recorded and compared between these groups. Results: Rheumatoid arthritis patients were significantly more affected by periodontitis compared with healthy subjects (p= 0. 006). There was no significant difference in rheumatologic indices between patients with and without periodontitis. Clinical attachment loss in old rheumatoid arthritis patients and gingival index in newly diagnosed ones were significantly more compared to the control group (p= 0. 003 and p< 0. 001 respectively). We could not find a linear relationship between the severity of rheumatoid arthritis and chronic periodontitis (p= 0. 1, r=-0. 224). Conclusion: Periodontitis and clinical attachment loss were more in patients with rheumatoid arthritis than the healthy group, especially in drug consumers. Gingival index in patients without the history of consuming anti-rheumatic drugs was significantly higher than those who were drug consumers, indicating the effect of the medications on the signs of inflammation.

Statement of the Problem: The goal of endodontic therapy is the reduction or elimination of microorganisms from the root canal system. The use of intracanal medicament between treatment appointments is recommended in order to eliminate any remainang microorganisms in the pulp space. Purpose: The aim of the present study was to investigate the antimicrobial activity of methanolic extracts of Myrtus communisL. and Eucalyptus galbie, their combination with calcium hydroxide powder; combination of calcium hydroxide powder with water, and ready-to-use calcium hydroxide paste with iodoform; against Enterococcus faecalis. Materials and Method: In this experimental study, after gathering the plants, After gathering the plants, their methanolic extracts were obtained by masceration method. The diameters of inhibition zone of all mentioned materials were determined by agar diffusion test. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC); and anti biofilm effect of the materials that showed antibacterial effect in agar diffusion test, were then evaluated by tube dilution test, and microtiter plate assay followed by colorimetric crystal violet methods, respectively. Results: After 48 hours, both herbal extracts showed antimicrobial effect. However, combination of calcium hydroxide with extracts produced no zone of inhibition. The mean inhibition zone of Eucalyptus extract was more than that of Myrtus. However, the results of ANOVA test, showed that there was no significant difference between the antibacterial effect of Eucalyptus galbie, Myrtus communisL. and positive control (Cefoxitin) (p Value= 0. 987). The MIC for both extracts were 12. 5 mg/ml. MBC evaluation of the two methanolic extracts showed no bactericidal effect on Enterococcus faecalis. Based on ELISA analysis, biofilm formation in response to different sub-MIC concentrations of both extracts was scored as weak to moderate. Conclusion: The methanolic extracts of Eucalyptus galbie and Myrtus communis L. in combination with calcium hydroxide powder were not able to eliminate Enterococcus faecalis within 48 hours.

Statement of the Problem: Assessment of bone density changes plays an important role in diagnosis, treatment, and follow-up procedures. The feasibility of cone-beam computed tomography (CBCT) for assessment of bone density changes is still controversial. Purpose: The aim of this study was to investigate the capability of bone density contrast dissociation of CBCT compared to digital periapical radiography. Materials and Method: In this in vitro, experimental study, we designed radiographic phantom for bone density simulation. The phantom was a polytetrafluoroethylene rectangular cube with five-chambers. Five micro-tubes (2 mL) containing different concentrations of dipotassium phosphate (K2HPO4) were placed within these chambers. Different concentrations of K2HPO4 were scanned by CBCT; the mean voxel value of each micro-tube was measured and compared with the concentration of K2HPO4 that represented bone density. Results: CBCT results showed that there were no significant correlations between 300 mg/mL and lower concentrations of K2HPO4 and CBCT voxel values (P≤ 0. 52) but there was a significant correlation between concentrations of K2HPO4 higher than 300 mg/mL and CBCT voxel values (p< 0. 001). Conclusion: CBCT is a reliable method for the assessment of bone density changes in the high range of bone density but it is not reliable for such assessment in the lower range of bone density. Digital periapical imaging method may not be applied for the assessment of bone density, whereas in higher densities, the employment of CBCT seems to be feasible.

Langerhans cell histiocytosis (LCH) is characterized by the congregation of proliferating langerhans cells (LC). Langerhans cells are a part of dendritic cell system of primary immune response that is responsible for presenting antigen to lymphocytes. Being a rare disease, the total incidence of LCH is reported to be 1 in 2 million people. LCH mainly affects children and young adults, with a slight male predilection. LCH is clinically divided into three groups namely Letter-Siwe disease (multiple multi organ affecting LCH at very young age), Hand-Schuler-Christian disease (LCH of bone involvement exophthalmos and diabetes insipidus), and Eosinophilic granuloma (LCH of bone, solitary or multiple). The extent of involvement influences the treatment planning. In this retrospective study, we survey five patients with eosinophilic granuloma in jaws (bony LCH). The diagnosis was confirmed by tissue biopsy and histopathologic examination. Surgery and curettage of the lesions were carried out under general or local anesthesia. After surgery, the patients were examined clinically every 6 month in the first year and then once in a year. The overall outcome was excellent. According to the results, it can be concluded that surgical curettage of localized eosinophilic granuloma is an appropriate and sufficient treatment.

Multiple primary tumors may develop in patients with head and neck squamous cell carcinoma. The coincidence of head and neck squamous cell carcinoma with papillary thyroid carcinoma is a rare finding. This study reports a case of papillary thyroid carcinoma, which was incidentally detected during the microscopic examination of lymph nodes of a patient diagnosed as gingival squamous cell carcinoma. A review of literature is also presented.

The granular cell odontogenic tumor is an extremely rare odontogenic neoplasm which about 38 cases has been reported with sufficient documentation in the literature. It has a prominent predilection to occur in the posterior of mandible of middle-aged women. Here, we report a case of mandibular granular cell odontogenic tumor in a 57-year-old female with chief complaint of swelling and tooth mobility. As rarity of these lesions, their clinical behavior and prognosis are not clear; hence, reporting more such cases may be beneficial to correct diagnosis and prevent unnecessary treatment.