Journal of Dental Medicine
Year:2007 | Volume:20 | Issue:1 (50)|Papers Count:14

Background and Aim: Patients always complain about metallic color of amalgam restorations. Covering amalgam by composite can solve this problem. Since polymerization shrinkage is a serious shortcoming in composites, application of the combined amalgam and composite restoration is one of the methods to reduce leakage in the cervical margins of posterior restorations. The aim of this invitro study was to evaluate the microleakage of amalgam/composite interface when Rely-X ARC adhesive resin cement was used in the joint.Materials and Methods: Twenty-four sound extracted premolars were chosen. Mesial and distal class II conventional cavities were prepared and the samples were divided into 4 groups of 12. In all groups, the bases of the cavities were restored with amalgam and then the remaining part was filled by composite resin. Specimens in groups 1 and 2 were restored with composite-resin, immediately after condensing amalgam without or with application of Rely-X ARC (3M, ESPE) respectively. In groups 3 and 4, composite resin were applied 24 hours after condensation of amalgam, without or with application of Rely-X ARC respectively. After polishing and thermocycling, all specimens were prepared for dye penetration and the degree of leakage was scored and analyzed using Kruskall Wallis test with p<0.05 as the level of significance.Results: The frequency of dye penetration in different groups was obtained. The most and the least scores were observed in groups 3 and 4 respectively. No statistically significant difference was observed in different methods.Conclusion: None of the methods in this study could seal the amalgam/composite-resin interface.

Background and Aim: Furcal perforation has a great impact on prognosis of endodontic treatments, requiring immediate and proper intervention. Gray MTA is applied as material of choice in repairing perforations. The aim of this study was to evaluate the repair of mechanical furcal perforations, histologically using white MTA and Portland cement and compare them with gray MTA. Materials and Methods: In this experimental study, second to fourth mandibular and maxillary premolar teeth of five dogs received endodontic treatment, then the furcation area of the teeth were perforated and repaired as follow: gray MTA in group1, white MTA in group 2, Portland cement in group 3 and cotton pellet in group 4 (control). Animals were controlled for 4 months and sacrificed using an over dosage of sodium thiopental intravenous injection and perfusion of 10% formaldehyde. Chi-square and Fisher exact tests were used to compare hard tissue formation between groups and between each two groups, respectively. Non-parametric Kruskall Wallis and Dunn procedure were also used to compare degree of inflammation among groups and between each two groups, respectively. Results: Gray MTA had more favorable results (90.9% hard tissue formation and only 9.1% severe inflammation) but the difference between gray MTA, white MTA and Portland cement was not statistically significant.Conclusion: The difference between gray MTA, white MTA and Portland cement groups was not statistically significant for degree of inflammation and hard tissue formation. In conclusion both white MTA and Portland cement can be used instead of gray MTA to repair perforations in accordance to esthetic considerations.

Background and Aim: Insufficient polymerization of resin cements is of considerable clinical importance, because of mechanical deficiencies and biological side effects of uncured resin. Dual cure resin cements are getting popular in luting tooth colored posts and although their curing is claimed to proceed chemically, polymerization efficiency in deep areas of canal is uncertain. The aim of this study was to evaluate degree of polymerization of dual-cure resin cements used for luting translucent and opaque fiber posts in different distances from the light tip.Materials and Methods: In this experimental in vitro study, degree of conversion of two dual cured resin cements, Rely X ARC (3M, ESPE) and Nexus 2 (Kerr, USA) were measured when used with DT-Light and DT-White posts (RTD, France). The light curing unit used was Optilux 501, with output of 650-700 mw/cm2 with emitting time of 60 seconds. Degree of conversion was measured in three different depths (4, 6, 8 mm) by FTIR. The data were analyzed using ANOVA and Post hoc tests. P<0.05 was considered as the level of significance. Results: DC% of Rely X with either of the posts was not significantly different in the studied depths (P>0.05). Nexus used with DT-Light had lower DC% in 8 mm depth (P<0.05). Nexus used with DT-White showed lower DC% in 8 mm depth compared to 4 mm depth. The control groups of both cements showed significant increased DC% in 4 mm depth compared to 6 and 8 mm depths (P<0.05). DT-White caused decreased DC% in both cements in 4 mm. DT-Light caused increased DC% of Rely X in 6 mm depth compared to DT-White and control. DT-Light increased DC% of Nexus in 6 and 8 mm depths, compared to DT-White and control groups.Conclusion: Based on the results of this study, application of translucent fiber posts has a significant effect on degree of polymerization in dual-cure resin cements, compared to opaque types. Their better light transmission to deep areas due to the effect of optical fibers, can lead to better results.

Background and Aim: Extensive and continuous consumption of acidic drinks is the main cause of enamel erosion in human teeth. The purpose of this study was to compare the erosive potential of two Iranian drinks with those of two imported ones.Materials and Methods: Two Iranian drinks (Cola Zamzam and Orange Zamzam) and two imported ones (Pepsi and Miranda) were studied in this experimental invitro study. 120 intact premolar teeth, extracted for orthodontic reasons were divided into 3 equal groups (A, B and C). Each group was exposed to one of the drinks for exposure times of: A: 15 minutes, B: 45 minutes and C: 12 hours. Each group was divided into 4 subgroups (each containing 10 teeth), which were exposed to 20 ml of one of the 4 drinks. The exposed surface was the same in all samples (a 5 mm in diameter semi circular window). The amount of Ca++ ion (mg/ml) added to each drink at the end of exposure time was estimated by atomic absorption spectrophotometer.Results: 2 way ANOVA showed that the drinks were significantly different with regard to released Calcium ion. Time had significant effect on erosive potential. The two mentioned factors had significant interaction (P<0.001). The most erosive effect was seen in 12 hours in all of the drinks. The erosive effect of Orange Zamzam in 15 minutes and Pepsi in 45 minutes and 12 hours was significantly more than other groups (P<0.001).Conclusions: Pepsi had the most long term erosive effect among the four drinks, and Cola Zamzam had the least erosive potential.

Background and Aim: The cell cycle is an important event in tumor growth and differentiation and several molecules are involved in this process. The aim of this study was to evaluate the expression of cyclin D1 (a cell cycle inducer) and p21 (a cell cycle inhibitor) in ameloblastoma of the jaws.Materials and Methods: In this cross-sectional study, 40 cases of ameloblastoma were selected from the archive of oral pathology department. 3 micron sections were cut from paraffin blocks and immunohistochemically stained with antibody against cyclin D1 and p21waf. Stained cells were counted using an eyepiece graticule and labeling index was calculated. Data were analyzed by SPSS version 11.5 for windows using Mann-Whitney and Wilcoxon signed ranked tests with p<0.05 as the level of significance.Results: Expression of cyclin D1 protein was detected in nuclei of many tumoral cells. The expression of cyclin D1 in solid and unicystic ameloblastoma and also between its follicular and plexiform variants was not statistically different (P>0.05). There was no statistically significant difference in expression of cyclin D1 between peripheral and central cells (P>0.05). Expression of p21 protein was detected in nuclei of some tumoral cells. There were no statistically significant differences between p21 expression in unicystic and solid ameloblastoma (P>0.05). P21 expression was statistically different between plexiform and follicular variants of ameloblastoma (P=0.049). The difference between p21 expression in peripheral cells of plexiform and follicular variants was statistically significant (P=0.009). This was not observed in central cells. There was no statistically significant relation between p21 and cyclin D1 expression in ameloblastoma (P>0.05).Conclusion: Based on the results of this study, cyclin D1 expression in ameloblastoma is in high level and it could have an important role in the process of tumorigenesis. P21 expression in ameloblastoma is very faint and its possible effects need further investigation.

Background and Aim: Mechanical preparation of canal is one of the most important stages in root canal therapy. Various kinds of hand or rotary techniques are used for mechanical preparation of canal and each of them has advantages and disadvantages. During canal preparation, extrusion of debris from the apical foramen can result in periapical inflammation and increased pain and edema. The aim of this study was to compare hand instrumentation technique with three rotary systems (Profile, Race, Flex Master) regarding the amount of extruded debris from apical foramen during canal preparation.Materials and Methods: In this experimental in vitro study, one hundred human extracted single rooted mandibular premolars with curvature between 0-10 degrees were selected and divided into four groups of 25 teeth each. All teeth were shortened to 15 mm length by cutting the crown. Group H was prepared by hand step back technique, group P by Profile system, group R by Race system and group F by Flex Master system. For debris collection, vials containing distilled water were used which were weighed before preparation. After the end of canal preparation, vials were completely dried and weighed again. The difference between weights of vials in two stages was the weight of debris extruded from apical foramen. The groups were compared by One-way ANOVA with p<0.05 as the level of significance.Results: Group H had the highest mean weight of debris which showed significant difference with all three rotary groups (P<0.001). The lowest mean weight of debris was observed in group R (Race) which was significantly different from group F (Flex Master) but not significantly different from group P (Profile). Conclusion: Based on the results of this study, race rotary system caused less debris extrusion from apical foramen compared to hand step back technique and Flex Master rotary system.

Background and Aim: Dental Amalgam is a common restorative material for posterior teeth. Because of Hg content in the composition of amalgam, during the handling of material, mercury may release as vapor in the environment. Excess amount of mercury vapor can cause serious health problems in dental personnel. The aim of this investigation was to determine mercury vapor concentration in working environment of dentists in Tehran. Materials and Methods: 211 dental clinics were participated in this cross-sectional study. The clinics were randomly selected from different regions of Tehran (north, center, south, east and west). The dentists were asked to complete a questionnaire including items on demographic characteristics such as age, sex and work history, method of handling of amalgam, environmental characteristics and general health conditions. Environmental measurements of mercury vapor in dentists’ offices were done by mercury absorption tubes (Hydrar) and personal pumps (SKC, 222-3, England) as suggested in NIOSH method. Analysis of air samples was done by atomic absorption spectrophotometery (cold vapor). The data were analyzed by non-parametric tests (Kruskall Wallis, Mann-Whitney and Kendall).P<0.05 as the level of significance.Results: The mean mercury vapor concentration in dentists’ offices was 8.39(±9.68) µg/m³.There was no significant relationship between the urine mercury of dentists (3.107±3.95) and the air Hg vapor concentration of their offices. Using precapsulated amalgam showed significantly less Hg vapor than bulk amalgam (P=0.034). Also the surface area of working room and air Hg vapor (P=0.009) had a significant relationship (P=0.009 r=0.81). There was not any significant correlation between mercury vapor and other factors such as working hours per day and working days per week, squeezing of triturated amalgam or not, storage medium of set amalgam (water or fixer solution), mercury storage method and type of ventilation.Conclusion: The concentration of mercury vapor in dental offices' environment was lower than threshold limit value. Based on this study the type of amalgam (precapsulated or not) and area of the working room had significant effect on the mercury vapor concentration of environment.

Background and Aim: Low birth weight is a significant public health issue. Recent studies have suggested periodontal diseases as risk factor for preterm labor. The aim of this study was to assess the relation between gingival health and preterm labor in a sample of Iranian female population. Materials and Methods: In this cross sectional study, 201 pregnant women without any systemic diseases or other risk factors like psychotic conditions were selected. Ninety-nine of them had term labor (infant≥37 weeks) and 102 had preterm labor (infant<37 weeks). Bleeding index, pocket depth and debris index were measured. Data were analyzed by Chi-square and Mann-Whitney tests with p<0.05 as the level of significance.Results: Bleeding index, probing depth and debris index showed statistically significant differences between preterm and term labor mothers (P<0.001).Conclusion: According to the findings of this study, there is a significant relationship between gingival health and duration of pregnancy. Consequently, periodontal diseases could be risk factor for preterm labor. Oral hygiene is strongly recommended to be included in pregnancy health programs.

Background and Aim: An important requirement for a dentin bonding agent is biological compatibility. Since dentin bonding agents are placed in cavity preparations with subgingival extensions, with direct contact to gingival and mucosal tissues, tissue response to these materials must be investigated. The aim of this study was to examine the cytotoxicity of AdheSE, a self etching adhesive, on human gingival fibroblasts.Materials and Methods: In this experimental in vitro study, primary human gingival fibroblasts were exposed to different dilutions of primer & bond of AdheSE (Vivadent, Liechtenstein). The toxicity of the primer was tested in 30 seconds, 300 seconds and 24 hours. The cytotoxicity of the bond was analyzed in uncured mode after 20 seconds, 5 minutes and 24 hours. In cured mode, tested materials were analyzed after 24 and 48 hours. Cytotoxic effects were evaluated using MTT, cell counting and DNA condensation assays. Data were analyzed by two way repeated measure ANOVA with p<0.05 as the level of significance.Results: MTT Assay revealed that uncured AdheSE Bond was toxic only in 10-1 dilution and the difference with control group was significant (P<0.05). By increasing the time to 300sec. and 24h, dilutions of 10-2 and 10-4 were the most cytotoxic respectively. Cytotoxicity of uncured primer after 30 sec. and 300 sec. began from 10-2 and after 24h began from 10-2 and reached to 10-1. AdheSE in cured mode showed significant difference with control group in 1:2 (P<0.001), 1:4 & 1:6 (P<0.01) dilutions. In cell counting assay only the 1:2 dilution was significantly more toxic than control group. Apoptosis (a morphological and biochemical distinct form of cell death that regulates cell turnover) comprised in less than 5% of total death in both cured and uncured adhesives.Conclusions: Based on the results of this study, by increasing the exposure time, smaller amounts of bonding could be cytotoxic. Cytotoxicity was related to material, dilution, time of exposure and curing. It would be necessary to identify the toxic ingredients of this adhesive and replace them by more biocompatible components.

Background and Aim: Qigong is a type of Chinese psychosomatic exercise that integrates meditation, slow physical movements, and breathing. Numerous physical and mental benefits have been classically ascribed to qigong. On the other hand, unstimulated saliva is thought to play an important role in oral immunity, enamel stability and moisturizing the oral mucous membrane. Impaired salivary secretion leads to dental caries, mucosal deterioration and mouth dryness. The aim of the present study was to analyze the effect of a qigong program on various parameters of saliva such as quantity of unstimulated saliva, pH and SIgA.Materials and Methods: Twenty three subjects participated in this clinical trial study. The experimental subjects underwent a qigong training program, conducted by a qualified instructor. The program consisted of half an hour daily practice for 6 months (spring and winter). Saliva was collected in two periods: once during the spring before the experiment commencement and the second, in the following spring. During each period saliva collection was done on tuesday of each week. pH and quantity of salvia measurements were taken simultaneously. SIgA measurements were also taken based on the values obtained in the last phase of the experiment at the end of each spring. The results were analyzed using paired sample T test, one way repeated measure and Bon Ferroni multiple comparison. P<0.05 was the level of significance.Results: Based on our findings, the change in the amount of unstimulated salvia as well as SIgA was statistically significant (P<0.001); however, there was no significant difference in pH values before and after experiment.Conclusion: These findings demonstrate that after 6 months of practicing qigong, significant changes in amount of unstimulated saliva and SIgA occurred in participants. The authors suggest that qigong may be a beneficial adjunctive treatment that enhances amount of unstimulated saliva and SIgA.

Background and Aim: Formocresol (FC) has been a popular pulpotomy medicament for primary dentition in recent decades. Concerns have been raised about the toxicity and potential carcinogenicity of FC, and alternatives have been proposed. Recently, the physical and biological properties of mineral trioxide aggregate (MTA) have been described in many studies. The aim of this study was to compare the success rate of pulpotomy with MTA (made in Iran) and FC in primary molars.Materials and Methods: In this clinical trial, 30 primary molars needing pulpotomy treatment were selected and randomly divided into two groups: (15 teeth in FC and 15 in MTA group). The teeth were then pulpotomized and restored. Clinical and radiographic results were recorded at 1-3-6-9 and 12 months and success rates of two groups were compared using Fisher’s exact test with p<0.05 as the level of significance. Results: After 12 months, there was no statistical significant difference between MTA group (85.8%) and FC group (93.3%) (P@ 1.0). The only observed radiographic failure was internal resorption. Conclusion: Based on the results of this study, MTA can be used as an alternative to formocresol in primary teeth pulpotomy.

Background and Aim: Proper designing of partial denture frameworks is the duty of dentists, but this task is often abdicated to technicians because of lack of time and experience. Computer assisted learning and designing can be used for both training dental students and helping dentists design proper frameworks. As the first step to prepare software for framework designing, this study evaluated the agreement on different framework designing principles, among prosthodontists of dental schools in Iran. Materials and Methods: A questionnaire consisting of 121 design rules was sent to 41 prosthodontists at seven dental schools in Iran .The percentage rate of agreement on results was used for data analysis. Results: The percentage of rules accepted by more than 60% of the prosthodontists was 76.2%. It consisted 80% saddle rules, 76.2% rest rules, 78.4% clasp rules, 63.6% maxillary major connector's rules and 80.9% mandibular major connector rules. Conclusion: The percentage of accepted rules by Iranian prosthodontists was 76.2%. Maxillary major connectors had the least acceptance.