Journal of Dentistry
Year:2023 | Volume:24 | Issue:SUPPLEMENT (1)|Papers Count:12

Statement of the Problem: Xerostomia is a subjective sensation of dry mouth considered as a complex state affecting multiple oral functions. Pilocarpine may be a useful medication for the treatment of xerostomia, but its side effects limit its use under certain conditions. Recent studies have focused on the pilocarpine mouthwash as an alternative. Purpose: We have undertaken this study to review the latest available scientific evidence systematically, concerning the effects of pilocarpine mouthwash on salivary flow rate in patients with xerostomia. Materials and Method: An electronic search for randomized controlled trials published in English until September 2021 related to pilocarpine mouthwash and salivary flow rate in patients with dry mouth was performed in PubMed/Medline, Web of Science, Google Schol-ar, Embase, and Scopus. A random-effects meta-analysis was conducted to evaluate the relationship between the groups. Results: Two papers with 86 patients were selected for the final review based on strict eligi-bility criteria. According to the results of the meta-analysis, the mean visual analogue scale in the patient treated with pilocarpine mouthwash was 0. 88 unit lower than that of the control group in the fourth week follow,however, it was not statistically significant (pooled mean difference=-0. 88, 95% CI = (-2. 72,0. 95), p= 0. 34). Conclusion: It seems that the use of pilocarpine mouthwash can increase the salivary flow rates,however, no optimal dose and application regimen can currently be suggested due to the high heterogeneity of the data. Regarding the relief of the symptoms using pilocarpine mouthwash, the existing evidence does not support its effectiveness.

Statement of the Problem: Obstructive sleep apnea (OSA) is an underdiagnosed and po-tentially serious disorder that is accentuated by edentulism. The overclosure of the mandible and a potential upper airway collapse during sleep creates challenges in treating edentulous sleep apneic patients. Purpose: To evaluate complete dentures and mandibular advancement devices as potential oral appliances in the management of sleep apnea in completely edentulous patients. Materials and Method: The study design was a systematic review with meta-analysis. The search criteria complied with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and the keywords in population, intervention, control, and outcomes (PICO) format was systematically searched for relevant research articles pub-lished till August 2021 in an electronic database (PubMed, Cochrane, Science Direct, Ovid). Randomized controlled trials and cohort studies were included that compared the effective-ness of oral appliances on apnea-hypopnea index (AHI), airway space, and quality of sleep in edentulous sleep apneic patients. Results: 1785 articles were derived from the initial search and based on inclusion criteria, 10 articles were systematically filtered for qualitative analysis and assessed for risk of bias using the Cochrane risk of bias tool and ROBINS-I tool. Out of the 10 articles, 5 articles were taken for quantitative analysis. The use of a mandibular advancement device (MAD) showed a decrease in AHI score, but the available data was heterogeneous to conduct a meta-analysis. The mean difference of AHI for the random effect model between the non-complete denture and complete denture wearers at sleep was-0. 49[95% CI (-1. 47, 0. 48)] events per hour, but the change was non-significant (p>. 05). Conclusion: The complete dentures as an oral appliance had reduced apneic episodes in completely edentulous sleep apneic patients, but the effectiveness cannot be solely attributed to the prosthesis in the treatment of OSA. MAD showed greater improvement in reducing AHI, however, the level of evidence was inadequate to provide a conclusive statement.

Statement of the Problem: Sex determination, using skeletal remains, is of paramount importance in forensic studies. The skull accounts for the most sexual dimorphism after the pelvis. Recent studies have shown that paranasal sinuses are valuable in sex determination and considering the location of the sphenoid sinus, the risk of traumatic injuries to this struc-ture is low. Purpose: The present study aimed to evaluate the morphology of the sphenoid sinus and determine the validity of sphenoid sinus volume (SSV) in sex determination using cone beam computed tomography (CBCT) images. Materials and Method: In this cross-sectional retrospective study, CBCT images of 469 Iranian patients (186 male and 283 female), aged 24-45 years, were selected. The morpholo-gy of the sphenoid sinus was recorded. 3D Slicer software (4. 10. 0) was used to assess SSVs in coronal and axial planes. For data analysis, t-test, chi-square test, and discriminant func-tion analysis (DFA) were performed using predictive analytics software (ver. 18. 0). Results: The most common morphology of the sphenoid sinus in both genders was the sellar type (50. 5%). SSV was significantly larger in males than in females (p< 0. 001). DFA showed that the capability of SSV in sex identification was 86. 0% and 92. 9% in males and females, respectively. Conclusion: The findings of this study suggest that SSV is a reliable variable in gender discrimination in a northeast Iranian population. However, since the morphology of the sphenoid sinus and sex were independent of each other, the morphology of the sphenoid sinus is not a suitable indicator for sex determination.

Statement of the Problem: Dentin margins have a higher microleakage than enamel in composite restorations due to weaker bond durability. Clinically, most margins are located apical to cementoenamel junction on the dentin or cementum. Different surface preparation methods may have dissimilar effects on the shear bond strength of resin-modified glass ionomer (RMGI) to composite resin, regarding the layering technique employed in restora-tion of these cavities. Purpose: This study aimed to investigate the shear bond strength of RMGI to composite resin using different mechanical surface preparation methods. Materials and Method: In this in vitro study, 72 RMGI samples were prepared in six groups (n=12): control, acid etching, air abrasion with aluminum oxide (Al2O3), bur, Er: YAG laser, and Er, Cr: YSGG laser groups. Two samples from each group were randomly examined under a scanning electron microscope (SEM). A bonding layer and composite resin were applied and cured. Then the samples were subjected to 5000-cycles thermocy-cling procedure. The shear bond strength was then evaluated using a universal testing ma-chine. Finally, the failed surface of the samples was evaluated under a light microscope to examine the failure mode. For the statistical analysis, one-way ANOVA and Games-Howell post hoc test was used to compare quantitative variables and chi-squared test to investigate the relationship between the failure mode and the groups. The significant level was set at 0. 05. Results: The results showed significant differences between the mean of the strength varia-ble in the groups (p<. 001). The acid-etch and air abrasion groups exhibited significantly the lowest and highest values, respectively. The chi-squared test results also showed a signifi-cant relationship between the failure mode in the study groups (p=. 008). Conclusion: Acid etching before completing RMGI polymerization could adversely affect shear bond strength. The air abrasion and bur methods are among the best methods to in-crease the shear bond strength between composite resin and RMGI. Using Er, Cr: YSGG and Er: YAG lasers could increase the bond strength results.

Statement of the Problem: Tooth-colored composites are used to repair caries lesions and other dental defects, particularly in anterior regions in children. Although a wide range of composites is using, little attention has been paid to the important indicators such as biologi-cal profiles or products released from these materials. Purpose: The current study aimed to compare the histocompatibility and cytotoxicity of light-curing resin used to repair children's teeth with different brands (3M, DenFil, and Opallis) in curing times of 20 and 40 seconds in human oral fibroblast cells (HGF1). Materials and Method: In this in vitro study, Three types of flow composites (3M, Opallis, and DenFil), all at A2 shade, were used. The composites were at 4×2mm with separate ex-posure times of 20 and 40 seconds. MTT test was used to determine the cytotoxicity of composites on oral fibroblast cells. This test is based on the conversion of tetrazolium bro-mide to a purple compound known as formazan that its color intensity can be evaluated using the ELISA. The higher intensity of the color reveals the higher survival rate of the mitochondria, which indicates less toxicity. One-way variance analysis and unpaired t-test were used to compare the cytotoxicity of each brand in two conditions of 20 and 40 seconds of curing. Statistical significance was considered when p< 0. 05. Results: 3M and Opallis composites were significantly reduced vitality of cells compared to control group in both 20s and 40s curing status. While DenFil brand did not show marked cytotoxicity. In each brand, there are no significant deference between 20s and 40s curing times. Conclusion: Histocompatibility depends on the type of composite resin. In the current study, DenFil brand showed the highest histocompatibility, followed by 3M and Opallis.

Statement of the Problem: Mobile usage has increased worldwide over the past two dec-ades. There are conflicting reports about the carcinogenic effects of cell phone radiation on the oral mucosa. Micronucleus (MN) is considered a reliable marker for genotoxic damage. Purpose: This study aimed to identify the impact of mobile phone radiation on the MN frequency in oral mucosal cells. Materials and Method: In this descriptive-analytical study, 50 mobile phone users between the age group of 20–, 38 years were included. Samples were obtained from the right and left cheek mucosa of each subject (a total 100 cell samples). Every participant filled out a ques-tionnaire about his or her cell phone usage habits. Additionally, personal information such as age, gender, and body mass index (BMI) were assessed. The Feulgen and Papanicolaou staining methods were used for staining of the cell samples. A total of 1000 cells in each sample were evaluated for MNs. Results: The mean number of MN in exposed and non-exposed mucosa by Feulgen method was 0. 71±, 1. 13 and 0. 57±, 1. 36, respectively. Also in Papanicolaou staining, the mean number of MN in the exposed mucosa and non-exposed mucosa was 6. 94±, 6. 61 and 6. 54±, 6. 88, re-spectively, but these differences were not significant (p> 0. 05). The frequency of MN in non-specific DNA staining was significantly (5-to 6-fold) higher than DNA-specific stain-ing. We observed no statically significant differences between MN frequency according to age, gender, BMI, and other cell phone usage habits (p> 0. 05). Conclusion: This study showed that cell phone use does not cause genotoxic effects in the buccal mucosa in the oral cavity. Moreover, using non-specific DNA staining methods can increase the frequency of MN by more than 5-to 6-fold.

Statement of the Problem: E-cadherin and N-cadherin are two types of cell adhesion mole-cules that are involved in organ development, wound healing, and pathological conditions through the process of epithelial-mesenchymal transition (EMT). However, their role has not yet been fully elucidated in the pathogenesis of periodontal diseases. Purpose: To determine the expression level of proteins associated with the EMT process (E-cadherin and N-cadherin) in chronic periodontitis. Materials and Method: In this cross-sectional study, 37 samples (19 cases with healthy gingival tissue and 18 cases with severe chronic periodontitis) that referred to the Periodon-tology Department of Zahedan Dental School, Zahedan, Iran, in 2018 were included. The samples were immunohistochemically stained with E-cadherin and N-cadherin monoclonal antibodies. Afterward, the percentage of stained cells and the staining intensity of the cells were evaluated. Finally, the obtained data were analyzed using by IBM©,SPSS©,Statistics version 21 using Mann-Whitney statistical test. Results: In this study, 89. 5% of the healthy gingival tissue samples and 61. 1% of samples with chronic periodontitis showed E-cadherin expression in more than 50% of cells. This difference between the two groups was not significant (p= 0. 13),however, the E-cadherin staining intensity of the healthy gingival tissue was strong while that of the samples with chronic periodontitis was moderate (p= 0. 002). The N-cadherin expression was negative in 68. 4% of healthy gingival cases, while 50% of the cases with chronic periodontitis showed a high expression of N-cadherin. This difference was statistically significant (p= 0. 04). More-over, the N-cadherin staining intensity also had a significant difference between the two groups (p= 0. 004). Conclusion: Based on the results of the present study, the increased expression of N-cadherin and reduction of staining intensity of E-cadherin was found in chronic periodontitis compared to healthy gingival tissues. Therefore, EMT process may be involved in the path-ogenesis of severe chronic periodontitis.

Statement of the Problem: In most cases, insertion of single implants with a standard diameter is used to replace a molar tooth but placing two implants with a narrow diameter seems to be a viable treatment modality to withstand functional and biomechanical forces. Purpose: This study aimed to evaluate and compare stress distribution in the bone surround-ing a single molar area rehabilitated by a single implant versus two implants with a narrow diameter. Materials and Method: The study was conducted by computer-aided in vitro modeling. The initial model used a single implant, 4. 8 mm wide in diameter, inserted with a 3. 9-mm distance from both sides and 12. 6-mm mesiodistal space. The second model used two 3. 3-mm narrow-sized implants with a 3-mm distance from one another, 1. 5 mm from both sides, and a 12. 6-mm mesiodistal space. Following the completion of these models, a 100-N force was exerted obliquely, once in three locations and once in the mesial aspect of the implant-supported crown. Stress distribution was then measured using finite element analysis (FEA) with ANSYS Workbench software package in both models. Results: The maximum stress in the bone around the single implant was less than that around double implants. The maximum stress of cortical bone in three-point loading was lower than mesial loading either in one (146. 7 vs. 126. 72 MPa) or two implants model (186. 8 vs. 139. 24). Conclusion: According to the results, because of more cortical bone contact area, the stress of surrounding bone in wide implant was decreased.

Statement of the Problem: The parental acceptance rate of the behavior management methods used in pediatric dentistry is influenced by various factors. Purpose: This study was aimed to investigate the relationship between mothers’,anger ex-pression and their acceptance of behavior management methods. Materials and Method: In this cross-sectional study, 110 mothers of children who had less than 12 years of age were recruited. They completed Spielberg’, s state-trait anger expression inventory (STAXI). The respondents watched an educational video that included explana-tions of seven behavior management methods. Then, they reported their acceptance of each of these methods using the visual analog scale (VAS). Results: The acceptance rates of behavior management methods from the highest to lowest included tell-show-do, pre-appointment behavior shaping, mouthpiece, voice control, gen-eral anesthesia, active restraint, and passive restraint, respectively. There was only a signifi-cant inverse relationship between the acceptance of the tell-show-do method and the anger expression (p< 0. 05). There was no significant relationship between the acceptance of be-havioral management methods and the previous history of a pediatric dental visit, age, and mothers’,education. Conclusion: There was a significant inverse relationship between acceptance of the tell-show-do behavioral management method and mothers’,anger expression. However, there is no significant relationship between other methods and mothers’,anger expression. According to this study, there was a relation between mothers' ages and their acceptance of using a mouthpiece.

Statement of the Problem: Continuous use of chemical agents to reduce the number of cariogenic bacteria leads to adverse effects,therefore, in recent years, many studies have focused on plant-based substances. Purpose: This study explores the antibacterial effects of Mentha Longifolia (M. longifolia) essential oil on Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), and Lactobacillus as cariogenic microorganisms and determines the compounds in it. Materials and Method: In this experimental study, S. mutans, S. sobrinus, and Lactoba-cillus isolates were collected from the saliva samples of five children with severe early childhood caries (S-ECC). The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of M. longifolia essential oil were determined by Broth microdilution method. Chlorhexidine 0. 2% and phosphate-buffered normal saline (pH= 7. 0) were used as positive and negative controls, respectively. The chemical composition of M. longifolia essential oil was evaluated by gas chromatography-mass spectrometry. The data were analyzed with a paired t-test and the p below 0. 05 was considered signifi-cant. Results: The MIC and MBC ratios for S. mutans were 3. 12% and 6. 25%, for S. sobrinus were 6. 25% and 12. 5%, and Lactobacillus were 3. 12% and 6. 25%, respectively. Chemical analysis of M. longifolia essential oil showed that 34 various compounds. Piperitone oxide (27. 59%), Transcariophylline (14. 55%), and 2-cyclohexane-1-one (12. 24%) were the ma-jor constituents. Conclusion: M. longifolia essential oil has both growth inhibitory and bactericidal effects on all the three species of bacteria. This antibacterial effect was similar against S. mutans and Lactobacillus, which was greater than S. sobrinus, thus, it can be used as a supplemen-tary for caries prevention compounds.

Plasmacytoma is an abnormal proliferation of monoclonal B-cells, and it can occur in several forms including multiple myeloma, solitary plasmacytoma of the bone, and extramedullary plasmacytoma primary. The solitary plasmacytoma of the bone accounts for about 3-10% of all plasma cell neoplasms, and occurs most often in the vertebrae, whereas the solitary plasmacytoma of the mandible is an extremely rare occurrence. This case report presents a 61-year-old woman with various underlying diseases diagnosed with solitary plasmacytoma of the mandible. This case is very well documented with radiographic imagery, clinical, and histopathological findings.

The central granular cell odontogenic tumor (CGCOT) is a rare, benign, slowly growing, odontogenic neoplasm. CGCOT was not considered as a distinct entity in the WHO classifi-cation reported on 2017. This study reports a rare case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white woman. In addition, to better delineate the clinical, radiographic, histopathologic and immunohistochemical characteristics of CGCOT, a literature review of all published cases (in PubMed/ Google Scholar/ MEDLINE/Scopus) of CGCOT is provided. CGCOT is a very uncommon tumor, with only 51 reported cases in the literature. The present case is interesting regarding to its rarity for being in the maxillary anterior region, which has not been previously reported in Asia. The immunohistochemical findings of the current case and other cases in the literature review, verified the mesenchymal origin of granular cells and odontogenic nature of the epithelium islands, which can be a possible promise for placing this lesion in the future WHO odontogenic tumor classification.