Journal of Inflammatory Diseases
Year:2011 | Volume:15 | Issue:3 (60)|Papers Count:15

Background: Root canal therapy (RCT) is the gold standard and commonly used treatment for pulpitis. However, regarding the importance of tooth survival, pulpotomy has become of great concern. Objective: The aim of this study was to compare the RCT and vital pulp therapy treatment in teeth with irreversible pulpitis.  Methods: This was a clinical trial carried out in 4 provinces of Iran including Khorasan Razavi, Tehran, Yazd, and Fars in 2008. Patients were randomly allocated into three arms: The RCT, pulpotomy with CEM, and pulpotomy with MTA. Periapical lesion and percussion test were evaluated at baseline, 6th and 12th month follow ups. Data were analyzed using marginal regression and generalized estimating equations by SAS software version 9.1.Findings: The odds ratio of periapical lesion in RCT group was 5.07 times higher than that of pulpotomy with MTA and 3.25 times higher than CEM cement group (P<.001). The difference between MTA and CEM cement groups was insignificant, statistically. Also, the odds ratio of percussion test failed to show any statistically significant difference in treatment group. In addition, neither the age nor the gender influenced the percussion test and periapical lesion responses, statistically.Conclusion: Regarding the data found in our study, Pulpotomy can be considered as an alternative treatment for RCT.

Background: The individual variations in patients with skeletal class III malocclusions affect the cephalometric indices e.g., the curve of cranial base and anteroposterior displacement of nasion and the SN inclination can affect the cephalometric indices such as the ANB angle. Objective: The aim of this study was to compare some cephalometric indices in skeletal class III with skeletal class I patients as control group.Methods: Samples in this Case-control study were 65 lateral cephalometric radiographs randomly selected before the orthodontic treatment. The samples were divided into two study and control groups with skeletal class III relationship (ANB<1) and skeletal class I relationship (2<ANB<4), respectively. Cephalometric radiographs were traced and the statistical results obtained by the correlation coefficient test between the cephalometric variables and the t-test between the skeletal classes I & III while a p value <0.05 was considered as statistically significant.Findings: The mean variables of SNA, Wits, Jaraback index, GOGn-SN, IMPA, overbite, lower facial height, and Mandibular length were indicative of significant differences between two skeletal class I & III groups. The Wits appraisal showed a significant positive relation with ANB (P<0.001, r= 0.71) and a significant negative relation with FMA(P=0.01, r= -0.41), lower facial height (P=0.02, r= -0.37),  anterior facial height (P<0.001, r= -0.47), and the mandibular length (P=0.02, r= -0.37).Conclusion: According to the data found in the present study, the Wits appraisal is a valuable diagnostic index for evaluating the intensity or anteroposterior jaw discrepancy in skeletal class III patients. From the jaw position and size point of view, the maxillary retrognathism and the mandibular length are the main determining factors for maxilomandibular relationship, respectively. The dental compensation for skeletal class III patients is more associated with the mandibular incisor retrusion rather that the maxillary incisors protrusion.

Background: The use of different stages of tooth eruption is preferred to estimate the children chronological age as it is less affected by hormonal changes or nutritional status. The most accurate method developed for determination of dental age is the Demirjian technique as indicated by different studies.Objective: The objective of this study was to assess the correlation between dental age and chronological age in 6-15 years old orthodontic patients in Qazvin in 2010. Methods: In this descriptive analytic study, 468 individuals (255 females and 213 males) were selected besed on simple sampling and the dental age for each person was determined by Demirjian technique based on 7 mandibular left teeth. The chronological age was calculated by subtracting the birth date from the panoramic date. The correlation between the dental age and chronological age was assessed by Pearson coefficient and the difference between two genders evaluated.Findings: Significant and direct correlation was found between the chronological age and dental age (r=0.912 for females and r=0.905 for males). With the exception of age12 in males, the dental age of each individual was higher than the chronological age. The highest and the lowest differences between the two dental age and chronological age in each gender was noted in chronological ages of 6 and 14 in males and 6 and 8 in females, respectively. Conclusion: Based on results found in The presents study, it seems that the Demirjian technique to be valid for dental age estimation among Iranian people. However, the development of exclusive tables for Iranian population is necessary due to the overestimation of the individual’s dental age compared to the chronological age.

Background: Different clinical steps, weak and ineffective bond are some of the problems of using fissure sealant in primary teeth.Objective: The aim of this study was to compare the effect of a total-etching adhesive (single bond) and a self-etching adhesive (G bond) on the shear bond strength (SBS) of a light curing pit& fissure sealant with primary enamel.Methods: In this experimental study, the crowns of 10 caries-free primary molars were sectioned in a bucco-lingual direction. These 20 specimens were randomly assigned into two groups (single bond & G bond). A light curing pit & fissure sealant (Concise) was bonded to the enamel following application of each bonding system. After 24 hours, the shear bond strength was measured. The data were statistically analyzed using t-test. The failure mode was determined in a stereo microscope at×20.Findings: The shear bond strength of single bond (16.71±0.72) was higher than the G bond (9.62±1.4). There was a significant difference between the shear bond strength in two groups (p<0.05). Most failures were cohesive (80% in single bond & 90% in G bond).Conclusion: According to our data, the self-etching adhesives (G bond) are not reliable alternatives to the total-etching adhesives, if strong bond strength is needed.

Background: Despite the durable enamel bonding, durability of dentin bonding is under question. However, some self-etch adhesives have been reported to perform as good as etch & rinse adhesive and can resist more against degradative mechanisms.Objective: To evaluate the dentin bond strength durability using etch & rinse and self-etch approaches over 1 day and 6 months water storage.Methods: This was an experimental study conducted at Shahed Dental School (Tehran, Iran) in 2010. A total of 32 extracted human third molar were sectioned to expose the superficial dentin and randomly distributed into four groups as: three-step etch & rinse adhesive (SBMP), two-step etch & rinse adhesive (SB), two-step self-etch adhesive (CSEB), and one-step self-etch adhesive (ABSE). A resin composite crown was incrementally built up. Microtensile specimens were fabricated and stored in distilled water containing 0.5% chloramine T and the tensile tested after 1 day and 6 months. The failure patterns of debonded specimens were recorded using stereomicroscopy.  One-way ANOVA and Tamhan statistical tests were applied. Findings: The SB group attain ed the highest bond strength, in 1 day (27.42±3.67 Mpa) and 6 months (27.28±3.25 Mpa). The short-term bond strength of SBMP and CSEB groups were similar (P>0.05). A significant decrease in bond strength was observed for both ABSE and SBMP groups (P<0.05). No reduction in bond strength of SB and CSEB groups was found after 6 months. The ABSE group attained the lowest bond strength compared to other groups (1 day: 11.77±2.81 Mpa, 6 months: 9.33±1.71Mpa). The failure pattern of SBMP and ABSE groups was adhesive which increased over 6 months. The most frequent pattern of SB and CSEB groups was adhesive which was stable over time.Conclusion: Based on findings of the present study, the resistance of resin-dentin bonds to degradation is material-dependent. The mild two-step self-etch adhesive (CSEB) demonstrates similar short-term performance with SBMP, and remains stable against degradative mechanisms.

Background: Today, the esthetic dentistry is considered as an important part of dental treatments. Regarding the increasing number of patients’ demand to remove tooth discolorations, need for bleaching treatment is on rise. The effect of bleaching on microleakage of composite restorations is regarded as the main factor of composite failure.Objective: This aim of this research was to investigate the effect of pre- and post-operative bleaching on microleakage of class 5 composite restorations.Methods: This experimental study was performed on 15, carries free eruptive human third molar divided into 3 groups of 5 members each and marked as 1) case group (pre-operative bleaching group), 2) case group (post- operative bleaching group), and 3) control group (no bleaching group). In group 1, samples were exposed to 20% carbamide peroxide-containing gel 2 hours a day for 7 days and kept in artificial saliva between the bleaching processes.  After 14 days and while the bleaching were finished, class 5 cavities prepared in buccal and lingual surfaces of teeth (dimensions: 4*2*2 mm) where the gingival margin of all cavities were 1mm under the CEJ. Later, all cavities were filled with composite (Z 250/3M). In group 2, class 5 cavities were prepared, filled with composite in a similar way and exposed to bleaching process as for group 1. In group 3, only class 5 cavities prepared and repaired without bleaching. Soon after, Samples were termocycled (500 times, at 4 and 55 ºC). The process of dye penetration was carried out by placing the samples in a solution containing 1% methylene blue for 24 hours. The teeth were later sectioned and the rate of microleakage evaluated using a stereomicroscope (magnification 40x). The data were analyzed by Mann Whitney test.Findings: The rate of microleakage in class 5 restorations exposed to bleaching (either before or after restoration) increased at both occlusal and gingival margins. The degree of microleakage at occlusal margin was lower than gingival margin in all groups. The rate of microleakage in both occlusal and gingival margins showed a significant difference, statistically (p<0.006; p<0.014) however, no significant difference at occlusal and gingival margins of case group was observed (p=0.684; p=0.264). Conclusions: Bleaching process increases the rate of microleakage following composite restoration.

Background: Recurrent aphthous stomatitis (RAS) is one of the most common painful diseases affecting the oral mucosa. The role of psychosocial factors especially depression and anxiety in RAS is controversial. Objective: This study was performed to determine the association between anxiety, depression and RAS.Methods: This descriptive-analytic study was carried out at Department of Oral Medicine of Zahedan Dental School from May 2007 to May 2008. Ninety patients were evaluated in three groups marked as RAS, negative control and positive control groups using Beck Anxiety (BAI) and Beck Depression (BDI) Questionnaires. Data were analyzed using ANOVA and Tukey tests. Findings: RAS patients and positive controls had significantly higher anxiety and depression levels compared to the negative controls (P< 0.05). However, no statistically significant difference was found in anxiety level between the RAS and positive control groups. In contrast, there was a significant difference in depression levels between the RAS and positive control groups (P<0.05).Conclusion: Regarding the data found in study, It seems that the psychosocial factors may play an important role in causation of RAS. These factors may form a starting point for initiation of various immune reactions, shown to be contributory to the pathogenesis of RAS.

Background: There is a vital need to assess the changes in oral health trend and also the preventive strategies in different locations, systematically. This could help to plan for promoting oral health in Iran. Objective: To describe the dental caries status in a sample of Iranian adolescents aged from 14 to 18 years old in Qazvin and to identify the related factors affecting the oral health in this group. Methods: In this cross-sectional study, a total of 380 adolescents were randomly selected from high schools in Qazvin. The adolescents agreed to participate and completed a questionnaire. Oral health status was assessed in terms of number of teeth, decayed teeth (DT), filled teeth (FT), and decayed, missing or filled teeth (DMFT). A multivariate regression analysis was used to assess the statistical association between the DMFT as dependent variable and those of other variables.Findings: Of total participants, 190 were females (50%). The mean age of the adolescents was 15.10 (SD=1.03) years. The mean DMFT was 2.62 (SD=1.89) for all subjects. There was a significant difference between the boys and girls regarding the DMFT as boys had higher DMFT scores than girls. The multivariate regression analyses revealed a significant associations between the high DMFT scores and other variables including: higher age, lower parental education, higher family income, lower frequency of dental brushing and flossing , no history of visiting a dentist, and bad perception of own oral health. Conclusion: Although the dental caries is rather low in this group but it has a major impact on Iranian adolescent’s daily living.

Objective: The aim of this study was to assess the oral changes related to consumption of tobacco & opioids in patients attending the Oral Medicine Center at Zahedan Dental School.Methods: This was a cross-sectional study performed based on simple sampling. A total of 211 tobacco and opioids smoker persons attending the Oral Medicine Department at Zahedan Dental School were examined during February to May 2006.  Data were collected using a questionnaire. Statistical tests including the chi-square and variance tests were used for analysis of data.Findings: Of 211 persons, 186 were males and 25 females with a mean age of 38.5±7.6 years. The overall prevalence of oral changes was 98.5% and the prevalence of every single change in oral cavity was 3.3% (leukoedema); 30.8% (pigmentation); 21.7% (leukoedema and pigmentation); 43.3% (leukoedema, pigmentation and hyperkeratosis); 0.9% (leukoedema-pigmentation, and tobacco pouch). The prevalence of oral changes in men was higher than in women (p<0.05). Cigarette smoking in men and hookah in females were common.Conclusion: The most common oral change was pigmentation. Oral changes were more common in men than in women. and the smoking pattern showed  difference between men and women. The most frequent material consumed  was cigarette in men and hookah in women .

Background: The geriatric population is the most rapidly growing segment of the society regarding the evolution and improvement of health programs.Objective: To assess the oral health associated with oral health behavior in independent elderly outpatients referred to public dental health centers in Talesh (Guilan, Iran).Methods: A cross –sectional study with total of 203 elderly patients (+65 years old) were investigated by means of interview and oral examination. Based on a simple cluster sampling, the demographic information, oral behavior, dental status, and systemic conditions were noted. Clinical examinations were conducted by a specialist in oral medicine on the basis of WHO criteria in urban and rural dental centers of Talesh. Statistical tests including the chi-square test, t-test, and the logistic regression were employed to analyze the data using the SPSS version 17. Findings: The mean age was 72±6.44 years with an age range from 65 to 79 years old. Of total patients, 125 (61.5%) were males and 78 (38.4%0) females with 102 cases from urban and 101 from rural areas. Furthermore, 160 patients (more than two third of cases) were completely without teeth among those 95% with dentures and 10 without denture. The mean numbers of remaining teeth in partially dentate people were 7.34 ±4 and 95% found to have root caries vs. 18.5% with coronal caries. Oral hygiene practices such as times of tooth brushing, inter-dental cleaning, and toothpaste use were significantly higher in urban than the rural residents. Sixty seven percent had at least one general health problem and hypertension was more prominent among both the female and rural people (p<0.001). Moreover, diabetes mellitus was dramatically more prevalent among females (p<0.004) than males.Conclusion: On account of this study, more than two third of the population were edentulous. Under such circumstances, routine oral examination as part of health program with or without welfare services in elderly people is recommended.

Background: The effects of aggressive periodontal disease in several clinical studies are shown. Knowledge, attitude and practice of dentists in this regard can lead to better diagnosis and timely treatment of patients.Objective: The aim of the present study was to evaluate the knowledge, attitude and practice of dentists on aggressive periodontal disease in Qazvin.Methods: This was a cross-sectional study carried out on 140 general dental practitioners in the province of Qazvin (Iran) in 2010. A questionnaire was the data gathering tool of the study and prepared according to the reliable sources. After completing the questionnaire, the data was analyzed by SPSS software using the Pearson correlation test, t-test, and ANOVA.Findings: The average knowledge score (p=0.004; F=5.89), attitude (p=0.018; F=4.18), and practice (p=0.468; F=0.765) of individuals decreased with increased experience. The highest mean attitude score (1.3±5.19) and function (1.16±3.44) were found in dentists under 30 years and the lowest average score (1.03±2.64) in individuals older than 41 years. The average score of knowledge, attitude, and performance was higher in women than men (1.76±5 versus 1.5±3.48; p=0.003; T=-3.04).Conclusion: Based on results found in the present study, the inclusion of topics regarding the aggressive periodontal disease through retraining courses seems to be necessary in promoting the professional knowledge of dentists.

Background: Idiopathic osteosclerosis is a common radioopaque lesion of the jaw. This lesion is asymptomatic and usually discovered on different radiographs quite by accident. Objective: The aim of this study was to investigate the radiographic characteristics of idiopathic osteosclerosis in jaw bones in patients referred to Department of Radiology at Qazvin Dental School. Methods: This was a descriptive study performed on 820 panoramic radiographs of 325 male and 465 female patients referred to radiology department for variety of reasons.  The radiographs, prepared by different methods, were examined for detecting idiopathic osteosclerosis. Information regarding each radiograph such as the location, number, structure, kind of relation to adjacent teeth, and density (trabecular-cortical) as well as the information on patients’ sex and age were registered. Using SPSS version 16, the desired frequency was calculated. Due to the descriptive nature of the study, no special statistical test was used.Findings: Of total radiographs, in 87 patients (10/61%), there were 97 idiopathic osteosclerosis lesions at different sites and shapes with demarcated border (50.52%) and trabecular density (54.52%). Of patients, 58.63% were females and 41.37% males. Most lesions were in the lower jaw especially in first (30.93%) and second molars region (24.75%) and frequently not associated with the adjacent teeth (35.05%). These lesions were more common in patients at their fourth and fifth decades of life.Conclusion: Based on our results it was revealed that the idiopathic osteosclerosis lesions are more frequent in lower jaw especially in molar areas and it is more common in women compared to men.

The frequency of oral pigmentation is different among diverse people and races and since the oral pigmentation is related with many systemic diseases in particular those of inner glands, the present study was attempted to determine the frequency of oral pigmentation in patients referred to Oral Medicine Department of Babol Dental School. This analytical study was performed on 1497 patients during 2008-2009. All patients were visited and the demographic data as well as the necessary information recorded. Data were analyzed using the Fisher’s exact test. Based on our data, the oral pigmentation was observed in the 27.9%, of patients. There was a significant correlation between the oral pigmentation, gender, pregnancy, and the presence of systemic diseases (p=0.05).

This was a cross-sectional study performed on 1000 subjects in 2004 to determine the prevalence of lichenoid reactions in a population of Qazvin in which 1% of subjects were found with lichenoid reactions. The most prevalent lesion was found to be reticular form and the most predisposed area of oral cavity for this lesion was buccal mucosa. None of them had any form of cutaneous lichen planus.