JOURNAL OF ISLAMIC DENTAL ASSOCIATION OF IRAN (MAJALLAH-I-DANDANPIZISHKI)
Year:2005 | Volume:17 | Issue:(55) (SPECIAL ISSUE OF ENDO, PERIO)|Papers Count:15

Background and Aim: The aim of this study was to determine CPITN and its influencing factors among 35 - 44 year old population referred to health centers in Khoramabad.Materials and Methods: In this study, periodontal status of 250 patients, 130 females and 22 males, age ranging from 35-44 years old, were studied using community periodontal index of treatments needs (CPITN).Results: It was indicated that 1.2% of subjects were healthy (code 0), 4.8% had bleeding on probing (code 1), 41.6% had supra or subgingival calculus (code 2), 36.8% had pockets of 4-5 mm depth (code 3) and 15.2%had pockets of6 mm or more depth (code 4).Conclusion: Periodontal status of younger subjects was better than the older ones. Kruskal Whitney tests revealed that the rewash a significant relationship between age, health status, smoking, and gingival recession with periodontal status, however; no significant relationship was found between economic status, improper dental treatment and sex with periodontal status. Treatment needs showed that 98.8% of the subjects required oral hygiene training, 94% required scaling, 15.2% needed complex treatment and 1.2% had no need for treatment.

Background and Aim: Periodontal diseases are highly prevalent among people. Considering the special attention paid by world organization for the development and application of traditional medicine in the system of health - treatment services, the goal of this study was to identify the valuable heritage of Iran traditional medicine on periodontal diseases and drugs.Materials and Methods: Based on the bibliography approcal taken in the present study, the related information was collected through the revision of valuable books compiled by conspicuouse Iranian authors which were kept in reliable centres such as libraries and research organizations.On the other hand, pharmaceutical - herbal companies were also investigated and the most recent information on the relationship between herbal medicine and periodontal diseases were obtained and analyzed.Results: Traditional medicine of Iran is based on exact observations and experiences in the description and treatment of periodontal diseases which, due to its natural origin, easy accessibility and relative safety, can be considered as an important source for modem pharmaceutical research.Conclusion: It was concluded that periodontal diseases, along with their symptoms and signs and treatment modalities such as herbal medication, diets and simple surgeries were fully dis cussed in Iran traditional medicine.

Background and Aim: Improper use of antibiotics may result in various economical and hygienic complications. The aim of the present study was to investigate antibiotic prescription by dental practitioners in Yazd.Materials and Methods: In order to conduct this descriptive cross-sectional study, a questionnaire concerning types and cases of antibiotic therapy was distributed among 73 dentists in Yazd.Results: According to the findings 60.6% of dentists prescribed penicilline V as their primary selected drug for endodontic infections. In allergic cases to penicilline, erythromycin was administered in 70.49% of cases. Loading dose was used by 45.46% of dentists and the duration of antibiotic therapy was estimated one week in 80% of cases. Dentists prescribed antibiotics in cases of irreversible pulpitis (13.8%), necrotic pulps without pain and swelling (21.53%) and sinus tract (47.69%).Conclusion: Higher training level of dentists, for more proper and logical administration of antibiotics during endodontic treatment is recommended.

Background and Aim: Procedural errors such as canal transportation and loss of working length are mainly associated with stainless steel files with insufficient flexibility. Apical transportation may also be attributed to the cutting or non-cutting tip of rotary instruments. The aim of this investigation was to compare apical transportation in three types of rotary instruments (Hero 642, Race and K3) using manufacturers' guidelines and a modified technique.Materials and Methods: Extracted maxillary or mandibular mesiobuccal roots of permanent human molars with a length of 19-23mm and curvature between 20 - 40 degrees (according to the Schneider method) were studied. The initial patency of the experimental canals was at least ¹10 and maximum ¹15. The samples were divided into six groups of twenty canals. In the first three groups, canals were instrumented using rotary systems according to the manufacturer's guidelines whereas in the 4th, 5th and 6th groups, prior to the instrumentation with rotary instruments, apical patency with ¹15 k hand file, ¹1-3 gates gliden, ¹2 peeso reamer and a full passive step back technique were used to create a better access to coronal and middle parts of the canal (modified technique). Statistical analysis was performed using Variance, Duncan and t-tests.Results: The mean degrees of apical transportation among groups instrumented according to the manufacturer's guidelines with Hero, Race and K3 rotary instruments were 2.79±1.12, 2.2±1.37 and 1.65±0.79, respectively and in samples instrumented with the modified technique 2.64±1.54, 2.10±1.40 and 1.93±1.23 degrees of apical transportation were recorded in Hero, Race and K3 instruments, respectively. There was a statistically significant difference between the first three groups (P<0.05) that were instrumented according to the manufacturer's guidelines, but no statistically significant difference was found in apical transportation between the modified technique groups and the manufacturer guideline groups (P>0.05).Conclusion: The use of modified technique, although leads to much easier instrumentation procedures, has no significant effect on the reduction of apical transportation degree as com- pared with the manufacturer's recommended method.

Background and Aim: The use of an irrigating solution during root canal cleaning and shaping is necessary for the elimination of all irritants. The aim of this study was to compare the antibacterial efficacy of distilled water, chlorhexidine 0.2% and sodium hypochlorite 2.5% as root canal irrigants on the reduction of Entrococcus fecalis (E.fecalis) colonies in extracted human teeth.Materials and Methods: In this experimental study, 80 extracted human teeth with single canal were selected. After preparation all root canals were contaminated with E. fecalis. Then, filing was done up to file ¹40 and flaring up to ¹70. During filing and flaring procedures irrigation was done using 20 cc of each solution. Finally, paper points were used to obtain samples which were then sent to laboratory for CFU (colony - forming unit) count after incubation.Sampling was done once after placing teeth in the incubator for one week. Data were subjected to Kruskal- Wallis and Duncan tests.Results: The finding of this study showed that sodium hypochlorite and chlorhexidine were more effective in the reduction of microorganisms' counts than distilled water (PV<0.05). Although sodium hypochlorite 2.5% had a mean CFU of 12.5 and cholorhexidine had a mean CFU of 22.5, no statistically significant difference was found between them (PV=0.799). The results obtained after one week showed that Naocl had a mean CFU of 42.5 and cholorhexidine had a mean CFU of 30, so the mean colony numbers increased in both groups and the differences were significant comparing to the samples of the first day, however; hypochlorite had 240% of elevation and chlorhexidine had 33.3%, distilled water had no substantivity effect. Conclusion: The results have shown that sodium hypochlorite and cholorhexidine can remove E-fecalis and reduce the number of colonies significantly when used as irrigating materials during filing and flaring but distilled water does not have such an effect with higher average of colony numbers. Moreover, chlorhexidine showed more substantivity effect than hypochlorite.

Background and Aim: Different drugs are used in the treatment of periodontal diseases because of their different bacterial sources. This aim of this study was to evaluate clinically the application of metronidazol gel 25% in surgical treatment of advanced chronic periodontitis.Materials and Methods: In this randomized double blind clinical trial 33 patients, age ranging from 37 to 42 years, with advanced chronic periodontitis were selected. They were not affected with any systemic disease. Following phase I of treatment, patients with symmetric pockets of 7-8 mm depth were selected and modified widman flap was elevated for them. In the experimental group, the gel was applied before suturing. Patients were dismissed without any antibiotic prescription.Sutures were removed after one week and pocket depths were recorded 6 – 7 months later.Results: The mean pocket depth reductions were 5.03 mm and 5.21 mm in control and experimental groups, respectively. Intergroups analytical test (Paired t - test) showed significant different between pocket depths of two groups (P<0.02).Conclusion: Considering the slight differences in pocket depth reductions between two groups, mote research is recommended for the application of this gel in the treatment of chronic periodontitis, however; its non-surgical and local application for the treatment of refractory periodontitis can be thoroughly beneficial.

Background and Aim: The relationship between periodontal health and teeth restoration is inevitable. For long - term survival of restorations periodontium must remain healthy and on the other hand for a healthy periodontium a lot of issues must be critically observed in restorations.The aim of this study was to evaluate the effects of crowns, made in Yazd dental faculty, on periodontal tissues.Materials and Methods: In this analytic cross - sectional study, 30 crowns were randomly selected.Modified gingival index (MGI), probing index (PI), probing depth (PD), and keratinized gingival crowns in cases were compared with the same indices of the normal contra lateral teeth (controls). Moreover, crown's features such as marginal position, marginal fitness and proximal contacts of crowns were evaluated. Wilcoxon signed rank test and Paired sample t - test were used for statistical analysis.Results: MGI and PD were significantly more around crowns than normal contra lateral teeth but PI and KG were less around crowns, however; the differences in keratinized gingival (KG) were not significant. In crowns with subgingival margin MGI, PI and KG were more than crowns with supragingival or gingival margins. Crowns with marginal overhang showed more Faculty of Dentistry MGI, PI, PD and KG, as compared with the normal ones. In crowns with normal proximal contacts PD, OI, MGI and KG were less than those with open contacts. In this study, just one case with tight proximal contacts was observed.Conclusion: Crowns significantly affect on the gingival inflammatory reaction of the restored Probing depth.

Background and Aim: Surgical bone level probing is the most precise method for the determination of bone level regeneration in regenerative therapy but due to the aggressive and damaging nature of this procedure. The aim of the present study was to evaluate the precision and accuracy of bone probing measurement as a non-surgical method to determine bone level changes.Materials and Methods: In this analytic- comparative study, 22 maxillary molars and premolars in patients with chronic periodontitis participated. An acrylic resin stent was made for the bone probing depth (BPD) measurements, surgical bone level measurements as well as proper orientation of probe of each sample. The mesial, distal, mid-buccal and mid-palatal aspects of each tooth were measured. Results: Differences between surgical bone probing and bone probing depth measurements in different surfaces of messiobuccal, mid buccal, disto buccal and mid palatal were 0.09±0.74, 0.068±1.01, 0.24±0.11 and 0.28±0.88, respectively, which were not statistically significant (P<0.05), however, there was positive coefficient of correlation in all surfaces (Y=0.97).Conclusion: The results of this study indicate that, regardless of probing surface, type of tooth and the presence of intrabony defects, there is a minimal difference between BPD and SBL and probing depth (PB) measurement can be a reliable method to estimate bone level regeneration following periodontal treatment and to replace surgical bone level (SBL) procedure.

Background and Aim: Having knowledge of the internal anatomy of teeth plays an important role in a successful endodontic treatment, however; this goal is not thoroughly achieved unless a full knowledge of possible anatomic variations becomes available. The aim of this study was to investigate the internal anatomy of the first maxillary human molar teeth.Materials and Methods: 105 first maxillary human molar teeth with unknown gender and cause of extraction were collected so as the molarity of all samples was ensured. After cleaning the samples manually, they were put in diluted sodium hypochlorite. Then an appropriate access cavity was prepared.1% fuchsine was used to die for 20 minutes.Dye penetration into canal makes the identification of canal position easier. Three study methods as observation, X - ray stereotypes and cross - sectional were used to recognize the number and type of canals, number of canal orifices and the schema of the access cavity. The results were recorded in special ID certificates according to the relevant codes.Results: The findings were as follows:- 100% of the palatal roots were of type 1.- 100%of the distal roots were of type 1.- 24.8% of the mesial roots were of type I, 32.4% were of type 11,39% were of type III and 3.8% were of type IV.Curves in palatal roots were frequently observed in buccal direction. Floor of pulp chamber was trapezoidal in 58.1%, triangular in 30.5%, elliptical in 4.8%, parallelogram- shaped in 2.8% and reverse trapezoidal in 3.8% of the cases.Conclusion: In the treatment of mesiobuccal canals, the existence of the second canal should Faculty of Dentistry be presupposed and also the probability of curved palatal roots to buccal direction should be highly considered which is not visible in normal radiography.

Background and Aim: Excess force while using dental floss may injure gums and lead to the formation of gingival clefts. Moreover, it seems that dental floss materials play an important role in the required forces for interproximal passages. The aim of this study was to compare the amount of forces required for the passage of three different dental flossed namely Mina and G.U.M made of nylon and Oral- B made of PTFE (Polytetrafluoroethylene).Materials and Methods: In this experimental study, the forces required for the interproximal passage of three above- mentioned flosses were measured using digital force measurer at 14 contacts between the first premolars from one side to the other of both jaws, of 30 subjects, age ranging from 18 to 35 years.Measurement procedures were similar for all three types of flosses and the forces were expressed in Newton. The mean values were statistically analyzed by one way ANOVA and Hot scheffe tests. Results: The results showed that the amount of required force was significantly lower for PTFE (1.89 N) than Mina (2.89 N) and G.U.M (3.10 N). Moreover, maxillary interproximal Faculty of Dentistry forces were significantly less than mandibular ones: 2.24 N versus 3.01 N, P < 0.05. Conclusion: It seems that PTFE dental flosses, due to less required forces and easier manipulation, are preferred to nylon flosses by patients.

Background and Aim: One of the most important indices for the evaluation of services provided in different health and treatment sections qualitatively is the satisfaction rate of clients toward the offered services. The main objective of this study was to examine the satisfaction rate of patients, referred to Endodontic Department of Guilan dental faculty, to root canal therapy.Materials and Methods: In this descriptive cross - sectional study, conducted in Guilan dental faculty in 2003-2004, 78 patients, 35 males and 43 females, were studied. Data were collected on patients' satisfaction rate through a questionnaire using split - half method and confidence coefficient of 10%. Finally, 67 subjects were selected. The relationship between different variables was calculated through SPSS (Version 11.5) program and X2 analysis.Results: The highest satisfaction levels were related to the following cases:- Students' behavior toward patients.- Faculty staffs behavior toward patients.There was a relatively lower satisfaction to the following cases:- Waiting time to take turns for endodontic treatments.- Waiting time since the completion of medical record until the beginning of treatment.- Received expenses for the treatment. - Welfare facilities (Parking lot, Hygenic service, waiting room). Conclusion: Comparing the present study to the previous ones suggests the general satisfaction of all clients referred to endodontic department, however; the mentioned deficiencies should be investigated and corrected as soon as possible.

Background and Aim: Immediate replantation of the avulsed teeth is the treatment of choice to achieve optimal periodontal healing. If the teeth can not be replanted immediately, the vitality of PDL cells on root surfaces must be preserved through a suitable storage media. The aim of this study was to compare the effects of different storage media including water, Hanks Balanced Salt Solution (HBSS), milk and egg albumen on the vitality of periodontal ligament cells.Materials and Methods: In this experimental study, 105 human premolar teeth extracted atraumatically for orthodontic reasons were collected. After extraction, root surfaces became blood free using HBSS. Thereafter teeth were placed in individual tubes containing 10 ml HBSS solution and transferred in ice flasks to laboratory during 30 minutes. Storage media, in this study, consisted of water, milk, egg albumen and HBSS. Evaluation periods were at 1h, 2 h, 4 h, 8 hand 12 h and afterwards teeth were again washed with HBSS. After isolating PDL cells from root surfaces first by trypsin and then collagenase, viability of PDL cells was evaluated by trypan blue staining. Fibroblast count and the ratio of viable cells to the whole ones were calculated. Data were subjected to ANOVA test.Results: There was no statistically significant difference between egg albumen and HBSS (p>0.05). Also there was no significant difference between water and milk (p>0.05). However, egg albumen and HBSS were significantly better, in the preservation of cells viability, than water and milks.Conclusion: Egg albumen can be suggested as an appropriate storage media for the preservation of PDL cells viability of avulsed teeth. Availability is one of its important advantages.

Background and Aim: Cleaning and shaping of the root canal system are important objectives in each root canal therapy. A lot of automatic devices are nowadays available on the market to simplify the preparation and decrease instrumentation time. The aim of this study was to compare root canal preparation by three NiTi rotary systems: Profile, Flex master and Race using CT scan. Materials and Methods: In this in - vitro study forty five single rooted human mandibular premolars, with root canal curvature between 20°- 30° and radius curvature between 5-7 mm, were divided into three similar groups. All teeth were shortened to the length of 15 mm. Preoperative CT scan of each root were recorded at 2, 4, 6, 8, 10mm cross sections from apices. Following canal shaping, post operative scans were superimposed on the original images by adobe photoshop 7 software. Changes in canal transportation, canal centering and shape of canal were analyzed. Fisher's exact test was used to examine each cross- section statistically.Results: All three NiTi rotary systems could prepare canals without any transportation and deviation of original shapes. These systems could also maintain canal centering with minimal deviation from the canal depth. Three NiTi rotary systems were independent of transportation, canal centering and shaping variables in all cross - sections. No statistically significant differences were observed between these three systems (P>0.05). Conclusion: all three NiTi rotary system, without any significant difference, can be recommended for clinical use.

Background and Aim: A proper root canal filling is accomplished by complete obturation of the root canal with an inert filling material. Therefore, the creation of an apical seal has been proposed as goals for a successful endodontic treatment. The aim of this study was to determine the effects of spreader penetration depth on apical seal.Materials and Methods: Thirty- three canals were instrumented by step- back technique. In 12 canals, finger (F) spreader penetrated at 0.5 mm of the prepared length (group 1). In another 9 canals, F spreader penetrated at 1mm of the prepared length (group 2). After 24 hours, in 100% humidity, the roots, except for the 3 mm of apical part, were covered by nail polish. Six canals were not obturated as positive group and other six ones were completely covered by nail polish (negative controls). All roots were suspended in dye for 72 hours. The teeth were then cut longitudinally and apical leakage was measured and recorded. Data were subjected to t - test and Manu - whitney U test.Results: The mean dye penetration and standard deviation, in group 1, were 0.4492 and 0.209, respectively whereas those of group 2 were 1.2767 and 0.916, respectively. It was shown that average dye penetration in groups 1 was significantly less than that of group 2 (P<0.05).Conclusion: Considering the importance of a proper apical seal in a successful endodontic treatment, more spreader penetration depth in lateral condensation technique is recommended.

Background and Aim: Plaque control is an effective technique in the prevention and treatment of gingivitis and a critical part of all periodontal treatment procedures. Among different methods of plaque control, the use of antimicrobial toothpastes has gained special importance. The aim of this study was to compare the effects of Nasim and Pooneh antibacterial toothpastes with and ADA approved antimicrobial toothpaste (Crest Complete) on plaque control.Materials and Methods: In this cross - over study, conducted on 19 adult subjects, plaque regrowth after a 4 - day tooth brushing with Nasim, Pooneh and Crest complete toothpastes as well as water rinsing (negative control) as the only form of oral hygiene was investigated following prophylaxis and single brushing with toothpastes, rinsing with toothpastes slurries, twice a day, was used for the following 96 hours. SPSS software, Friedman and Wilcoxon Signed Rank tests were used for data analysis.Results: Comparison between four groups through non - parametrical Friedman test showed statistically significant differences. Wilcoxon's signed ranks test revealed that only between Pooneh and Nasim toothpastes significant difference did not exist. Average ranks for Pooneh, Nasim, Crest and water were 2.05, 2.45, 1.50 and 4, respectively.Conclusion: Pooneh and Nasim toothpastes were proved to be effective in plaque regrowth prevention, however, Crest complete in this short -time study yielded Faculty of Dentistry more satisfactory results.