JOURNAL OF ISLAMIC DENTAL ASSOCIATION OF IRAN (MAJALLAH-I-DANDANPIZISHKI)
Year:2004 | Volume:16 | Issue:2 (49)|Papers Count:13

Background and aim: Nowadays Calcium hydroxide is used as a dressing for canal sterilization and repair progression of apical lesions. The aim of this study was to determine the incidence of apical leakage after susing Calcium hydroxide as an intracanal dressing and filling the canal with gutta percha and AH26 sealer.Materials and Methods: The crowns of fifty-eight single-root extracted human teeth were resected and then divided into three test groups and two control groups (test groups=15 teeth, positive control=3 teeth, negative control=10 teeth). The canal of each tooth was prepared using step-back technique upto 50≠ k-fileand MAF=30 in groups A and C, MAF=30 in group B.The teeth of groups Band C were filled with Calcium hydroxide for one week and then the paste was removed by 35≠ file and irrigated with normal salin in group B and sodium hypochlorite in goup C.Then canals of test groups and negative control were obturated with gutta percha and AH26sealer using lateral condensation technique. Following this, teeth were centrifuged in India ink before floating in it for three days. Specimens were sectioned vertically and examined under a stereomicroscope to measure dye - penetration level. The results were analyzed using ANOV A statistical test.Results: Dye - penetration of group C in which calcium hydroxide. paste had been removed with sodium hypochlorite was less than two other groups, however, no statistically significant difference was found between three experimental groups of A, Band C in dyepenetration.Conclusion: It can be concluded that using calcium hydroxide for canal sterilization has no effect on the level of apical leakage.

Background and aim: The number and configuration of root canals in maxillary molars particularly in mesiobuccal roots display a wide range of variations. Therefore, enough knowledge of root canals anatomy, prior to root canal therapy, is an important factor for a successful treatment and long-term prognosis. Root canal anatomies have been studied by different techniques. The purpose of this study was to determine the percentage of root canal types in maxillary molars in Iranian population using staining and clearing techniques.Materials and Methods: In this study, 100 human first and second maxillary molars (50 of each) were studied to determine the type and number of root canals and also the presence of accessory and lateral canals. Root canal systems were studied with a little modification using staining and clearing technique based on Vertucci"s classification. Results: Different types of canals in mesiobuccal root of first maxillary molars were as follows: 20% type 1, 32% type 2, 40% type 4, 4% type 5, 4% type 6, in 30% accessory canals and in 20% lateral canals were seen, in distobuccal root 90% typel, 10% type 5 in 22% accessory canals and in 14% lateral canals were seen, in palatal root 92% type 1, 8% type 5 and in 30% accessory canals and in 18% lateral canals were seen.Different types of canals in mesiobuccal root of second maxillary molars were as follows: 74% type 1, 14% type 2, 10% type 4, 2% type 5 and in 32% accessory canals and in 8% lateral canals were seen, in distobuccal root 94% type 1, 6% type 5 and in 20% accessory canals and in 8% lateral canals were seen, and in palatal root 100% type 1, 30% accessory canals and 12% lateral canals were seen. First and second maxillary molars had two canals in the mesiobuccal root as 76% and 24%, respectively. The percentage of type 1 canals in distobuccal and palatal roots of both molars were similar and more than other types.Conclusion: Because of high prevalence of different types of canals in mesiobuccal root of maxillary molars, careful exploration for extra canals during access cavity preparation is mandatory, otherwise treatment failure is inevitable

Background and aim: Palatal groove as a growth-developmental anomaly can lead to periodontal problems, therefore diagnosis and treatment of its complications is of high importance.The aim of this study was to evaluate clinically the efficacy of enamel matrix derivative (EMD) in the treatment of periodontal defects due to palatal groove.Materials and Methods: Ten patients with palatal groove on maxillary lateral incisor with pocket depth ≥4mm were chosen from those referred to department of periodontics, Faculty of Dentistry Tehran University of Medical Sciences, and private office (2002-2003). During the surgical procedure, a full thickness flap was elevated and respective root thoroughly planed. After groove saucerization, EMD was used to cover the defect. The flap was then coronally positioned and secured with 3-0 silk sutures.Clinical measurements were taken at baseline, 1 and 3 months post-surgery. These parameters included pocket probing depth (PPD) and clinical attachment level (CAL). Statistical analysis was performed by the test of difference between means.Results: mean PPD and CAL before surgery were 5.7mm and 6.2mm, respectively that changed to 1.5mm and 2.05mm at 3 months post-surgery-statistically significant gain of attachment (71.05%) was observed 3 months after surgery (p-value <0.000).Conclusion: The results of this study suggest that EMD can be used successfully for periodontal attachment gain in teeth with palatal groove.

Background and aim: The occurence of medical emergency, among patients under dental treatment, is probable and upon the absence of readiness and in accurate diagnosis can endanger patients" life particularly for those with systemic problems. Dentist during his training career, should become thoroughly familiar with emergency signs and their correct mangement. The purpose of this study was to identify the most prevalent kinds of medical emergencies and their relationship with different dental treatments.Materials and Methods: The present cross-sectional and descriptive study was conducted on all the patients, regardless of sex, referred to four departments in faculty of dentistry Tehran University of Medical Sciences during one year (2001-2002). The information were collected through a questionnaire. During this period totally 12660 patients underwent treatment in four studied departments including: surgery 4480 (35.4%), periodontics 2560 (20.2%), endodontics 2240 (17.7%) and operative dentistry 3380 (26.7%).Results: The results of this study showed 72 emergency cases iranked as follows: surgery department (36.1%), periodontics department (23.6%), endodontics department (20.8%) and operative dentistry department (19.4%). The most prevalent reported type of emergencies was vasovagal syncope (39 cases), Orthostatic hypotention (19 cases), hyper ventilation syndrome (3 cases), sensitivity to anesthetics (2 cases), hypoglycemia (2 cases), bronchospasm (1 case) and seizure (1 case).Conclusion: It should be noted that emergency cases were mostly observed among females aged less than forty. Accurate diagnosis and proper therapeutic steps were taken in 100% of cases.

Background and aim: Furcation involvement is one of the most prevalent periodontal lesions in multi-rooted teeth. For the treatment of such lesions, regenerative techniques, being claimed to reconstruct the lost structures, have been focused by a lot of investigators.The purpose of this study was to clinically evaluate the effectiveness of Atrisorb membrane along with coronally positioned flap technique (CPF) in the treatment of classII furcation defects in mandibular molars and also to compare it with CPF alone.Materials and Methods: Twenty-four bilateral class II mandibular molar furcation lesions belonging to 12 subjects (7 males, 5 females) participated in this study. Twelve furcations were treated by Atrisorb along with CPF technique (test group) where as the other twelve ones were treated with CPF technique alone (control qroup).Clinically evaluated parameters included: probing depth (PD), clinical attachment level (CAL), gingival recession (GR), Keratinized gingiva (KG), closed horizontal probing depth (CHPD). These parameters were measured at baseline, 3, 6 and 12 months after surgery.Results: In a 12-month follow up, mean KG in test and control groups decreased 0.316mm and 0.492mm, respectively.Mean GR in test and control groups increased 0.35mmand 0.4mm,respectively, an inevitable side-effect of regenerative treatments. Mean PD in test and control groups decreased 2.175mm and 2.35mm, respectively and mean CAL gain in test and control site were 1.825mm and 1.975mm, respectively. Mean CHPD gain in GTR group was 3.917mm and in CPF group was 3.917mm.Conclusion: The results of this study suggest that both methods were effective in the improvement of CAL gain, PD and CHPD but their differences were not statistically significant.

Background and aim: In recent years, using dental amalgam because of its potential risk of mercury toxicity particularly for dental personnel has become a great problem in dentistry. The aim of this study was to evaluate the relationship between practical indices and mercury levels in the urine of dentists with more than four years experience.Materials and Methods: Thirty dentists filled a questionnaire including: duration of office experience, number of amalgam restorations, method of amalgam wastes removal, number of daily polished restorations, and the number of amalgam restored teeth in dentist"s mouth. Thirty urine samples were collected from dentists and specific gravity of each urine sample was measured by a refractometer on the same day.After processing, mercury was collected from the upper layer of solution using potassium bromid and was measured by a spectro photometer (µHg/l) in 485nm. Then cratinin of each sample was also measured and mercury concentration was divided into cratinin concentration. Finally, the rate of urine mercury was reported in µgHg/gr cr. Data was analyzed by t-test, pearson correlation coeficient and lined multi variable regression test.Results: Mean value of urine mercury was 31.62, μghg/gr cr which was less than threshold allowable level.Totally, 11 samples exceed the allowable levels. From practical contaminated instruments, method of amalgam wastes removal significantly related to urine mercury levels (P<0.05).Conclusion: According to this study, the measured mercury level was less than TLV level. The most significant factor was the number of restorations.

Background and aim: Periodontal diseases are of the most common problems in oral cavity which frequently require surgery. Some of the patients because of their impossibility to take conventional analgesics due to systemic problems and post-surgical pain and also intolerance toward periodontal pack for one week, refuse surgery. Therefore, it seems advantage use to perform surgery free from such complications.The aim of this study was to investigate the effects of Benzydamine HCL for post-surgical periodontal patients.Materials and Methods: For thiry patients with similar periodontal problems on contralateral sides of the mouth full thickness flap was performed at an interval of six weeks. No periodontal pack was used following surgery. Patients were given Benzydamine HCL or a placebo randomly and asked to rinse mouth for a 7-day period every four hours. During this period, a questionnaire on pain was filled by each patient. Plaque and bleeding indices were also evaluated at 0, 1, 3 and 7 days post-surgery. Six weeks later the second surgical procedure was carried out on contralateral part of the mouth and if patients received benzydamine HCL, now used a placebo and vice versa. Data were analyzed statistically using t-test and variance analysis test.Results: The results from 30 regions which were randomly divided into Benzydamine HCL and placebo groups (n=15) showed that all Benzydamine samples suffered from a mild pain on first day and were without pain from the 2nd to 7th day. However, all placebo samples suffered from a moderate pain on first day and a mild pain from the 2nd to 7th day. Bleeding index, in Benzydamine group, on 3rd and 7th days were 0.73 ±0.08 and 0.62±0.09, respectively which were less than that of placebo group (2.4±0.2). t.test statistical analysis revealed significant difference between two groups (P<0.00l). Plaque index, in benzydamine group, on 3Id and 7th days were. 1.43 ±0.12 and 1.3 ±0.18, respectively and those of placebo were 2.06 ±0.1 and 2.2±0.28 that statistically significant differences were found on both days between two groups by t-test (P<0.00l).Conclusion: According to the findings of this research, using Benzydamine HCL mouth rinse 15% post periodontal surgeries can be effective on pain reduction, gingival bleeding and plaque control and may be substituted for periodontal pack and analgesics such as asprine, acetaminophene and Ibuoprophene.

Background and aim: Three methods are commonly used in hyperthyroidism treatment including drug therapy, radioiodine therapy and surgical operation. Selection of each method is somewhat optional. Radio iodine therapy is indicated when antithyroid drugs fail to treat the patient or hyperthyroidism recurs after surgical operation. Radioactive iodine (I131)may have some adverse consequences on salivary glands followed by a decrease or cease in salivary secretion which in turn lead to an increase in dental caries rate. The purpose of this study was to compare the average of CSI and PI and also xerosthemia in patients treated with I131and antithyroid drugs.Materials and Methods: Seventy-six patients, after definite hyperthyroidism, diagnosis, were selected and divided into two groups consisting of 30 and 46 patients, depending on treatment plan. Patients of one group were treated using I131radioactive where as for another group antithyroid drugs were prescribed.Caries severity index (CSI) and dental plaque index (PI) were measured and compared for all patients before and after treatment. Moreover, patients were studied on xerosthemia and the effects of treatment plan. Data were analyzed using paired samples, independent samples and chi square tests.Results: The findings of this study showed significant differences in CSI and PI rates. before and after 6-8 months I131treatment (p-value=0.016), however, these differences among patients treated by antithyroid drugs, were not significant.Conclusion: Xerosthernia was observed more among those treated by I131radioactive. Furthermore, CSI and PI showed significant differences before and after treatment but these effects were not seen while using antithyroid drugs.

Background and aim: Successful treatment and health could be achieved by ontime referring and rapid and accurate diagnosis. It sounds necessary to study the reasons underlying patients" delay in their referral to specialists. Therefore, the aim of the present study was to determine the main reasons of patients" attendance, sources and causes of their referral to oral medical center of Mashhad Dental Faculty.Materials and Methods: All subjects referring to this centre, from September to December 2000, were examined and questionnaires were filled out for them. Sampling method was consecutive using poison's method. The study was of cross-sectional type that performed descriptively.The subjects included 1310, 501 (38.2%) males and 809 (61.8%) females with the mean age of 28.21±14.59 ranging from 1 to 78 year.Results: Out of the total patients, only 76 (5.80%) of them had oral lesion or symptom complaint and other referred for dental problems. The most common chief complaints were ranked as: dental filling (44.4%), denture (21.7%), toothache (19.4%) and periodontal diseases (13.4%). Patients with oral lesion or symptom were referred by dentists (73.3%), medical practitioners (11.53%), others (8.9%) and by themselves (8.9%). Each patient was examined, (on) average, by 2.38±1.56 clinicians (ranging from 1 to 7 ones). Mean period from the onset of oral-facial lesions as noticed by the patients, until they referred to clinic was 17.07±35.17 months (ranging from 1 day to 192 months). The most prevalent causes for patients" referral to oral medical center consisted of: inflammatory hyperplasia (11.8%), jaw cysts (10.52%), lichen planus (9.2%), abcess (5.26%), recurrent aphthous stomatitis (5.26%) and pain (6.57%).Conclusion: Patients with oral lesions, for different reasons such as improper examinations by non-specialists, do not refer to Oral medical center on time. Therefore, intercommunication between oral specialists and other practitioners and also the improvement of general health knowledge, should be considered as a priority in any health system.

Background and aim: Zinc oxide eugenol (ZOE) impression material, due to its favourable characteristics, has numerouse uses in removable denture impression making and jaw relation recording.In Iran this material is commercially produced as Duralite. The purpose of this study was to investigate consistency and working time of Iranian ZOE (Duralite) and compare it with foreign ZOE (Luralite) based on British standard 4284: 1981.Materials and Methods: In this invitro experimental study, forty samples were studied. An apparatus for the determination of material consistency and a penetrometer for workingtime measurement were used.For consistency measurement, 0.5cc of each impression paste was put between two glass plates and under one 1500gr. load. After 15 seconds, the diameter of resulting disk was measured with a digital caliper. For working time measurement, each paste was put in a metalring (diameter: 30mm, height: 3mm) and then in 30-second intervals the penetration of penetrometer needle was measured. Data were analyzed by t-student test.Results: Mean consistency of Duralite impression material was measured 43.42±2 mm and that of luralite was 45.22±1 mm. Mean working time for Duralite impression material was measured 2':50"±0':19" and for Luralite was 8':30"±0':28".The results of this study revealed that the consistency and working time of Duralite and Luralite impression materials are within the range of British standard.Conclusion: No statistically significant difference was found in mean consistency of Duralite and Luralite impression materials (P=0.08), but there is a significant difference between their mean working times (P<0.001).

Background and aim: Nowadays, Gutta Percha cones are widely used as a canal filling material. Since these materials can not be sterilized through common methods of dry or wet heat, quick sterilization of Gutta Percha cones, while and prior to manipulation, is a necessity as a substantial factor in a successful endodontic treatment.Materials and Methods: The purpose of this study was to assess the disinfectant effect of HcloNa solution of variouse concentrations on Gutta percha cones artificially contaminated by Entrococous fecalis and Bacillus subtilis spore.Results: In this study, 160 Gutta percha cones No.80 of Ariadent brand were used. Gutta percha cones were initially immersed in microbial solutions for thirity minutes. Having been transferred to vessels containing sterile filter paper, they were dried for ten minutes in room temperature. caries were then transferred to plastic containers each seprately in a sterile condition and immeresed in HcloNa solution of 0.5%, 1%, 2% and 5.25% concentrations for 1, 3 and 5 minutes. All cones cones were then transferred into tubes containing serum physiology and tiosulfate (0.6%). This solution was mixed for twenty seconds by Vortex mixer and samples of undiluted solution (5.25%) and 0.5%, 1% and 2% diluted ones were cultured in tryptic agar environment. The number of colonies were then counted and reported in CFU/ML.Conclusion: Considering that all HcloNa solutions of different concentrations showed anit-bacterial and anti-spore properties, Gutta percha cones sterilization by HcloNa (0.5%) solution for one minutes,is recommended.

Background and aim: The application of dentin bonding agents in operative dentistry, has led to numerouse advantages such as microleakage reduction. The goal of this study was to clarify the possible effects of dentin bonding agents on dental pulps, in contact with dentinal extended surfaces. Materials and Methods: In this experimental study, 72 restorations were made on the anterior teeth of six adult dogs: Restorations were divided into four groups.Group 1: Small CIV cavities restored directly with composite and denin bonding agent. Group 2: Large cavities (prepared for full coverage crown) restored indirectly composite and dentin bonding agent.Group 3: Large cavities (prepared for full coverage crown) restored with composite and cemented polycarboxylate cement indirectly.Group 4: Large cavities restored with composite crowns and cemented with resin cement along with dentin bonding agent. After 7,25 and 60 days animals were killed and histopathological studies were made on their pulp tissues. Data were subjected to one-way ANOV A, Kruska-Walis, Mann-Whitney and U-Wilcoxon tests.Results: There were significant differences between groups 1 and 2, groups 2 and 4, groups 1 and 4 and groups 3 and 4 (p<0.05). Generally, the most irritation was observed in group 4 and groups 2, 3 and 1, respectively. In group 1, a slight inflammation was found after 7 days that decreased or totally eliminated in 25 and 60 days. In group 2, all inflammatory markers were more then group 1 and some of then remained after 60 days. The inflammafory markers, in group 3, were more than group 1 and considerably less than group 2 and decreased in 25 and 60 days. In group 4, all markers in all periods, were more than other groups, with its peak after 60 days.Conclusion: It seams that dentin bonding agents put irritative effects on dental pulp. If other factors such as previous irritations, or those associated with cavity preparation methods or extensive surface contacts were present, more or even irreversible changes could be made in dental pulps.