Journal of Mashhad Dental School
Year:2012 | Volume:35 | Issue:4 (79)|Papers Count:12

Introduction: Every day, numerous people undergo dental treatments, and if required different drugs are prescribed by dentists. Some patients have systemic disorders, so dentists must have correct information about drug prescriptions and drugs that are to be used by their patients. The aim of this study was to evaluate and compare the awareness of dentists and dentistry students about using drugs in dentistry.Materials & Methods: In this cross-sectional study, the awareness of general dentists and dentistry students about drugs used in dentistry were evaluated during 2009-2010. A questionnaire was prepared and completed by 58 final year dental students and 96 Hamadan general dental practitioners for a total of 154 completed questionnaires. The questionnaire consisted of some demographic questions and questions about their awareness and their main information resources about drugs. Gathered data were analyzed using descriptive statistics, Pearson Chi-square, Mann-Whitney and Independent t-test statistical analysis. More questions about dtug awareness were answered by dental students than general dentists.Results: Dentistry students answered the question about awareness of drugs used in dentistry more correctly than did general dentists (64.96% versus 56.73%, respectively) P<0.001. The assessment of general dentists and dentistry students indicated that the awareness of dentistry students was much better, and the difference was statistically significant. Overall, 94.9% of students had to some extent desirable and completely desirable awareness, while this level for general dentists was about 82.3%.Conclusion: The awareness level of general dentists about drugs which are used in dentistry is moderate. An inverse relationship between job experience and the score of awareness shows that the awareness of dentists has not updated along with experience and there is no serious follow-up in this field. This issue indicates the necessity of retraining courses for dentists about drugs prescribed in dentistry.

Introduction: Mental retardation is a general word used for people whose intellectual development is significantly lower than normal individuals. One consequence is their limited ability to comply with their environment. Providing dental services for mentally retarded people requires matching with social growth, intellectual and spiritual factors of the person Therefore dentists should plan methods for communication and reducing anxiety of these patients. The general purpose of this research is to compare the oral health status of normal and mentally retarded children and also to examine the effect of educational intervention on the amount of plaque in both groups.Materials & Methods: A group of 130 children (70 girls and 60 boys) with mild to moderate mental disability at the elementary level and a group of 130 children (67 girls and 63 boys) aged 7-11 years old from Jay region of Esfahan were randomly selected. The questionnaire was completed with background information from their parents and coaches. Oral health status was evaluated using DMFt, Dental caries treatment, and Sillness-Loe plaque indices.Results: Decay rates in the healthy group and the mentally disabled group were 93.5% and 93%, respectively. The means of the DMFT index in the mentally disabled group and in healthy group were 0.26 and 0.14respectively. The means of the dmft in the disabled group and in the healthy group were 0.26 and 0.51, respectively. Dental caries treatment indices for deciduous teeth in the disabled group and in the healthy group were 0.18 and 0.97, respectively and dental caries treatment indices of permanent teeth in the disabled group and in healthy group were 0.14 and 0.13, respectively. The Sillness-Loe plaque indices for the deciduous and permanent teeth before brushing in the disabled group and in healthy group were 1.51 and 1.64, respectively, and the Sillness-Loe plaque indices for the deciduous and permanent teeth after brushing in the disabled group and in the healthy group were 0.56 and 0.41, respectively.Conclusion: Oral and dental health status of elementary level students with mild to moderate mental retardation is undesirable. Oral health policy makers should try to promote and improve health policies in this group.

Introduction: Radiographic usage for determination of working length is difficult in children, because of hazardous irradiation, superimposition of the permanent tooth germ and primary tooth root, mouth opening limitation, lack of cooperation, and radiographic misinterpretation of primary teeth. The purpose of this clinical study was to evaluate the accuracy of the Raypex5 apex locator for root canal length determination in primary teeth.Materials & Methods: This experimental study used 23 primary second molar teeth that were scheduled for extraction. Following access cavity preparation, the working length was determined with a Raypex5 electronic apex locator. The teeth were extracted and real lengths of root canals were measured with insertion of a K-type file into the each canal until it emerged at the apical foramen. This length, minus 0.5 mm, was recorded as the real root canal length. The data were statistically analyzed using a One Sample t-test.Results: The accuracy of the Raypex5 electronic apex locator in determining working length within 0.5 mm of the real length was 81.2% and 100% within 1mm of the real length.Conclusion: This study concluded that the Raypex5 apex locator is a useful tool for measuring root canal lengths in primary teeth.

Introduction: Jaw bone defects are the origin of many complications for patients, and completebone healing has a special importance. Histological examination can be regarded as the "gold standard." However, noninvasive diagnosis techniques are needed for clinical application. The aim of this study was to compare digital and conventional radiography for detection of bone healing.Materials & Methods: In this study, premolar teeth of 4 dogs were extracted. 5.5mm bone defect was created in each quadrant of the jaw bone Three months after healing of the extraction sites. Digital and conventional radiography was performed at 15, 30, 45 and 60 days after surgery. At every stage, bone specimens were removed and studied with histomorphometric procedures. At all stages, bone defect density was determined by conventional and digital radiography and compared with the percentage of bone formation determined by histomorphometry. The data were analyzed using descriptive analysis variance test for repeated data and paired t-test using SPSS software.Results: At all stages, the differences between both radiographic methods and histomorphometry were statistically significant. At days 15 and 60, a statistically significant difference was seen between digital and conventional radiography. The differences between digital and conventional radiography at days 30 and 45 were not statistically significant.Conclusion: Digital radiography showed changes more clearly in the early stages of bone formation (day 15) and at later stages (day 60).

Introduction: Periodontal disease with alveolar bone resorption and tooth loss is common in rheumatoid arthritis (RA). RA subjects show inadequate plaque control due to physical disability as well as compromised immune response, both of which might result in a greater predisposition to periodontal disease in these subjects than in the normal population. The aim of this study was to evaluate the prevalence of periodontal disease among rheumatoid arthritis patients.Materials & Methods: Periodontal status (plaque index, papillary bleeding index, and missing teeth) was examined in 70 individuals including 35 patients with active rheumatoid arthritis and 35 healthy individuals as control group. The results were analyzed using SPSS software and student t-test.Results: Patients with rheumatoid arthritis included 31 females (88.6%) and 4 males (11.4%) with a mean age of 45 years. Healthy control group included 26 females (74.3%) and 9 males (25.7%) with a mean age of 37 years. Patients with rheumatoid arthritis showed significant increases in Plaque index (P=0.0001), papillary bleeding index (P=0.002), and number of missing teeth (P=0.03) compared to the healthy control group. Three patients also had secondary Sjogren's syndrome.Conclusion: Patients with rheumatoid arthritis had a greater level of periodontal disorders compared to control group. In addition to the effects of this chronic inflammatory disease and immune host deficiened, this could be attributed to physical disability in maintaining oral health and gingival effects of anti rheumatic medications.

Introduction: Bond strength between veneer ceramic any zirconia framework is the weakest component in the layered structure. This bond was sensitive to the liner application and type of veneer ceramic. This study examined the core-veneer microtensile bond strength of a CAD/CAM (computer aided design/computer assisted manufactured) zirconia ceramic by comparing two ceramic veneers with and without liners.Materials & Methods: Disc-shaped (19.4×3.5mm) specimens were fabricated using CAD/CAM zirconia core materials (Cercon). Half of the discs were left white and the others were colored with an A2 liner. The specimens were veneered with Ceram Kiss or Zirkonzahn ICE veneering ceramics (3.5 mm). The discs were then cut into microbars (CC, ZC, CW, ZW) and the microtensile strength of the core-veneer bond was calculated. The specimens were analyzed by SEM and the data were compared using one-way ANOVA and Post hoc tests.Results: The type of veneering ceramic (Ceram Kiss) and liner application (coloring) significantly affected the core-veneer microtensile bond strength (P<0.0001). The Zirkonzahn layer (ZC, ZW) did not show significant differences (P=0.08)Conclusion: Careful selection of veneering ceramics and liner applications can be recommended as they have significant roles in microtensile bond strength of core veneered restorations.

Introduction: In periodontal diseases, pathogen discrimination by the immune system is an essential factor for triggering host responses. The Toll-like receptor family is responsible for recognition of evolutionarily conserved microbial structures like bacterial lipopolysaccharide (LPS) and activates signaling pathways that eventually lead to immune responses. The aim of the present study was to use real-time PCR to compare TLR-2 and TLR-4 gene expression levels in diseased sites and healthy sites of gingival tissue from periodontitis patients.Materials & Methods: Gingival biopsies were harvested from healthy sites (BOP- and PD£3mm) and diseased sites (BOP+ and PD³5mm) of 20 patients with moderate to severe chronic periodontitis. RNA was extracted from all gingival biopsies. Real-time PCR was performed to evaluate relative quantities of TLR-2 and TLR-4 mRNA. Statistical analyses were done using the Paired Wilcoxon test (2 related sample tests).Results: The relative expression levels of both TLR-2 and TLR-4 were significantly higher at diseased sites (2.41±2.06 and 1.25±1.16) than at healthy sites (0.91±1.04 and 0.41±0.60) (P£0.01).Conclusion: Periodontal disease can significantly increase TLR-2 and TLR-4 gene expression in gingival tissues.

Introduction: Effective pain management after dental surgeries is one of the most common problems in dentistry. Ibuprofen is the most common non selective non steroidal anti-inflammatory drug (NSAID), which inhibits both COX-1 and COX-2. Celecoxib is a COX-2 specific NSAID and also the only COX-2 specific drug available in Iran. Naproxen is a non selective NSAID that is often used for postoperative pain management all around the world; however, it is not the first choice in our country. The purpose of this study was to compare the effectiveness of Celecoxib, Naproxen, and Ibuprofen in pain control after periodontal surgery.Materials & Methods: This double-blind clinical trial study included a total of 30 patients who presented with chronic periodontitis and who underwent surgical procedures on the anterior sextant of the mandible. They were randomly assigned to 3 groups of 10 patients. Each group received one of the following medication protocols: Group A: 400 mg Ibuprofen, group B: 200 mg Celecoxib , Group C: 250 mg Naproxen. Patients reported their pain levels using a VAS (visual analog scale) at 1, 3, 6, 12, 24, and 48 hours after periodontal surgery. All data were analyzed by SPSS Ver 15 program. Data were analyzed using Kruskal-Wallis and Mann-Whitney tests, respectively.Results: Statistical analysis of the data showed no significant differences between Ibuprofen, Celecoxib, and Naproxen after 1, 6, 12, 24, or 48 hours after the surgery. Significant differences were seen only at the third hour after surgery between Celecoxib and Naproxen and between Ibuprofen and Naproxen.Conclusion: Considering the lower rate of side effects of Celecoxib its similar degree of pain reduction as Ibuprofen, and its better efficiency than Naproxen, Celecoxib can be considered an appropriate drug for pain control after periodontal surgeries.

Introduction: Endodontic treatment causes local trauma and subsequent inflammation, making pain and discomfort common side effects of endodontic treatment. Since there is an important relationship between post- endodontic pain and preendodontic pain, use of non-steroidal anti-inflammatory drugs (NSAIDs) before root canal therapy can suppress the inflammatory process before it starts, and reduce the pain after root canal therapy. The aim of this study was to compare the efficacy of prophylactic Ibuprofen Sulindac (both are NSAIDs) and placebo in controlling pain after root canal therapy.Materials & Methods: In this triple-blind clinical trial study, 48 patients with vital, single rooted anterior teeth were selected. These teeth were divided into three groups. One capsule was given to every group as prophylaxis before the treatment, which according to its code, contained Ibuprofen, Sulindac, or placebo. The treatment was then performed by one person (a general practitioner) according to standard methods. The pain of each patient was recorded before treatment and at 6, 12, 24, 48, and 72 hours after the treatment using a VAS scale. The results were collected and comparison of the means of pain between the three groups was conducted statistically.Results: A reduction in pain was seen in Sulindac and Ibuprofen group at 6,12,24,48, and 72 hours after treatment compared to before treatment and placebo group, but the difference was not statistically significant (P>0.05).Conclusion: Since no statistically significant difference was observed between the groups, prophylactic use of these drugs for reduction of post-endodontic pain is not suggested.

Introduction: Sialolithiasis is the formation of a calcified obstruction within the salivary duct. It may form in any of the major or minor salivary glands or their ducts. Overall, 80% to 90% of salivary gland stones occur in the submandibular gland. Sialoliths commonly measure from 5 to 10 mm in size and all stones over 10 mm can be reported as sialoliths of unusual size. In this study, we report a large sialolith presenting without clinical symptoms. Case Reports: The CBCT images of a 52-year-old man who referred for implant treatment evaluation of lower jaw showed a large radiopaque mass in floor of mouth. The patient did not have any history of pain or pus, and this sialolith was not his chief complaint. The sialolith was surgically removed. Conclusion: Some sialoliths, despite their remarkable size, can be a diagnostic and therapeutic challenge for the clinician. Appropriate diagnosis and treatment with minimal side effects is very important.