Journal of Dental Medicine

Comparison the effect of chlorhexidine 2%, ethanol 70%, sodium ascorbate 10% and delayed bonding usage on the shear bond strength of composite resin to bleached enamel

Neda Pazhoohi

Background and Aims: The purpose of this study was to compare the effect of chlorhexidine 2%, ethanol 70% and sodium ascorbate 10% and delayed bonding for 1 week on the shear bond strength of composite resin to enamel after bleaching.

Materials and Methods: 90 human central incisors were divided into 6 equal groups: Group 1: no bleaching Group 2: bleaching with carbamide peroxide 45% for 45 minutes Group 3: bleaching + restoring specimens in distilled water for 1 week. In group 4, 5 and 6, after bleaching, 1 cc of chlorhexidine 2%, ethanol 70% and sodium ascorbate 10% were applied for 15 minutes. Composite cylinders were bonded on the buccal surfaces. Specimens were thermocycled for 1000 cycles and the shear bond strength test was done. Specimens were examined under stereomicroscope and SEM. Data were analyzed a sign ANOVA and Bonferroni test.

Results: The shear bond strength values were not significantly lower in the bleached teeth (group 3, 4, 5 and 6) than that of negative control group (group 1) (P=1.000, P=0.069, P=0.081, P=1.000) Bonferroni test results show significant difference between test groups (3, 4, 5 and 6) and group 2 (P<1.000, P=0.007, P=0.008, P<1.000) Under SEM, resin tags in group 2 was thinner and lesser than group 3, 4, 5 and 6. The most adhesive failures were in group 2.

Conclusion: Bleaching with carbamide peroxide and immediate bonding of composite decreased the shear bond strength. Sodium ascorbate 10% and delayed bonding for 1 week were the most effective way.

A comparison between the effect of All-Ceramic and metal-ceramic restorations on the plaque accumulation

Ezatollah Jalalian

Background and Aims: Tooth crowning often leads to changes in periodontal index through changes in emergence profile zone. The purpose of this study was to compare the effect of metal-ceramic with that of
All-Ceramic restorations on the plaque a accumulation.

Materials and Methods: In this clinical trial, we used 102 teeth covered with metal-ceramic and all-ceramic restorations. Before and after crowning, plaque index (PI) and gingival indexes (MGl) were measured. Data were analyzed using covariance (ANCOVA) test.

Results: Measured PI and MGI (Mean±SD) in PFM Group prior to crowning were (1.96±0.38) and (1.45±0.48), respectively. In metal-ceramic restorations group, six months after crowning, measured PI and MGI (Mean±SD) were (1.22±0.49) and (1.82±0.61), respectively. Measured PI and MGI (Mean±SD) in All-Ceramic Group prior to crowning were (1.22±0.52) and (1.25±0.29), respectively. In All-Ceramic, six months after crowning, measured PI and MGI (Mean±SD) were (0.88±0.51) and (1.43±0.50), respectively. ANOVA test showed statistical significance difference between metal-ceramic and All-Ceramic Groups in Indexes (P<0.001).

Conclusion: Metal-ceramic and All-Ceramic crowns were associated with inflammatory changes in gingival. Metal-ceramic restorations were associated with higher inflammatory indexes compared with All-Ceramic crowns.

Effectiveness of an educational intervention based on the trans theoretical model in order to smoking cessation in patients referred to dental clinics

Amir Pakpor Pakpour Haji Agha

Background and Aims: Constant contact with dentists, the ability to diagnose early effects of tobacco use on oral health and general health has made the dental clinics to the appropriate place to provide smoking cessation counseling. The aim of this study was to determine the effectiveness of an educational intervention using Trans Theoretical Model (TTM) on the smoking cessation in patients attending dental clinics.

Materials and Methods: This study was a quasi-experimental study conducted in 2013. 40 patients in the experimental and control groups were completed self-administered questionnaire including general and demographic questions, change questionnaire stages, change scale processes, smoking cessation self-efficacy scale, decisional balance scale before and 6 after months educational program. The experimental group received two training sessions through group discussion for 60 minutes. Data were analyzed using Chi-square tests, independent T-test, Mann-Whitney and Wilcoxon tests.

Results: In terms of the patients distribution in the change stages (pre-contemplation, contemplation and preparation), there was no significant difference between the experimental (22.5, 35, 42.5%) and control groups (27.5, 35, 37.5%) before intervention (P = 0.55). However, 10 and 20 percent of patients in the experimental group was reported action and maintenance stage regarding smoking cessation after intervention (P<0.001). Results showed a significant increase in the mean score of experimental process of change, behavioral process of change, proc and self efficacy (P<0.001). Also, the mean score of cons constructs decreased significantly after education in the experimental group (P<0.001).

Conclusion: Results indicated that the educational intervention using the TTM to increase the patients' smoking cessation rate was effective. Therefore, it is recommended that dentists have to become more familiar with TTM frameworks for smoking cessation.

Frequency of creative debonding failure rate and related factors in patients of a private dental practice

Elham Esmaili

Background and Aims: The aim of this descriptive longitudinal study was to determine the type of teeth that were more prone in accidental bracket debonding and also to investigate the relationship between broken bracket bond and intervening factors such as age, type of malocclusion and sex.

Materials and Methods: We used a pilot study to determine the correct sample size for this study. According to the pilot study which consisted of 20 records of patients, it was concluded that 576 patient’ records was needed. The mean time for a bracket before it fails was also measured using Kaplan-Meier method. Cox regression analysis was done to examine the effect of age, gender, and class of malocclusion on each tooth with broken bracket. Data were analyzed using the software SPSS 20.

Results: Results showed that the percentage of unexpected broken bracket bond for each tooth varied and they were significantly related only in second premolars in both jaws with malocclusion that was different for each tooth (P=0.037, P=0.004).

Conclusion: Maxillary second premolars and mandibular second premolars had the highest rate of unexpected broken bracket bond in CL II CL I malocclusion respectively. Age, gender and malocclusion had no effect on the unexpected broken bracket bond for other teeth.

Comparison of the shear bond strength of orthodontic brackets bonded using silorane base and metacrylate base composite

Mohadeseh khosravanian

Background and Aims: Orthodontic bracket failure during treatment is a common problem. With the introduction of low shrinkage composites the question is that whether: this sufficient has coefficient bond strength for bonding bracket during orthodontic treatment. The aim of this study was to compare the shear bond strength (SBS) of silorane-based and metacrylate-based composites to metal brackets.

Materials and Methods: 30 human premolar teeth were collected and divided into 2 groups. In group 1, 15 orthodontic brackets were bonded using silorane-based composite, in group 2, 15 orthodontic brackets were bonded using metacrylate-based composite. The shear bond strength of each specimen was determined in an Instron machine. Amount of residual adhesive remaining on each tooth was evaluated using a stereomicroscope. Data were analyzed using T-test to compare the shear bond strength between groups and LSD method to compare the Adhesive Remnant Index (ARI) scores.

Results: There was significant difference in the SBS between the test groups (P<0.001). The mean bond strength of bonding brackets to silorane-based composite was (42.42 ± 7.03) MPa, and the mean bond strength of bonding brackets metacrylate-based composite was (21.08±2.97 ) MPa. No significant difference in the ART was found between groups (P=0.66).

Conclusion: Silorane-based composite provided higher bond strength to orthodontic metal brackets.

Comparison of methods for controlling dental caries in the classical medicine and alternative medical practices and future prospects

Maryam Khoroushi

Dental caries is a multi-factorial disease and the most common human infection that annually are spent millions dollars to control and treat it. Several methods have been proposed so far to control it. The most important control methods it is now include : dental hygiene, proper nutrition , fluoride therapy , the use of non- cariogenic sweeteners . Also, the use of probiotics , nanomaterials , bacteriophages , antimicrobial peptides and anti- caries vaccines can be considered as new perspective of human in the dental caries control field. In addition, the use of complementary and alternative therapies , especially herbal drug therapy recently has been considered . Demonstrating the efficacy of complementary medicine against dental caries and its use in combination with conventional medicine or trial of new methods for decline of dental caries in the future would be hopeful.

Reverse contrast enhancement in digital radiography in detection of vertical root fracture (in vitro)

Maryam Edalat

Background and Aims: Diagnosis of vertical root fractures often poses a clinical dilemma. Diagnosis of VRF in intraoral radiographs, except in cases where the beam is perpendicular to the direction of fracture is difficult. Misdiagnosis often leads to wrong decisions about the design of teeth future treatment plan. The aim of this study was to determine the diagnostic accuracy of reverse contrast enhancement options in digital radiography, and to compare it with the original images to find a suitable method to detect vertical root fracture.

Materials and Methods: In this experimental study, digital radiography with phosphor plate detector was taken from 40 extracted single root teeth. From each intact and fractured tooth, the original and reverse contrast images captured and stored. Two expert observers viewed the images twice with an interval of two weeks. Diagnostic criteria (Accuracy, PPV, NPV, Specificity and Sensitivity) in form of absolute and complete for each observer and each images was calculated. Inter and intra observer reliability was obtained using Mc-Nemar test.

Results: No significant differences in inter-observer reliability between the initial appearance and reverse contrast was observed (P>0.05), but in view of the intra-observer reliability in two cases, the difference was significant (P<0.05). No significant difference in the accuracy, sensitivity, specificity and PPV was observe between the two used images (P>0.05), whereas significant difference between the two images was found in NPV index (P<0.05).

Conclusion: The use of reverse contrast enhancement option for detection of vertical root fracture did not show significant difference from initial view.

The effect of medication on the rate of orthodontic tooth movement (Part 2: Mediators and other drugs)

Pedram Baghaeian

Molecules produced in various diseased tissues or drugs and nutrients consumed regularly by patients, can reach the mechanically stressed paradental tissues through the circulation and interact with local target cells. The combined effect of mechanical forces and one or more of these agents may be inhibitory, additive or synergistic. The aim of this review was to outline the mechanisms of action and effects of some commonly used drugs on tissue remodeling and Orthodontic Tooth Movement (OTM). A review on the effects of medications and dietary supplements on the rate of experimental tooth movement was performed using Cochrane library, Embase and Medline (1980-2013). 63 articles were included in the review. 34 of them related to the effects of hormones and analgesics were evaluated in the first part of this review. The rest of them (29 articles) were evaluated in the current review, but their interpretation was hindered by the variability in experimental design, magnitude of force applied during tooth movement and medication regimens. Vitamin D₃ might enhance the pace of tooth movement, but dietary calcium and fluorides appear to reduce the rate of OTM. Bisphosphonates (BPNs) are considered to have marked inhibitory effects on the rate of tooth movement. Nicotine and nitric oxide might effectively increase the speed of OTM. All drugs reviewed had therapeutic effects, as well as side effects, that may influence the cells targeted by orthodontic forces. Therefore, it is imperative that the orthodontist pays close attention to the drug consumption history of each and every patient, before and during the course of orthodontic treatment. When the use of drugs is revealed, their effects and side effects on tissue systems should be explored to determine their potential influence on the outcome of mechanotherapy.

Effect of mechanical load cycling on the microleakage of three different glass ionomer restorations in class V cavities

Aida Mirnejad Joybari

Background and Aims: Microleakage is an important problem with direct restorations and familiarity with contributing factors is of utmost importance. The aim of this study was to evaluate the microleakage of three glass ionomer restorations in class V cavities.

Materials and Methods: In this in vitro study, class V cavity preparations were made on the buccal and lingual/ palatal surfaces of 30 human premolars (60 cavities). The specimens were divided into three group (n=10, 20 cavities). Restored as follows: group1: with Fuji IX (HVGI) ionomer/G coat plus, group 2: Ionofil molar (HVGI)/ G coat plus, and group 3: Fuji II LC (RMGI) / G coat plus. All specimens were finished and polished immediately and were thermocycled (2000 cycles, 5-50°C) . In each group half of the teeth were load cycled (50000 cycles). Finally, the teeth were immersed in 0.15% basic fushine dye for 24 hours at room temperature and then sectioned and observed under stereomicroscope. Data were analyzed using Kruskal-Wallis, Man- Whitney test and a comparison between incisal and gingival microleakage was made using Wilcoxon analysis.

Results: It was shown that the mechanical load cycling and filling material did not cause a statistically significant increase in the incisal and gingival microleakage in any of groups (P>0.05).

Conclusion: It was concluded that the extent microleakage of Fuji II LC was similar to that of the highly viscous glass ionomers (Ionofil molar, Fuji IX) and load cycling did not increase the microleakage.

Retention of castings fabricated by plastic coping and direct wax up for single crown and bridge in different implant systems

Hamid Jalali

Background and Aims: Adequate retention has significant importance in the prognosis of implant supported cemented the restorations. Limited literature had evaluated the effect of direct wax up or use of plastic coping on the retention of these restorations. This aims of this study was to compare the retention of castings fabricated by the plastic coping and direct wax up for single crown and bridge in three implant systems.

Materials and Methods: 28 specimens of each implant systems were randomly divided into 4 groups. Groups included wax patterns for single crowns and bridges that were made from plastic coping or direct wax up. All the wax patterns were invested and casted with base metal alloy, in similar conditions. After castings were cemented to the related abutments, the specimens were subjected to a pull out force in a universal testing machine at a cross head speed of 0.5 mm/min. The load required to decement each casting was recorded and the mean values for each group were calculated. Data were analyzed using three-way ANOVA.

Results: Comparing the between systems in crowns fabricated from plastic coping, there was no significant difference between Replace and Implantium (P=0.124), but ITI had significantly lower values than that of other systems (P<0.001 Comparing the systems in crowns fabricated from direct wax up, Implantium had the greatest retention and ITI had the lowest retention (P<0/001). Comparing the bridges with both method, Replace had the greatest retention and ITI had the lowest retention.

Conclusion: Implantium and Replace system exhibited the highest retention for fabricating crowns, and bridges, respectively.