Journal of Dental Medicine

---

Normal 0 false false false EN-US X-NONE AR-SA Granular cell schwanomma is a rare benign tumor that has been reported sporadically. Our case was a 38 year old man with a pink to yellow small lump of 5mm in right buccal mucosa without any complaint of pain or hemorrhage. Microscopic evaluations showed malpighian epithelium with intense hyperplasia in some parts. In underlying connective tissue a new formed tissue is seen with cytoplasmic giant cells. Any malignancy was reported. In this article, clinical and microscopic characteristics as well as misdiagnosis of the disease are discussed.

---

Normal 0 false false false EN-US X-NONE AR-SA Burning mouth syndrome is a painful oral disease without specific clinical symptoms. Explanation and definition of the disease depend on many factors and is characteristics to each patient.  3 types of this syndrome have been defined. Almost all oral disease specialists believe that burning mouth syndrome is multifactorial and have not mentioned any specific risk factor for it. Currently, etiologic factors are divided into 3 groups of local, systemic and psychological factors.

---

Normal 0 false false false EN-US X-NONE AR-SA In recent years, Medical science has been developed remarkably in treatment of malignant diseases. New treatment modalities, chemotherapy, radiotherapy and immunotherapy in patients with different types of neoplasm have cured some cases and increased their life long. On the other hand, considerable complications have also been developed for both patients and clinicians. Viral infections of oral cavity in patients receiving chemotherapy is ignored in most cases. Therefore, we aimed to evaluate viral infections in hospitalized patients receiving chemotherapy in Hematology department of Amiralam and Imam Khomeini Hospitals. On this account 84 patients with leukemia (AML,ALL, CML, CLL) and lymphoma ( hochkin and non hochkin) who were in immunosuppression phase after chemotherapy were evaluated in 3 months. Lower incidence of viral infections in comparison to the results of other countries were obtained.

---

Normal 0 false false false EN-US X-NONE AR-SA Non-removable Keratotic lesions are relatively prevalent in various types in oral mucosa. The treatment modality is often problematic and is done by using  various specific regimens. Bleomycin was used in two primary studies with limited number of patients (N=9) . In current survey, more patients were recruited in a longer period of study. In fact, 50 leukoplakia and lichen planus patients were treated by local administration of belomycin  in a 21 months follow-up period. Statistical analysis was done by using Kaplan meier and cox Regression methods. The obtained results showed that belomycin can remove many of these lesions and can prevent both chronic pattern and malignant changes of the lesions. As In 9 cases of leukoplakia, 2 cases of recurrence were recorded. According to statistical analysis, in case of complete treatment up to 11 months , the recurrence  would not be possible. In 41 cases of lichen planus, recurrence rate was higher and after  a longer period (17 months ) following complete treatment, recurrence was totally eliminated. In fact, Recurrence can be due to psychological conditions. To conclude, local administration of Bleomycin is recommended to use to treat Oral  keratotic lesions and can act successfully based on current study's findings.

 

---

Normal 0 false false false EN-US X-NONE AR-SA Canine retraction was done for 19 patients. Movement , Tipping and rotation of canine and molar movements  was done by two approaches of sliding hook and sliding mechanics using 16% wire and 18% twin edgewise brackets and were compared. 350 g force via elastic chin was applied and measurements were done both intra- and extraorally. There was not any significant statistical difference between canine and molar movements in both approaches. Canine Tipping and rotation in two approaches showed significant difference. In fact, both were lower in sliding hook approach than sliding mechanics. As lower tipping results were obtained in sliding hook approach, it is suggested to apply this method to bodily retract canine.

---

  In 1996 Grinspan et al presented the association between primary hypertension and diabetes mellitus as Grinspan Syndrome. Through various studies, Researchers have noticed that epidermal lichen planus cells show enzymatic disorders as well as defective carbohydrate expression. Therefore, it was assumed that there is a relationship between cells and hormones in metabolic actions. Besides, some researchers presented the possible relation between hormonal dysfunction and immunological disorders leading to lichen planus development. It was found that primary hypertension is not related to lichen planus and lichen planus is presented in hypertensive patients as a result of antihypertensive medications. Therefore, the majority of studies in this regard have been focused on diabtese and lichen planus, their prevalence , comparing patients with the control groups and the association between blood sugar, blood fats , antihypertensive drugs and lipid lowering drugs.

---

  Complex mechanisms have been known for keeping blood pressure in normal level. In fact, these mechanisms have inter-related functions and can be dysregulated by both internal and external stimuli while cardiovascular system functions to minimize these changes. Vasoconstrictors can cause clinical and hemodynamical changes as 1-2 cartridges of epinephrine containing lidocaine can has no considerable effects in a normal individual ( unless administered IV) but 3 cartridges can bring about some clinical symptoms, according to a number of investigations. In current study, epinephrine’s effect on heartbeat rate was found more potent than felypressin which is considered as a disadvantage. on the other hand, epinephrine acts on arteries and can cause less bleeding, less drug toxicity and deeper and longer anesthesia. Therefore, it is preferred to felypressin due to its better action. It should be noted that the changes resulted by epinephrine and felypressin are of no significant importance in healthy individuals.

---

Odontoma is an odontogenic lesion with epithelial and mesenchymal origin and is composed of differentiated dental parts. Than because of abnormal organization of mature tissues. It seems that it is a hamartoma rather than real tumor. Odontoma is seen in two types of compound & complex.Out of 57 studied cases, 31 cases (54.2%) were of complex type 12 cases (21 %) were compound & 8 cases were of cystic. The age of incidence ranged from 5.5 to 68 years. The mean age in complex odontoma was 27 years & compound type was 19 years. There was no significant difference regarding the sex in the complex type. In compound odontoma women were affected 2 times more than means.Complex type are found in mandibular posterior era ereas more and compound type in anterior regions .In this studied found 12 cases impaction teeth.

---

A case involving the rare occurance of hyperparathyroidism in association with neurofibromatosis is reported.Radiographic findings revealed multiple radiolucency which diagnosed as giant cell lesions. Also, high levels of PTH and alkalan phosphatase were found from repeated measurements of the serum.Neurofibromatosis associated with hyperparathyroidism diagnosed in this case report.

---

: One of the main aspects of orthodontic treatments is hard and soft tissue changes and their effects on patients appearance.Fixed orthodontic treatment with extraction of upper first premolars to camulfalge of ci II malocclusion is very common,however there is not sufficient studies about lip and incisors changes after this procedure. For evaluating of vertical changes of upper, lip and incisors following retraction of upper incisors, fifteen adult Iranian patients aged 15 to 24 years who sought treatment for their CI II DI malocclusion were treated. Standard edgewise technique(0.018") following extraction of four first premolars were used.A cephaiometric study was undertaken to determine the vertical change in upper incisors and upper lip. For this evaluation, thirty linear and angular measurements were utilized.Results show that: 1- The upper incisors were intruded (X=0.83mm).2- The upper lip length was increased(X~1.2mm).3- The occlusal plane, rotated upward (Anteinclination).4- The palatal plane rotated downward and backward (Retroinclination).This study shows that the standard edgwise appliance has the capacity of reduction of incisor protrusion significantly without extruding them.

---

Up to now, no complete study was carried out about the prevalence and location of periapical granuloma and radicular cysts from the point of view of clinical symptoms (e.g. pain and swelling fistula) in Iran. The data was collected from the files available in the Department of Pathology, faculty of Dentistry, Tehran University of Medical Sciences. With a consideration on different therapeutic methods. a proper method was selected. Radicular cyst occurred in 59.3 percent of 324 cases while 45.7 percent were granuloma. The most common incidence of these lesions was in the range of 24-25 years old. The most common location of lesions was the maxillary anterior. Sinus tracts occurred in 74 of all cases. 47.3 percent of these patients have been previously received root canal therapy. It is noticeable that 24 percent of all patients were treated endodontically before surgery. Higher incidence of granuloma occurred in small lesions while cysts were more common in large lesions. 232 of all cases showed one of the clinical symptoms, 16% pain, 35.8% swelling and 22.8% fistula. No symptoms were found in 92 cases.

---

---

The aim of this study was to evaluate the incidence of postoperative wound dehiscence and infection after early closure of evulsive facial wounds. This treatment was conducted on 28 male patients with evulsive facial wounds. The formation of these evulsive wounds was due to the rupture of temporary cavitation caused by high and extra high velocity messiles. All patients with average age of 18 years old were treated 24-48 hrs afire accidents at base hospitals (1988-1990).Primary healing was achieved in 24 subjects from 7 tO 15 days after the standard operation. Wound dehiscences and bacterial infections were observed in 4 subjects.The conclusion can be made from the results is that the early closure of evulsive facial wounds may reduce the rate of wound dehiscence and infection because of high vascularity in this area.

---

Epidemiologic studies have shown that caris or "infective damage of hard tissues in teeth" are the most common type of infection in human. In Iran, a few studies have investigated this hygienic problem, but no practical results have been defined yet. In this research, the conditions of the first upper and lower permanent molars (it contains four minor variables), have investigated. For this reason, in a descriptive analytic study, which was of retrospective and cross- sectional type, one thousand files were chosen systematically. The data were analysed by SPSS packages. The mean values of DMFT for permanent first molars were 3.47±0.50 (MT-1.23, FT=0.86, DT-1.38). The number of extracted teeth in mandible was moer than maxilla and the number of untreated caries teeth in maxilla was more than mandible (PO.001). DMFT ratio of the first molars to total DMFT, was approximately 29%, which indicates that caries and that complications on the first molars, make the main part of the overall DMFT. Therefore, hygiene training, preventive methods and the improvement of ecomonical status seem necessary in dental services.

---

Composite resin restorative materials, that nowadays are used as tooth-colour materials, have both benefits and weaknesses. One of these weaknesses is the contraction resulted from resin polymerization which influences on the composite dentin bond strength and it has been tried to be eliminated by different bonding systems. The aim of this in-vitro study was to compare the dentin bond strength of two dentine adhesive systems: multi-step Scoth Bond Multipurpose (SBMP) and single- step Excite, by two composites of Ideal Makoo and Tetric. One hundred sixty (160) sound human molars were selected. At first they were debrided and mounted with acrylic resin in molds. The enamel of the buccal surface was eliminated by diamond burs. To provide a flat dentin surface, it was removed about lmm. Then, based on the type of dentin adhesive, they were divided into two groups of 30 teeth and were applied on the exposed dentine surface according to the manufacturer's instructions. Then, each group was divided into two subgroups of 15, based on the type of composite resin. Cylinders of the desired composite resin, attached to the dentin surface, were used for 80 seconds. The samples were stored in 100% humidity (37°c) for 24 hours. The bond strengths was measured by a cross head blade with the speed of 2mm/min. Variance analysis and Duncan test, with 95% confidence level, showed that statistically, two factors of adhesive and composite, interact on each other, in bond strength. There was no significant difference in bond strength, between two composites with similar adhesives, however, comparing two different adhesives with the same composite, showed that the bond strength of Tetric with Excite (28.39) was more than that of SBMP (17.98 Mpa). Finally, it was recognized that among four experimental groups, there was only a significant difference in bond strengths, between Tetric-Excite with Tetric- SBMP. This study shows that dentin bond strength is influenced by dentin bonding agents, composite type and dentin structure, and using a type of composite with a dentin bonding agent, manufactured by the same company, results in a higher bond strength.

---

The differential diagnosis between pleomorphic adenoma, the most common salivary gland neoplasm, microscopically, and two other common salivary gland neoplasms, meaning adenoid cystic carcinoma and mucoepidermoid carcinoma, is difficut.The purpose of this study was to determine the differences between pleomorphic adenoma, adenoid cystic carcinoma and mucoepidermoid carcinoma regarding the staining intensity with PTAH and H&E and also to investigate the relationship between staining intensity with PTAH and malignancy grade in mucoepidermoid carcinoma. 72 paraffin embeded samples including 24 pleomorphic adenoma, 24 adenoid cystic carcinoma and 24 mucoepidermoid carcinoma were selected and stained with PTAH. The staining intensity in total, in nucleus and cytoplasm of tumoral cells were evaluated and compared with H&E staining, statistically. The results were analyzed by Kruskal-Wallis, and Wilcoxon signed ranks tests (P<0.05).The logistic model was presented to predict the degree of malignancies through the assessment of nucleus and cytoplasm staining intensity in tumoral cells, and the patient's age. In this study, a statistically significant relationship was observed between staining intensity by PTAH and H& E in nucleus of tumoral cells in pleomorphic adenoma. Moreover, statistically significant relation between staining intensity by PTAH and H & E in cytoplasm of tumoral cells in adenoid cystic carcinoma was found. But there was no relation in other cases. On the other hand, a statistically significant relation between intensity of staining in total, in nucleus and cytoplasm of tumoral cells and the type of tumor was found. No relation was obtained between malignancy grade of mucoepidermoid carcinoma and staining intensity in total, in nucleus and cytoplasm of tumoral cells. The presented logistic model indicated a direct relation between tumor malignancy with patient's age and staining intensity in nucleus of tumoral cells, but a reverse relation was found between cytoplasm staining intensity in tumoral cells and tumor malignancy.Our findings show that PTAH and H & E staining methods, lead to similar results, however, PTAH staining is a reliable method in differential diagnosis of such salivary gland tumors.

---

Statement Problem: A few studies have been conducted about bioglass posts.
Aim: The aim of this study was to compare bioglass posts with prefabricated metallic posts in clinical performance of extensive composite restorations for anterior endodontically treated teeth.

Materials and Methods: Sixty endodontocally maxillary anterior teeth, with horizontally or vertically destruction, were selected. Teeth were divided into two groups based on the kind of post: Metallic prefabricated parapost and bioglass post. Each group was divided into three subgroups based on anterior bite: normal, deep bite and edge to edge. Gutta-percha was removed from 2/3 of canal length for parapost and 1/3 for bioglass post. After etching with phosphoric-acid (37%) and applying dentine bonding syntac, Duo cement was used for the adhesion of bioglass post and a self cured composite (Degufil) for parapost. Restoration was done with a hybrid composite (Heliomolar). Follow up studies, radio-graphically and clinically, were done every three months for a 1.5-year period. Exact Fisher and Pearson tests were used for data analysis.
Results: Apical lesion was not observed in any of the radiographs. Post seal was increased by resin cement and dentin bonding agent. Post type did not significantly affect on the clinical success rate of the restorations. The retention of restoration, for both posts, was the same. Crown destruction had no significant effect on success rate. The type of anterior bite had a significant effect on success rate, as the total 6.6% failure rate was related to the patients with anterior deep bite.
Conclusion: It is suggested to use metallic paraposts and bioglass posts, in extensive composite restorations for patients with deep-bite, more conservatively.

---

Statement of Problem: Menopause can exert extensive somatic and psychological effects on women at this stage including: oral complaints such as dry mouth, glossodynia, viscous saliva, although these findings should be studied further.
Purpose: The aim of this study was to investigate the stimulated salivary flow rate of 158 menopause and post menopause women.
Material and Methods: In this cross- sectional and analytic- descriptive study, 158 women, at post menopause stage, were selected as case group. The controls consisted of 83 same aged men. None of the subjects had any systemic disease and did not use any drugs. Age range, in both groups, was 50-69 years old. Psychical condition of two groups, were compared by HADSCALE test. Oral symptoms were also compared and evaluated. In order to analyze the results, "t" and "Mann- Whitney" tests were used.

Results: No significant difference was found between two groups regarding the quantity of stimulated saliva and psychological condition, but the incidence of oral symptoms in case group was significantly higher than the control group (P=0.002).
Conclusion: Based on this study, although oral symptoms have a significant relation with menopause, can not be attributed to the quantity of saliva or psychical condition. In order to find the underlying reasons, more investigations should be performed on quality changes of saliva or other factors.

---

Statement of Problelem: Lichen plannus is a relatively common mucotanous disorder, due to accompanying burning sensation and pain in addition to its malignant transformation, has potential importance. On the other hand, B and C hepatitis are of the five most common death causes, resulting in significant disease spread problems among dentists. As a result, the relationship between these two disorders has been recently investigated.
Purpose: The aim of the present study was to investigate the oral Lichen plannus prevalence among patients with B and C hepatitis.
Material and Methods: In this case series study, 500 patients with B, C hepatitis, 3 04 female and 369 male with the mean age of 39.09±13.13 (the youngest was 4 and the oldest was 72 years old), who referred to the hepatitis center of Shariati hospital, Transfusion organization and Hemophilia center, from August 2001 to August 2002, were evaluated. The information about all white lesions that couldn't be scraped was recorded on a questionnaire for each patient. To analyze the data, t and Fisher tests were used.
Results: Two hundred and eighty nine patients were MBS Ag" 223 were HCVAb", 12 were positive for both types of hepatitis and 23 were cyrotic. From among these patients, 3 subjects were with oral Lichen plannus (0.6%), one belonged to HBS Ag1 group (0.35%), (P=0.38) and two patients belonged to HCV Ab' (0.9%),(P=0.44). These results showed no statistically significant relationship between Lichen plannus and B, C hepatitis. Two cyrotic patients from among 23 were with LP, which statistically was significant (P<0.05).
Conclusion: All patients with LP should be tested for B, C hepatitis and liver enzymes.

---

Statement of Problem: Dental practices such as oral, periodontal and endodontic surgeries cause damages to the intraoral tissues, so having knowledge of the dental procedures that necessiciate endocarditis prophylaxis is of high importance.
Purpose: The aim of the present study was to determine the knowledge level of dental senior students in Tehran dental faculties about endocarditis
Materials and Methods: In this cross- sectional descriptive- analytic study, 253 senior students of four dentistry faculties in Tehran took part as follows: Tehran University: 71 students (M:42, F:29), Shahid Beheshti University: 74 students (M:40, F:34), Shahed University: 35 students (M:35, F:38), Azad University:73 students (M:35, F:38). The questionnaire used in this research consisted of three parts as follows: part one:
information on cardiac diseases, part two: dental procedures requiring endocarditis prophylaxis, part three:antibiotic diet in endocarditis prophylaxis. Sex and place of education of the students were also studied in detail. For statistical analysis, Chi-square test was used.
Results: On the basis of the sex, the correct answers of the female respondents of different universities wereranked as: Azad University: 72.5%, Tehran University: 71.1%, Shahid Beheshti: 57%, ShahedUniversity:55.7%. In the same way, the male respondents were reported as: Tehran Universitys: 71.6%, Azad University:66.2%, Shahed University: 57.3%, Shahid Behesti University: 52.1%, On the basis of the place of education,the following results were reported: Tehran University students managed to answer 71.3% , Azad University,Shahed University and Shahid Beheshti University students could answer 69.5%, 56.5% and 54.6%,respectively. All these differences were statistically significant, indicating that first ranked students have more information than the students of other schools.
Conclusion: It is recommended to develop more practical training programme in dental schools on cardiac
diseases, dental procedures requiring endocarditis prophylaxis and antibiotic diets.