Journal of Dental Medicine

  There is lack of consensus among endodontic specialists about the necessity of tug back. In this regard, we designed a study in which 44 single rooted teeth with closed apex were selected and filed up to file #50. The teeth were obturated with lateral condensation method while in half of them there was not any tug back and in the other half tug back was achieved. Apical leakage was assessed by color infiltartion via microscope. The obtained results showed significantly lower infiltration in tug back group which leads to a direct relation between tug back and color infiltration although due to statistical analysis, this relationship was not reliable and needs further proofs.

Background and Aim: Oral health is a sign of overall health. Sometimes fear of dental office deprives  patients from receiving proper care. This problem decreases the self-esteem of dentists and can also reduce health indices. Understanding anxiety factors may help solve this problem. The purpose of this study was to assess anxiety in patients undergoing treatment in dental offices in the city of Hamedan.

Materials and Methods: In this analytic cross sectional study patients above 9 years old and referred to general dental offices in Hamedan were randomly selected and surveyed with questionnaires in two stages. The first questionnaire included 17 standard items based on Dental Anxiety Scale (DAS) and screened anxious patients. Then 400 anxious patients were evaluated with a questionnaire of 64 items based on Corah scale. Data were analyzed by SPSS 13 with multivariate analysis of variance. P<0.05 was considered as the level of significance.

Results: Factors related to dental office environment with 31.1%, those related to personal imaginations with 19.4% and factor concerning office management and dental treatment each with 19.1% frequency showed to be most related to anxiety in patients. Improper rest-rooms (46.3%), blood stains in the environment (44.5%) and dirty dentist's gowns (43.8%) were reported to be the most prominent environmental factors. Among the factors originated from personal imaginations, the risk of disease transmission was accounted for the most justifiable source of anxiety (67.3%). Regarding factors concerning office management, dentist's nervous behavior (47.8%) and his carelessness to the patient (46.8%) were considered as the most significant anxiety sources. Extraction, injection and root canal therapy (48.3%, 44.5%, 44.3%) were the treatment related factors of higher importance respectively. Previous painful treatment experience (47.3%) and poor oral hygiene of the dentist (34.5%) were reported to be among the other justifiable anxiety sources. In all mentioned situations, variations in anxiety factors were significantly higher in women.

Conclusion: This study showed that the main cause of anxiety in patients undergoing treatment in dental offices in Hamedan is their personal imagination which is by far more obvious in women than men.

 The goal of each root canal therapy is cleaning and obturating the entire root canal system. A thorough knowledge of root and root canal morphology and a good anticipation of their possible morphologic variations are essential and will help to reduce endodontic failure caused by incomplete root canal preparation and obturation. In this study, one case of maxillary molar with two palatal roots has been reported in a a 40-year-old woman is reported..

Background and Aims: It is important to use intracanal medicaments in teeth with necrotic pulp. Calcium hydroxide is the intracanal medicament of choice in such cases. Also, Mineral Trioxide Aggregate (MTA) is a suitable root canal filling material because of its favorable characteristics. MTA can be used in some cases where calcium hydroxide is used. The purpose of this study was to evaluate the Ca++ and OH ˉ diffusion through root dentin using calcium hydroxide paste and two different brands of MTA as root canal filling materials.
Materials and Methods: In this in vitro study, the root canals of 52 single-rooted teeth were instrumented and shaped. External defects were created on the middle one-third of the root surface. 17% EDTA and 5% NaOCl were used to remove the smear layer. All surfaces except the external defects were sealed and the teeth were placed in normal saline. Ten teeth were selected as the control group. Forty-two remaining teeth were divided into three groups of 14 teeth each (A,B, and C groups). ProRoot MTA was placed in group A. Angelus MTA was placed in group B and Calcium hydroxide paste was placed in group C. After sealing the coronal access, all specimens were placed in normal saline solution. Ca++ concentration and pH were determined after 24 hours, 48 hours and one week in all groups. The data were analyzed with Repeated Measure ANOVA and Pair T- tests.
Results: Ca++ release and pH in group C was significantly higher than those in groups A and B in all time periods (P<0.001). The difference between groups A and B was not significant (P>0.05).
Conclusion: The results of this study indicate that in necrotic cases with lesion which MTA is indicated (open apex and perforation), calcium hydroxide might be better used as an intracanal dressing before using MTA as a permanent filling material.

Background and Aims: Apical root resorption is an adverse side effect of fixed orthodontic treatment which cannot be repaired. The aim of this study was to use panoramic radiographs to compare the root resorption before and after the orthodontic treatment with standard edgewise .018 appliance.

Materials and Methods: The before and after treatment panoramic views of sixty-three patients needed fixed orthodontic treatment included 1520 teeth were categorized into 3 Grades (G0: without resorption, G1: mild resorption with blunt roots or ≤ 1/4 of root length, G2: moderate to severe resorption or > 1/4 to 1/2 of root length. Relationship between root resorption and sex and treatment duration was analyzed with Mann-whitney and  Spearman's correlation coefficient, respectively.

Results: The findings showed that 345 teeth were categorized as Grade 1.  Grade 2 of root resorption was not found in this study. The highest amount of root resorption was recorded for the mandibular lateral incisor. In both gender, the root resorption of the mandible was more than that of the maxilla. The males showed significantly higher rate of resorption than the females (P<0.05). Root resorption was not significantly related to the treatment duration and the side of the jaws (P>0.05).

Conclusion: The mandible and male patients showed higher amount of root resorption. In addition, root resorption was not related to the treatment duration and the side of the jaws.

Background and Aims: Soy milk in competition with other drinks introduced as healthy and nutrient drink. Nowadays, most important tendency to consume soy milk is new extended developments to produce soy milk with more acceptable taste and is believed that soy milk is a good substitute for bovine milk in lactose-intolerant people. Cariogenic potential of bovine and soy milk is a subject for lots of researches in the last decade. The aim of this study was to evaluate the effect of soy and bovine milks on the pH changes of dental plaque.

Materials and Methods: In this study, 10 healthy dental students in age range of 25-35 were selected after written consent upon study entrance criteria's such as, amount of saliva streptococcus mutans, amount of lactobacillus, salivary secretion rate, buffering capacity of saliva, absence of active dental caries, absence of systemic disease and etc. Dental plaque pH in the interproximal areas of 2nd premolar and 1st molar in all 4 quadrants was taken by Metrohm micro electrode and digital pH meter before (0) and at 2, 5, 7, 10, 15, 20, 30, 40, 50 and 60 min after taking with 3 tested materials (soy milk, plain milk 1.5% and 10% sucrose solution as a positive control). Then pH curves were drawn according to the time of each test product. In this study, using pH=6 was considered as critical pH. Maximum pH drop and ∆pH after taking 3 tested materials were analysed Repeated measure ANOVA (P<0.05).

Results: According to the test materials, the lowest pH was after rinsing with 10% sucrose solution following soy milk and in the last was 1.5% bovine milk. All the test materials showed significant differences among each others
(P<0.05).

Conclusion: Bovine milk in none of frequent timing dropped its pH below basic pH but also significantly increased the plaque pH above the critical pH. The maximum pH drop for soy milk was in 2minutes after consumption but it never reached below the critical pH.

Background and Aims: Type 1 diabetes mellitus, is the most common metabolic disorders in children and adolescents. The aim of this study was to assess the state of oral health in children with type 1 diabetes compared with healthy children in 2013-2014 in Hamadan province, Iran.

Materials and Methods: The specimens were selected through convenience sampling in two groups. Group one consisted of 80 individuals (5-18 years old; case group), suffering from type 1 diabetes mellitus referred to the Pediatric endocrine clinic. Control group consisted of 80 non-diabetic healthy children who were out- patients of pediatric and orthodontic department of Hamadan dental school. Two groups were similar in age and sex. The data were collected through a questionnaire, medical records and clinical examination. DMFT, dmft, GI and PI indices were assessed in each patient. Data were analyzed using ANOVA and T-test.

Results: In spite of similarity in oral hygiene habits in both group, there was no significant difference in mean DMFT and permanent decayed teeth in both groups (P>0.05), but the mean dmft (P<0.008) and primary decayed teeth (P<0.011) in the control group was significantly higher than that of the case group. Also, diabetic patients had significantly more gingival inflammation (P<0.05). The mean PI in the two groups did not differ significantly. Oral hygiene habits were similar in both groups but diabetic patients were significantly referred to dentists with lower frequency then that of control group (P=0.00).

Conclusion: The devastating effects of diabetes on the oral health, along with other side effects can be effective in promoting tooth decay and gingivitis in diabetic patients. Unfortunately, oral health care and programmed dental visit were not the priority for the diabetic patient (and parents) involved in our study. Therefore, programs to increase awareness and encourage patients for a better control of their oral health in order to diminish diabetes' devastating effects is recommended.