Journal of Dental Medicine

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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.

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According to different studies - especially geometric ones - different factors have been proposed that can affect horizontal dimension parameters. The aim of this study is claimed on the title. The study is of a descriptive and cross- sectional type.Fourteen lateral cephalogerams were selected to the sample consisted of 21 boys and 19 girls with the mean age of 9.83 years who suffered from different skeletal & dental malocclusion and were selected by simple sampling method.The linear parameters of wit's and wylie (which depend on occlusal & FH planes), the harvold parameter (which is independent of reference planes) & the proportional parameter of Schwartz were selected & their correlation with angular parameter of ANB were evaluated.

The results showed:1- All of the horizontal analyses showed statistically significant correlation.2- The ANB parameter showed high correlation with wit's, wylie, harvold & shawartz analyses and the correlation between ANB & wit's was higher than others.

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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.

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: 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.

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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.

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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.

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Electromyographic (EMG) investigations about the activities of the muscles have been the focus of attention for many years. In the field of orthodontics, investigators, among other things, tried to evaluate correlation between EMG activity, occlusal relationships and craniofacial morphology to analyze the effect of muscular activity, as an etiological factor in malocclusion. The purpose of the present investigation is to analyze the effect of EMG activity of temporal and masseter muscles quantitatively in skeletal class III malocclusion. 26 patients (9 to If years old), with class III malocclusion were selected and their EMG activity of temporal and masseter muscles in rest position, centric occlusion, clenching, mastication and swallowing were compared with 20 normal children at the same age range. Then the statistical correlation between 13 cephalometric parameters and EMG activities were analyzed and then the regression analysis was performed and the results were as follows:
1- The mean amplitude of masseter and temporal muscles activity in rest position, centric occlusion, mastication, and clenching in class III samples were greater than normal group (PO.05).
2- The mean duration of masseter and temporal muscles activity in rest position and centric occlusion in class III samples were more than normal group (PO.05).
3- According to regression analysis, a linear correlation was observed between ANB angle and temporal muscle activity in rest and centric occlusion that was not observed in other cases.
The findings of this study showed that difference in temporal muscle activity in class III malocclusion, in comparison with the normal group, is correlated with skeletal morphology of the face, but according to other investigations it is not ture for the masseter muscle.

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Conventional cephalometric analysis, based on intracranial reference line SN and Frankfurt plan, sometimes leads to incorrect diagnostic findings and unpleasant theraputic results, especially in orthosurgery patients, mainly due to the instability of the mentioned references. Natural head position (NHP) is the standardized orientation of the head that its record in lateral cephalometric radiographs, provides us with extracranial references. The aim of this study is to evaluate the necessity for providing a lateral cephalogram in NHP for diagnosis and treatment of severe malocclusion (orthosurgery) in comparison with mild to moderate malocclusions. For this reason, 28 orthodontic and 26 orthosurgery patient's cephalograms, in natural head position, were selected. Diagnosis and treatment planning were based on clinical evaluation and cephalometric analyses especially Harvold and Tweed ones. Each group, based on their growth pattern, was divided vertically and horizontally. The angles between SN and TH planes with TH (True vertical Sine) were measured. Then, the correlation between the angles in two groups and also in relation to the severity of malocclusion, were analyzed in vertical and horizontal directions. The results of two groups were compared by the independent t-test. The findings of this study showed that:1- The SN line was found to be more inclined than FH line and in orthodonthic patients, FH plan is a more reliable reference than SN.2- In orthosurgery patients, the SN-TH and FH-TH angles were strongly different statistically.3- Variation in SN-TH angle, in patients with vertical growth pattern, was high in both groups of patients.These conclusions prove the necessity of a lateral cephalogram in NHP for all orthosurgery patients and those orthodontic patients with vertical growth pattern.

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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.

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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.

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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.

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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.

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Statement of Problem: Musculoskeletal disorders (MSDs) are major parts of the occupational diseases in workplaces. Protection from such diseases is dependent on assessment and improvement of job postures by using job analysis methods in ergonomics.

Purpose: This study was aimed to evaluate ergonomic conditions in dental professions by rapid entire body assessment (REBA) in Birjand city and also to assess the relation between MSDS in different parts of the body and work conditions.

Materials and Methods: This study was a descriptive-analytical approach performed on 48 persons working at different professions by using REBA method. The prevalence of MSDs was obtained by using Nordic Musculoskeletal Questionnaire (NMQ). The data were analyzed by independent t-test, Chi-square and Fisher tests with P<0.05 as the limit of significance.

Results: In this investigation, the prevalence of disorders for different parts of the body was as follows: 65% for neck, 60% for back, 38% for shoulders, and 31% for wrist. These disorders were higher in women than men except for the back. There were significant correlation between disorders of femur and foreleg with work history, ankle and sole with body mass index (BMI), and MSDs with work conditions (P<0.05).

Conclusion: It is concluded that the work conditions and postures need to be improved. In addition the level of dental professional education regarding biomechanical hazardous effects as well as correct work conditions and postures should be increased.

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Background and Aim: Pulpotomy is one of the routine methods for pulp therapy of primary teeth. At present it is a fact that ideal agent for this has not been discovered. The aim of this study was to compare the clinical and radiographic success rates of electrosurgical pulpotomy versus formocresol pulpotomy in human primary molar teeth.

Materials and Methods: In this clinical trial study, pulpotomy was performed on 68 primary molars in children aged from 5 to 10 years. The teeth were treated using either a conventional formocresol (35 teeth), or electrosurgical technique (33 teeth). Following the pulpotomy procedure, the teeth were evaluated regarding clinical and radiographic success for 3, 6 and 9 months periods. The teeth were evaluated clinically and radiographically for the presence of pain, abscess, fistula, mobility, internal and external resorption and radiolucency. Finally clinical and radiographic data were collected and analyzed with Fisher exact test using P<0.05 as the limit of significance.

Results: After 9 months follow up, the clinical and radiographic success rates for the electrosurgery group were 96% and 84% respectively and for formocresol group, 100% and 96.8% respectively. There were no statistically significant differences between the success rates for the two groups (P>0/05).

Conclusion: Although electrosurgical pulpotomy is a nonpharmacological and easy to use technique, further investigations with longer evaluation periods are suggested.

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Background and Aim: Many methods and techniques of canal preparation work well in large and relatively straight canals. However, in severely curved canals, the complexity increases markedly, and techniques rendering good results in usual cases may be unsuccessful. The aim of this study was to compare the effect of five root canal preparation techniques on original canal anatomy in simulated severely curved canals.

Materials and Methods: In this experimental in vitro study, 100 simulated canal blocks with similar hardness were made from polyester. The degree of curvature was 45º with a radius of 2.55 mm and a straight part of 8mm. The blocks were prepared with five different techniques (20 canals in each group) as follows: 1-Stepback 2- Passive step back 3- Balanced force using flex-R files 4- Balanced force using Ni-Ti hand instruments 5- Hybrid using a rotary Ni-Ti system (XtremRace). Digital photographs were taken from pre- and post instrumentation colored canals. Then images were superimposed and analyzed by an image editing software. The amount of removed material from the inner and outer canal walls was measured at five levels: 1-The canal orifice (O) 2-The halfway between the orifice and the beginning of the curve (HO) 3-The beginning of the curve (BC) 4-The apex of the curve (AC) and 5-The endpoint of preparation (EP). Additionally, the time of instrumentation, instrument failure and changes in working length were recorded. Data were analyzed by ANOVA and Kruskall-Wallis tests with p<0.05 as the limit of significance.

Results: Mean transportation was towards the outer aspect of the curve at the EP in all canals but there were no significant differences between the studied groups. At the BC point, all of the canals were transported towards the inner aspect of the curve and there were significant differences for both transportation values & direction among different groups. The highest amount of transportation was in step back and the lowest, in hybrid group. The highest transportation value was in step back and the lowest in balanced force group. Fractured and deformed instruments were observed in Flex-R files. The shortest canal preparation time was seen in XtremRace and the slowest, in Passive step back groups (P<0.001).

Conclusion: Based on the results of this study, changes in canal curvature were less with techniques using nickel titanium instruments and the fastest technique with least transportation was XtremRace.

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Background and Aim: Chin cup is an orthopedic appliance for treating growing skeletally Cl III patients. The amount of chin forward movement in addition to morphologic changes in bony structure, determines the final profile of treated patients. The aim of this study was to evaluate the amount of morphologic changes of symphysis after chin cup therapy in skeletally Cl III patients.

Materials and Methods: In this clinical trial, twenty eight cephalometries before and after chin cup therapy of 14 skeletally Cl III patients were analyzed. Landmarks introduced by Ricketts were determined to evaluate the symphysis and describe its relation to mandible. َAlso four additional measurements regarding the symphysis individually were evaluated and analyzed. Data were analyzed by paired t and pearson tests with P<0.05 as the level of significance.

Results: The results showed that the height of symphysis increased after treatment (P=0.02), but its depth decreased (P=0.04). The sysmphysis turned down and back.

Conclusion: These findings suggest that in Cl III malocclusions with a prognathic mandible, chin cup therapy creates changes in the horizontal dimension of symphysis morphology, which improves the Cl III profile. If the patient isn't a vertical grower, vertical changes of symphysis would be desirable. In addition, changes in the vertical dimension of the mandible (body and ramus) could be observed as a backward and downward rotation.

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Background and Aim: Three Dimensional obturation of root canal is one of the main goals of root canal therapy to preserve health or reach the regeneration or healing of periapical tissues. Root end filling materials are used in numerous situations to reach the mentioned goals. One of the common root end- filling materials is mineral trioxide aggregate (MTA) which the foreign and Iranian ones are different in their prices. The aim of this study was to compare the rat connective tissue reaction to Iranian and foreign MTA.

Materials and Methods: This was an animal study in which 40 rats were divided into 5 groups of each 8. The polyethylene tubes filled with foreign (Pro Root MTA) and Iranian (Root MTA) white MTA and were implanted in subcutaneous connective tissue. Similarly, the empty tubes were inserted in subcutaneous connective tissue as control group. The samples were examined histologically after 7, 14, 30, 60 and 90 days and were scored as followings: 0, was characterized to samples without inflammatory cells without inflammatory reaction 1, for samples with less than 25 inflammatory cells mild inflammatory reaction. 2, for samples with 25 to 125 inflammatory cells moderate inflammatory reaction and 3, for ones with more than 125 inflammatory cells severe inflammatory reaction. The data were analyzed using Kruskal-Wallis test and p<0.05 was considered as the level of significance.

Results: In general, inflammatory reactions were reduced in all groups. Experimental groups had moderate to severe inflammation in the 7th day which had significant difference with the control group having mild to moderate inflammation (p=0.04). There was not any significant differences between experimental and control group in 14th, 30th, 60th and 90th days (p>0.05).

Conclusion: Based on the findings of this investigation, inflammatory subcutaneous connective tissue reaction to Iranian (Root MTA) and foreign (Pro Root MTA) MTA was the same.

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Background and Aim: According to controversies in the prevalence of hypersensitivity to dental local anesthetic drugs and patients who claim hypersensitivity to these drugs, the aim of this study was to determine the prevalence of hypersensitivity to dental amide local anesthetic drugs in patients referred to Tehran Allergy Clinic in 2005-2007.

Materials and Methods: In this Study (Review of existing data), records of 130 patients who were referred to "Tehran allergy Clinic" (2005-2007) were studied.

Results: The average age of patients was 29.5±18.8 years. 34% of cases showed positive skin reactions to at least one of the tested Lidocain concentrations and 10% of cases showed positive skin reactions to at least one of the tested Prilocain concentrations. There was a statistically significant difference in hypersensitivity to Lidocain 0.01 and 0.001 (p=0.017) and also between Lidocain 0.001 and 0.0001 (p<0.01). There was no statistically significant difference between other tested drug concentrations (p>0.05).

Conclusion: Many patients with history of hypersensitivity, show positive reaction to local dental anesthetic drugs. Prilocain hypersensitivity reactions are less than Lidocain. So application of Prilocain accompanies with less risk but its application should not be considered completely safe.

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Background and Aim: The objective of this study was to measure and compare the tissue absorbed dose in thyroid gland, salivary glands, eye and skin in maxillofacial imaging with panoramic, conventional linear tomography, cone beam computed tomography (CBCT) and computed tomography (CT).
Materials and Methods: Thermoluminescent dosimeters (TLD) were implanted in 14 sites of RANDO phantom to measure average tissue absorbed dose in thyroid gland, parotid glands, submandibular glands, sublingual gland, lenses and buccal skin. The Promax (PLANMECA, Helsinki, Finland) unit was selected for Panoramic, conventional linear tomography and cone beam computed tomography examinations and spiral Hispeed/Fxi (General Electric,USA) was selected for CT examination. The average tissue absorbed doses were used for the calculation of the equivalent and effective doses in each organ.
Results: The average absorbed dose for Panoramic ranged from 0.038 mGY (Buccal skin) to 0.308 mGY (submandibular gland), linear tomography ranged from 0.048 mGY (Lens) to 0.510 mGY (submandibular gland),CBCT ranged from 0.322 mGY (thyroid glad) to 1.144 mGY (Parotid gland) and in CT ranged from 2.495 mGY (sublingual gland) to 3.424 mGY (submandibular gland). Total effective dose in CBCT is 5 times greater than Panoramic and 4 times greater than linear tomography, and in CT, 30 and 22 times greater than Panoramic and linear tomography, respectively. Total effective dose in CT is 6 times greater than CBCT.
Conclusion: For obtaining 3-dimensional (3D) information in maxillofacial region, CBCT delivers the lower dose than CT, and should be preferred over a medical CT imaging. Furthermore, during maxillofacial imaging, salivary glands receive the highest dose of radiation.

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Background and Aims: One of the common human evolutionary anomalies is dental Missing. Evolution of dental system is toward deduction of teeth number. The Missing of third molar is interesting subject for dentists and genetic researches because of its variety in different races. Consideration of bilateral effect of third molar Missing with jaw relation is an important subject. The aim of this study was to evaluate the third molar missing in Cl I and Cl II skeletal (without rotation) and comparison of them together.

Materials and Methods: The patients of the orthodontic department of school of Dentistry (Tehran University of Medical Sciences) were analyzed. About 121 patients had Cl I and 60 patients had ClI jaw relation. This relation identified based on cephalometric lateral radiographic ANB corner angle. Patient who had rotation in maxilla or mandible based on SN-Go Gn angle were excluded. The incidence of third molars agenesis in individual dentition quadrants, upper and lower jaw and right and left side of dentition was examined from panoramic radiography. AChi-square test was used for statistical analysis of data.

Results: Missing of one or more third molar in skeletal Cl I and Cl II was 43% and 33.3%, respectively. Missing of one or more third molar in Cl II was fewer than Cl I, but no statistically significant differences were seen between them.

Conclusion: There was not a direct relationship between jaw relation and third molar Missing.