Journal of Dental Medicine

Normal 0 false false false EN-US X-NONE AR-SA As special microbial species are identified as etiologic factors for periodontal diseases and since conventional periodontal treatments could not eliminate these factors, Using Antimicrobial agents as alternatives to prevent  post operation  infections seems essential. In This study Phenytoin (Gel 10%) was used as an topical antimicrobial agent in periodontal surgeries. 21 patients with advanced periodontal disease were selected. Sampling was carried out before and after the surgery. The results showed that phenytoin can act effectively on gram positive and negative cocci while this concentration was not effective to eliminate opportunistic gram negative bacilli.

Guided Tissue Regeneration (GTR) is the most recent and common method for regeneration of class II forcation molars. However, it requires membrane, which seems expensive for most of the patients. In order to overcome this problem, Coronally Position Flap (CPF) procedure may be applied which arresting the epithelial cell down growth, follow the same aim. This study is aimed to compare GTR technique utilizing bioresorable collagen membrane and CPF utilizing citric acid. Nine patients with grade II forcation defects were selected. Defects were bilateral that randomly assigned into two groups: GTR and CPF groups. Measurements recorded at baseline and after surgery (6 months). Paired-T test was performed on these data. The following results were obtained after 6 months: In both groups significant reduction in probing pocket depth were measured in GTR and CPF groups, 1.55 Ind 1.88 mm, respectively. Also, open vertical probing depth: 0.33, 1.11 mm. Reduction in forcation weight in both groups was 0.22 mm. Bone fill was observed in 0.33% and 51% of defects. No recession was observed in GTR group, in CPF was 0.11 mm. Loss of attached gingiva was 0.34 and 0.78 mm, respectively. No significant difference was found between clinical parameters except OHPD. Comparison of means at the day (0 and 180) in each group showed the success for regeneration of forca. Considering the results, it can be concluded that CPF may substitute for GTR technique.

Statement of Problem: One of the problems associated with the treatment of periodontal diseases is caused through the extension of disease toward furcation area. Several techniques in Conservative, Resective and Regenerative categories have been suggested for the treatment of furcation involvement.
Purpose: The aim of this study was to compare the results of the treatment of grade II furcation involvement in mandibular molars using an allograft material named 'Dynagraft' (a type of demineralized bone matrix) and the coronally positioned flap.

Materials and Methods: In this randomized controlled clinical trial study, twelve patients (9 females and 3 males), aged 25 to 40, suffering from bilaterally grade II furcation involvement of mandibular molars who referred to dental faculty Tehran University of medical Sciences, were investigated. The molars of one side were treated by Dynagraft whereas those of the opposite side underwent the CPF method. Measurements of the probing pocket depth (PPD), clinical attachment level (CAL), keratinized gingiva (KG) and horizontal probing depth (HPD) were recorded at baseline, 3 and 6 months after surgery. In order to investigate the bone radiographic changes, radiovisiography at the mentioned periods in addition to clinical investigation, were performed. For statistical analysis, Paired West was used.
Results: The mean PPD reduction three months and six months after the operation were 1.75 mm and 2.25mm, respectively in the Dynagraft (test) group whereas 1.26mm and 1.27mm in the CPF (control) group (P<0.005). The mean attachment gain three months and six months after the operation were 1.1 mm and 1.5mm respectively in the test group, and 0.2mm and 0.3mm in the control group (P<0.005). The mean KG reduction three months and six months after the operation were 0.5mm and 0.6mm respectively in the test group and those of the control group were 1.1mm and 1.1mm. The mean HPD reduction three months and six months after the operation were 1.55mm and 2mm respectively in the test group (P<0.005) and 0.55mm and 0.55mm in the control group (PO.01). Radiovisiography of the mentioned areas three months and six months after the operation confirmed the changes obtained from clinical measurements, showing appreciable reconstructive results (Bone filling) in the test group as compared with the control group. Moreover, root resorption was not observed.
Conclusion: Based on the results of this study, Dynagraft can be used as an appropriate material in the treatment of grade II furcation involvement in mandibular molars. However, for a through evaluation of such regenerative techniques in furcation involvement, further studies with larger population and long term follow up in addition to histologic studies are suggested.

Statement of Problem: Hemodialytic patients may be exposed to periodontal diseases during treatment. No information of any kind is available regarding the periodontal treatment needs of such patients.

Purpose: The aim of the present study was to determine the periodontal treatment needs of hemodialytic patients, living in Tehran, to be presented to the public health system.

Materials and Methods: In this descriptive study using CPITN index 75 patients according to multi-stage sampling method and in proportion to the number of patients in Tehran were selected. Following necessary training, qualified subjects were chosen and a special questionnaire was completed for each using personal protection, CPITN index, by WHO prob, was examined and numbered according to (0-4) codes. Results: The findings showed that 10.6% of the patients had normal periodontal status (Code-0), 12% of the patients had bleeding upon probing (code-1), 21.4% had calculus (Code-2), 21% of the patients had shallow pockets (Code-3) and 24% had deep pockets. It was also shown that 89.4% of the patients needed oral hygiene instruction, 77.4% needed scaling and 24% required advanced periodontal treatments whereas only 10.6% did not need any treatment.

Conclusion: No statistically significant relationship was found between periodontal status and factors such as age, sex, the history of hemodialysis treatment and level of patients’ education.

Background and Aim: Intrabony periodontal defects are important problems in periodontology and up to now several ways have been suggested for their treatment .Treatment with enamel matrix derivatives (EMD) has been shown to enhance periodontal regeneration. There is limited information available from clinical trials regarding the performance of EMD in the treatment of periodontal intrabony defects. This study was designed to compare the clinical and radiographic effects of EMD treatment to that of open flap debridment (OFD) for two and three walled intrabony defects.

Materials and Methods: 18 patients were included in this clinical trial which have 24 two and/ or three intrabony defects. Defects were randomly divided into two groups (test and control). Defects in test group were treated with flap surgery plus EMD and in control group with open flap debridment. At baseline and at 3 and 6 months follow up, clinical and radiographic measurements were performed. Data were analyzed using Greenhouse-Geisser test with p<0.05 as the limit of significance.

Results: At 3 and 6 months, mean probing pocket depth reduction was greater in the test group (EMD) (4.33 mm and 4.70 mm) compared to the OFD group (2.54 mm and 3.09 mm). Mean values for clinical attachment gain in the EMD group after 3 and 6 months were 4.29 mm and 4.98 mm, and in OFD group were 2.83 and 2.82 mm respectively. Radiographic bone gain measured by radiovisiography technique was greater in the EMD group compared to the OFD group (4.66 mm in EMD and 1.11 mm in OFD group after 3 months and 5.78 mm in EMD and 1.39 mm in OFD group after 6 months).

Conclusion: Based on the results of this study, treatment with flap surgery and EMD compared to open flap debridment, produced more favorable clinical improvements in two and three walled intrabony defects.

Background and Aim: In spite of the achievements in the field of dental adhesives, we are facing challenges with dentine bonding resistance, strength and stability. According to recent studies the role of MMP inhibitors in association with bonding^,s persistence and leakage reduction and restoration^,s persistence is important. The aim of this study was to investigate the effect of doxycycline as a MMP inhibitor on the degree of conversion (DC) of an experimental dental adhesive.

Materials and Methods: In this experimental study, a new dental adhesive blend was prepared by mixing doxycycline monohydrate (in concentrations of 0.0, 0.25, 0.5, and 1 wt.%) with monomers. The monomers were composed of 12% Bis-GMA and 10% TMPTMA, 28% HEMA, and 50% Ethanol by weight for all groups. Comphorquinone and amines were chosen as photo initiator system. Degree of conversion of all adhesives was measured using FTIR spectroscopy. The results were analyzed using one-way ANOVA and Tukey post hoc tests.

Results: The results showed that addition of 0.25, 0.5, and 1 weight percent doxycycline did not significantly reduce the DC of the adhesives compared to 0.0% control group (p>0.05%).

Conclusion: According to the results of this study, adding doxycycline to the adhesives did not adversely affect the DC.

Background and Aims: In spite of the advances achieved in the field of dentin adhesives, the longevity of bond to dentin is still a challenge. According to recent studies, Matrix Metaloproteinase (MMP) inhibitors can increase clinical longevity of bonding and decrease leakage. The aim of this study was to evaluate the amount and pattern of doxycycline release from an experimental dentin adhesive containing this MMP inhibitor.

Materials and Methods: In this experimental study, specimens containing 0.25 and 0.5 loading percent of doxycycline in an experimental monomer were prepared in cylindrical moulds of 12 mm diameter and 2 mm thickness. The adhesive monomer was composed of 12 wt% Bis-GMA, 10 wt% TMPTMA, 28 wt% HEMA and 50 wt% ethanol. Camphorquinone and amine were used as initiators.

Results: Addition of 0.25 and 0.5 w% doxycycline showed linear release in both groups. Increasing the loading percent of doxycycline caused more release. The release continued during the test period.

Conclusion: Doxycycline release was observed from the experimental adhesive. Further studies in this field will help in preparing adhesive systems with more clinical longevity.

Background and Aims: Evaluation is a continuous process which is necessary for improvement of students learning and planning for required changes to obtain the educational objectives. The aim of the present study was to assess students' perspective on the achievement of the educational objectives of the Community Oral Health and Periodontology Departments using the CIPP model of evaluation.
Materials and Methods: A cross-sectional survey has been conducted using a questionnaire consists of four domains as introduced in the CIPP model of evaluation (Context, Input, Process and Product). Two groups of senior dental students of the dental school of Tehran University of Medical Sciences were approached. Data was collected anonymously and was analyzed with non-parametric Mann-Whitney test using the SPSS statistical package.
Results: The response rate was 67.7% for year 6 and 87.5% for the year 5 students. Respondents considered material presented in Periodontology Department more relevant and in need for their future career. However, teaching skills and motivation of the educators in Periodontology Department was considered inadequate. 67% of students reported having problem with material taught in Periodontology Department. Overall, significant difference in domains of Context and Process was observed between two departments (p<0.05). In the output domain students rated their clinical and theoretical ability "weak" in relation to splint, implant, management of acute gingivitis and electrosurgery compared with other topics which rated "good". Students considered their ability in using the principals of Evidence-Based Dentistry moderate.
Conclusion: The evaluation of the educational achievements of the two departments (COH and Periodontics) using CIPP model of evaluation showed that there is significant difference in two domains (Context and Process). In those topics which achievement was reported weak the revision of teaching methods is recommended.
Key Words: Education dental Program evaluation Self-evaluation

Background and Aims: Approximately 5% of cancers involve structures of oral cavity. Partial resection of maxilla (maxillectomy) may be performed in these cases. Maxillectomy often results in significant functional disabilities such as inability in mastication, deglutition and speech with adverse impact on psychological status and social life of patients. Obturator prosthesis is a prosthodontic treatment to separate nasal and oral cavities and restore the critical above mentioned functions. The assessment of speech is considered to examine speech function restored by the treatment. The purpose of this study was to evaluate the speech in patients with resected maxilla who have been treated by obturator prosthesis from a pool of related patients in the Prosthodotnics department of dental faculty, Tehran University of Medical Sciences. The evaluation was performed with computer software using sentence intelligibility (SI) test.

Materials and Methods: This cross sectional study was conducted on 10 subjects (23-66 years) referred to the Prosthodontics department of the faculty and received an obturator. After primary examination of the prosthesis, the patients completed SI test in an acoustic room under guidance of a speech therapist. The performed tests were analyzed by the speech therapist. In addition, the SI with and without the prosthesis was evaluate by lay audience. The statistical analyses were performed using Wilcoxon-signed rank test and Weighted Kappa.

Results: Significant differences were found between SI tests with and without the obturators (P<0.001). Two of 10 patients showed problems in speech function using obturator.

Conclusion: Within the limitations of the present study, obturators had significant effect on improvement of the speech outcomes of examined patients. Improvement of the quality of life could be predicted.

  Background and Aims: The increase in the number of complex implant cases has drawn the attention of researchers toward materials having bone regeneration promoting ability. Socket preservation and bone graft are recommended to minimize bone resorption. The aim of this study was to evaluate a kind of xenograft collagenic bone (osteo biol gen_oss) in socket regeneration.

  Materials and Methods: This randomized clinical trial was performed in 12 cases (6 in test and 6 in control groups) with two hopeless teeth. After tooth extraction, in test group, graft material was put in sockets but in the control group the socket was healed naturally. Three months later, during implant placement the specimens from both sites were sent to a pathologist for histologic and histomorphometric evaluations. Data were analyzed using Mc Nemar and Wilcoxan sigh rank test (α=0.05).

  Results: There were no significant differences between two groups in foreign body reaction, inflammation, bone vitality and percentage of bone gain. Average percentage of residual graft in test site was 6.73±1.43.

  Conclusion: Osteobiol gen_oss xenograft is an appropriate biocompatible osteoconductive material that promotes bone regeneration at 3 months following socket preservation in human extraction sockets.