Journal of Dental Medicine

Statement of Problem: In order to eliminate the esthetic problem of metal collar in porcelain fused to metal crowns various techniques, such as shoulder porcelain, have been suggested.

Purpose: The aim of this study was to investigate the effects of repeated porcelain firing cycles on the marginal integrity of shoulder in porcelain fused to metal crowns, made of two kinds of alloys: noble and base-metal.

Materials and Methods: In this experimental study, four groups of ten brazen models (Die) were used. Metal crowns of groups A&B were made of a noble alloy and those of C&D of a base-metal alloy. Groups A&C had the shoulder width of 1mm and groups B&D had the shoulder width of 1.5mm. After degassing and opaqing, shoulder porcelain was completed in the area of shoulder. At this stage, the average vertical gap of margin was measured by a reflective microscope (400). Data were analyzed using ANOVA and Duncan tests.

Results: No simoltaneouse interaction between the type of alloy and the shoulder width was found (P=0.709). The type of alloy had a significant effect on marginal integrity (P=0.021) attributing the best marginal integrity of shoulder porcelain to base-metal alloys. Shoulder width played also a significant role on marginal integrity (P=0.00) indicating that the reduction of shoulder width would increase the marginal integrity.

Conclusion: According to these findings, the best marginal integrity of shoulder porcelain is achieved through shoulder width of 1mm along with base-metal alloys.

Background and Aim: The goal of dental treatment is to improve oral hygiene, to maintain teeth and minimize the risk of diseases. Although data obtained from radiographs has distinct advantages to patients, the radiation side effects should be considered as well. FDA has developed a guideline for prescribing radiographs in the middle of the eighties. The aim of this study was to evaluate the reasons of ordering panoramic radiographs and their accordance with FDA guidelines in Tehran dental school.

Materials and methods: This descriptive study was carried out on 250 patients referred from different departments of Tehran dental school to radiology department for panoramic radiography. Chief complaints and clinical findings of patients were recorded in a check list and compared with the FDA guidelines prescribed.

Results: Our findings showed that prescription of panoramic radiographs were in accordance with FDA guidelines in 97.2% of cases.

Conclusion: Based of the results of this study, the trend of panoramic radiography ordering in the dental school of Tehran university is adequate. This may be attributed to the academic field of this study.

Background and Aims: Since there is a relationship between the tooth size and race, it seems that having statistical information about the tooth size in a society in which the orthodontic treatments are done, is very important. The aim of this study was to determine the relationship between the mesiodistal width of permanent incisors and first molars in both jaws with unerrupted permanent canine and premolars. New regression equations for prediction of the sum of mesiodistal width of canine and premolars were established.

Materials and Methods: A total of 715 dental casts (526 female, 189 male) were recruited from the department of orthodontics of Shiraz dental school and private offices of orthodontists for this cross sectional study. The greatest mesiodistal widths of all teeth were measured with digital caliper with accuracy of 0.01 mm. All data were analyzed with SPSS software and Pearson Correlation, independent T-test, paired sample T-test and multiple linear regression tests.

Results: Tanaka-Johnston equations and Moyer’s prediction tables had significant difference with mesiodistal dental width of south Iranian population, so new regression equations (based on incisors and first molars) for different jaws and sexes were presented in this study for south Iranian population. The best suggested regression is the regression that is based on all maxillary and mandibular incisors and first molars and has 12 variables. The suggested regression for prediction of maxillary canine and premolars based on the summation of mesiodistal width of all incisors and first molars in both jaws was Y=0.177X+4.227 and for prediction of mandibular canine and premolars was Y=0.188X+2.730, which a the greatest in r2 prediction of unerrupted teeth in comparison with the regressions based on incisors alone or incisors and first molars in one jaw.

Conclusion: Tanaka-Johnston and Moyer’s prediction tables are overestimated the actual size of south Iranian’s teeth width. So new regression equations based on incisors alone and incisors and first molars are suggested to increase the accuracy of space analysis in both jaws.

  Background and Aims: Orthodontic patients’ cooperation is a determining factor in treatment outcomes. The aim of this study was to evaluate the relationship between patient cooperation during orthodontic treatment with variables such as age, sex, life setting, treatment duration and functional and social discomfort experienced.

  Materials and Methods: Specimens were consisted of 100 orthodontic patients (36 males and 64 females) between 13-35 years old (average age: 22.57±1.69 years). Patients’ demographic traits, treatment duration and
functional-social discomfort by the orthodontic treatment were evaluated using a questionnaire answered by the patients or their parents. The degree of patient cooperation was assessed by the modified cooperation questionnaire (Orthodontic Patient Cooperation Scale [OPCS]) which was completed by an orthodontist. Data were analyzed using One-way ANOVA, T-test, intraclass correlation coefficient and Pearson Correlation.

  Results: No significant difference was found between the cooperation of male and female patients (P=0.867) and also between the cooperation of the patients who lived in the urban and rural setting (P=0.613). Treatment duration and compliance showed a low negative correlation which was not statistically significant (r=-0.155, P=0.127). Functional-social discomfort and compliance showed a low negative correlation which was not statistically significant (r=-0.118, P=0.244). No significant correlations were found between the compliance and age (r=0.002, P=0.988) and also the treatment duration and functional-social discomfort experienced
(r=0.164, P=0.105).

  Conclusion: Patient compliance appears to be a complex issue that cannot easily be predicted only by factors such as age, gender, life setting, treatment duration and functional-social discomfort experienced.

  3- Dentist

  Background and Aims: An attractive, well-balanced smile is a paramount treatment objective of the modern orthodontic therapy. The purpose of this study was to determine the effects of the buccal corridor size and tooth-gingival display on the smile esthetics as perceived by two groups of the students.

  Materials and Methods: A colored image of a woman frontal posed smile was selected. The image was altered digitally to produce different buccal corridor sizes (6%, 12.5% and 20%) and different tooth-gingival displays (maxillary central incisors and 2 mm of gingival, maxillary central incisors and dental papilla and 80% of the maxillary central incisors). The different buccal corridor sizes and tooth-gingival displays were combined to produce 9 images. These altered images were rated by 120 medical and dental students using Visual Analogue Scale (VAS). Data were analyzed using Mann-Whitney test, Pairwise comparison LSD test, Repeated measure MANOVA and ICC (Intraclass Correlation Coefficient).

  Results: The smile which had the buccal corridor size of 12.5% and complete incisor display without gingival display received the highest rates among the nine smile images in the dental students group. But in the medical students group the smile with the buccal corridor size of 12.5% and 2 mm gingival display, received the highest rates among the nine smile images. There was no significant difference in judging between the male and female raters for the both groups (P>0.05). The dental students were more critical about the increasing of the gingival display.

  Conclusion: In the treatment procedure that may lead to the combination of wide buccal corridor and more tooth-gingival show, more caution should be considered.

Background and Aims: The aim of this study was to investigate the effects of sodium bicarbonate against candida albicans, the main infectious factor of denture stomatitis, and to compare it with other common anti-candida medications.

Materials and Methods: Three concentrations of Candida albicans (105, 106, 107 CFU/mL) were prepared. Experimental substances were 5% sodium bicarbonate, nystatin, chlorhexidine, and sterile saline (as control). Each of them was added separately to the same amounts of Candida albicans of different concentrations, and sampled at the intervals of 1, 2, 3 and 4 min. Then, the samples were cultured and incubated. The number of formed colonies was counted for each plate. The data were analyzed, using ANOVA and Tukey test.

Results: Sodium bicarbonate showed a noticeable anti-candida effect on the concentrations of 105 and 106 CFU/mL, with almost similar anti-candida effect as nystatin and chlorehexidine(P=0.29, P=0.32). Nystatin was the most effective medication on the concentration of 107 CFU/mL of candida (P=0.03, P=0.01). Sodium bicarbonate and chlorhexidine were less effective in this concentration with no statistically significant difference (P=1.00).

Conclusion: Sodium bicarbonate showed a significant anti-candida effect at low and medium concentrations of Candida albicans, but nystatin was more effective in the higher concentrations.