Journal of Dental Medicine

Statement of Problem: Hyperlipidemia is a major risk factor for cardiovascular disease. In recent years some evidence has been presented regarding the association between periodontal and cardiovascular diseases.

Purpose: The aim of this study was the evaluation of association between hyperlipidemia and periodontitis.

Materials and Methods: In this case-control study, levels of plasma lipids in 40 subjects with periodontitis (CPITN score III or IV) were measured and compared with 40 age and sex matched controls. Data were analyzed using t-student test with P<0.05 as the limit of significance.

Results: Total cholesterol (CHL) and triglyceride (TG) were significantly higher in case group compared with control group. (P=0.045 and P=0.016 respectively). HDL and LDL cholesterols were higher in cases but showed no significant differences with controls. The relative frequency of pathologic values of CHL and TG were significantly greater in cases compared with control group (P=0.005 and P=0.001 respectively).

Conclusion: Based on the findings of this study, hyperlipidemia may be associated with periodontitis in medically healthy peoples but whether periodontitis causes an increase in levels of serum lipids or whether hyperlipidemia is a risk factor for both periodontitis and cardiovascular disease need to be further investigated.

Background and Aim: Handpieces are in current use in dental practice. Cross contamination from these instruments is very high because of their direct contact with blood and saliva. The purpose of this study was the evaluation of antiviral effects of different disinfectants on dental handpieces.

Materials and Methods: In this experimental study, the effects of 5 groups of different materials and methods of sterilization and disinfection on virus elimination from dental handpieces were evaluated. Groups were as follows: 1- autoclave 2- Solarsept 3- Unisepta 4- Sodium hypochlorite (2% solution of household bleach) 5- Sanosil. 14 handpieces in each group were washed, dried and autoclaved, then contaminated with polio and Herpes Simplex virus type I. Samples were washed with sterile distilled water. Antiviral agents were applied according to the manufacturer or previous investigations. After washing with water, the instruments were washed with MEM (Minimum Essential Medium) and two samples of cell culture from each handpiece were prepared. In each group one handpiece was treated as control. The results were recorded after one week.

Results: The percent of negative cell cultures in each group were as follow: A- For Poliovirus: 1- Autoclave: 100%. 2- Solarsept: 28.6%. 3- Unisepta: 0%. 4- Sodium hypochlorite: 28.6%. 5- Sanosil 92.9%. B- For Herpesvirus: 1- Autoclave: 100%. 2- Solarsept: 100%. 3- Unisepta: 100%. 4- Sodium hypochlorite: 57.1%. 5- Sanosil: 100%.

Conclusion: According to our findings autoclave is the best method for virus elimination from dental handpieces. Sanosil with 92.9% efficiency was the best solution. Solarsept, hypochlorite with special method and Unisepta had the lowest effectiveness.

Background and Aim: The efficiency of disinfecting materials and procedures in removal of contamination from dental surfaces and equipments is essential. In authors' previous study, daily use of 2:100 dilution of 5% sodium hypochlorite in water and disposable covers were recommended since HBV contamination was found on semi-critical parts of the operative dentistry department. The aim of this study was to evaluate the HBV contamination following application of the recommended procedures.

Materials and Methods: The study was conducted in two parts. In the first cross-sectional part, samples were collected from 17 sites of dental surfaces. In the second interventional part samples were collected from 10 sites of 9 dental and 3 sites of 2 light cure units, before and after disinfection with 5% sodium hypochlorite solution diluted to 2:100. Sterile cotton swabs moistened with sterile BSAS (Bovine Serum Albumin in Sodium Chloride) solution were used for sampling. Samples were tested by PCR technique in Pasteur Institute, Iran.

Results: None of the samples collected in the first part of the study showed contamination. In the second part of the study, from 96 samples taken from various parts of dental and light cure units, before and after disinfection, there was only one HBV contaminated site before disinfection which showed no contamination after disinfection.

Conclusion: Based on the results of this study, disinfecting procedure with 5% sodium hypochlorite solution diluted to 2:100 along with using disposable covers is effective in preventing HBV contamination.

Background and Aim: Because of polymerization shrinkage and high viscosity of posterior composites, there are some difficulties in using them in posterior restorations. Several methods have been represented to reduce the effect of shrinkage. The aim of this study was to investigate the effect of curing flowable composites under condensable ones in adaptation and microleakage reduction of posterior composite restorations.

Materials and Methods: In this experimental in vitro study, forty class II MO cavities were prepared on extracted intact molar and premolar human teeth. Gingival margins were placed 1 mm apical to CEJ. The teeth were divided into two groups. In group 1, flowable composite (Filek Flow, 3M, ESPE, USA) with 0.5-1 mm thickness was applied and cured following application of bonding agent (Single Bond, 3M, ESPE, USA). The rest of the cavity was filled by condensable composite (p60, 3M, ESPE, USA). In group 2 the flowable composite was not cured, and the condensable composite was applied in two increments. After light curing of composites, all the specimens were thermocycled and then immersed in 0.3% basic fuschin. Specimens were sectioned and evaluated for degree of dye penetration under a stereomicroscope. Data were analyzed by Mann-Whitney test with p<0.05 as the level of significance.

Results:. There was no significant difference between the two studied groups regarding microleakage.

Conclusion: Based on the results of this study, neither cured nor uncured flowable composite under condensable composite can omit microleakage in posterior composite restorations.

Background and Aim: Amalgam is one of the mostly used restorative materials, but has some disadvantages. Microleakage is one of the short comings of amalgam which may lead to sensitivity and recurrent caries. The aim of this study was to evaluate the effect of three dentin bonding systems on reduction of microleakage in amalgam restorations.

Materials and Methods: Class II amalgam restorations were made in 40 noncarious molar and premolar teeth. Then the specimens were divided into four equal groups. Scotch Bond Multi Purpose, Single bond,
iBond, were used as liner in groups one to three respectively and in group four no liner was used. The teeth were restored with high copper spherical amalgam. After thermocycling for 500 cycles at 5⁰C and 55⁰C, the specimens were immersed in basic fuchsin for 24 hours, bisectioned mesiodistally and evaluated under stereomicroscope at X25 for dye penetration. The data were analyzed by Kruskal-wallis and Scheffe. P<0.05 was considered as the level of significance.

Results: The groups showed significant difference (p=0.003). The group four had significantly less microleakage than the first and second groups (p<0.05). The second and third groups showed significantly different microleakage (p=0.038).

Conclusion: Based on the results of this investigation applying dentin bonding agents has no effect on reducing microleakage in amalgam restorations, however more studies are recommended.

Background and Aim: Various studies have shown that reliable bond at the root - post - core interfaces are critical for the clinical success of post - retained restorations. Severe stress concentration at post - cement interface increases post debonding from the root. To form a bonded unit that reduces the risk of fracture, it is important to optimize the adhesion. Therefore, some post surface treatments have been proposed. The purpose of this study was to investigate the influence of various surface treatments of tooth - colored posts on the bonding of resin cement.

Materials and Methods: In this interventional study, 144 tooth colored posts were used in 18 groups (8 samples in each group). The posts included quartz fiber (Matchpost), glass fiber (Glassix), and zirconia ceramic (Cosmopost) and the resin cement was Panavia F 2.0. The posts received the following surface treatments: 1- No surface treatment (control group), 2- Etching with HF and silane, 3- Sandblasting with Cojet sand, 4- Sandblasting with Cojet sand and application of silane, 5- Sandblasting with alumina particles, 6- Sandblasting with alumina particles and application of silane. Then, posts were cemented into acrylic molds with Panavia F 2.0 resin cement. The specimens were placed in water for 2 days and debonded in pull - out test. Statistical analysis was performed using ANOVA followed by Tamhane and Tukey HSD. Failure modes were observed under a stereomicroscope (10 ). P<0.05 was considered as the significant level.

Results: Surface treatments (sandblasting with Cojet and alumina particles ,with or without silane) resulted in improved bond strength of resin cement to glass fiber post (Glassix) and zirconia ceramic (Cosmopost) [p<0/05], but not to the quartz fiber post (Matchpost). In general, higher bond strengths resulted in a to higher percentage of cohesive failures within the cement.

Conclusion: Based on the results of this study, sandblasting with cojet and alumina particles increases bond strength of resin cement to glass fiber post (Glassix) and zirconia ceramic (Cosmopost).Generally, the bond strength of resin cement to the posts is affected by the post's composition and surface treatment.

Background and Aim: Nonmetallic tooth- colored posts adhere to canal walls by dentin bonding agents and resin cements. Better retention and proper distribution of stress result from enough and proper bonding. The purpose of this study was to evaluate bond strength of D.T. Light - post with two different resin cements (self-cure & dual-cure) and to investigate the effect of irrigating solutions applied in root canal on bond strength of the resin cements and D.T.Light- post to root canal wall.

Materials and Methods: In this experimental study 40 single root teeth (maxillary canine & central) were selected and stored in 0.1% thymol solution for one week and transferred to distilled water. The teeth were decoronated 2mm above CEJ. The canal space was mechanically enlarged using k-files (up to # 70). The teeth were randomly divided into two groups. The first group was irrigated with 2.6% NaOCl, and the second was irrigated with normal saline. After drying, the teeth were filled with gutta percha cones using lateral condensing method. After two weeks the post space was prepared and D.T.Light- post was inserted in each subgroup using self or dual-cure cements according to manufacturer's instructions. After thermocycling, the apical part was cut 1cm below CEJ. The remained length was divided into 9 equal sequential sections. Each section was submitted to shear push-out test in universal testing machine. Statistical analysis of the bond strength data was performed using ANOVA and post hoc tests with p<0.05 as the level of significance. All failed specimens were examined under stereomicroscope. Degrees of conversion of the cements were determined by FTIR.

Results: Significant difference in bond strength values were found among sites (P=0.001) and cements (P=0.03). With increasing in depth, bond strength decreased. The mean bond strength value in dual-cure resin cement was higher than self-cure cement. The irrigating solutions caused no significant difference in bond strength (P=0.46). DC% had significant difference in various depths.

Conclusion: According to the results of this investigation, bond strength of dual-cure cement is higher than self-cure one in D.T Light- post because of post's translucency. 2.6% sodium hypochlorite does not affect the bond strength.

Background and Aim: Decreasing the hardness of dental restorative composites after curing in oral environment can influence their clinical durability. The aim of this study was to evaluate the effect of food-simulating liquids such as 25%, 50%, 75 % ethanol and 50 % heptane on surface hardness of two composites - (Gradia and P60) after curing and immersing time of 24 hours and 7 days.
Materials and Methods: 45 specimens of each composite were prepared in a stainless steel mold with 6 mm diameter and 2 mm depth. 5 specimens of each composite were tested for microhardness immediately after curing as the control group. The other specimens of each composite were randomly divided into eight groups. Each specimen was immersed in one of the following solutions 25%, 50%, 75 % ethanol and 50 % heptane for either 24 hours or 7 days. Then the specimens were taken out of the solutions and washed and dried and transferred to the refrigerator until performing the test. In standard conditions, surface microhardness of specimens was evaluated by the microhardness device based on Vickers. The data were analyzed by one way ANOVA 3 way ANOVA and Tukey Post Hoc tests. The level of significance was set at p<0.05.
Results: Surface hardness of P60 composite was higher than that of Gradia. An analysis of variance in gradia and p60 showed significant difference between the control and all the other groups (P<0.05) except the 25% ethanol (P=0.514). After 24 hours all the solutions had significant effect on Gradia (P<0.05) except 50% and 75% ethanol (P=0.793). After 7 days all the solutions had significant effect on Gradia except 50% and 25% ethanol (P=0.385)and 50% and 75% ethanol (P=0.150) According to P60 after both 24 hours and 7 days all the solutions had significant effect on the hardness. 50 % heptane increased the hardness (P=0.00). 75% ethanol significantly decreased the hardness (P=0.000) followed by 50% (P=0.001) and 25% ethanol (P=0.007).
Conclusion: Based on the results of this study, the effect of time was not significant. P60 showed to be more resistant. 75% ethanol had much more effect followed by 50% and 25% ethanol. Heptane increased the mean surface hardness.

Background and Aims: The main objective of this study was to determine the effect of polyethylene fibers and veneering composites in fiber-reinforced resin systems on the opacity (contrast ratio).

Materials and Methods: The specimens were divided into four groups. Two groups were used as the control groups, with no reinforcement. The fibers of polyethylene (Fibre-Braid) with special basement composites were used as the reinforced framework materials. Filtek Z250 and GRADIA (shade A2) were used as veneering materials. The total thickness of samples was 3 mm with 13 mm diameter. Specimens were prepared in disk shaped metal mold. The composite materials were light-cured according to their manufacturers' instructions. The contrast ratio (CR) of each specimen was determined on black and white backgrounds using reflection spectrophotometer. Reflectance was measured at intervals of 10 nm between 400 nm and 750 nm. Data were analyzed by two-way ANOVA and Tukey HSD test.

Results: When contrast ratio were compared among the different types of materials statistically significant differences were observed in both veneering composites (P<0.05). The Z250 resin composite had the lowest CR. It was shown that CR tended to decrease as the wavelength of incident light increased from 400 nm to 750 nm. On the other hand, the most differences in CR between groups were found in longer wavelengths.

Conclusion: It was found that polyethylene fibers reduced the amount of the translucency in FRC samples. The results of this study indicate that light reflectance characteristics, including the wavelength dependence, play an important role for the CR of a fiber-reinforced composite.

Background and Aims: There is concern that leached components from dental composites may cause adverse changes in the reproductive health. This study aimed to assess the effects of leached components from a hybrid resin composite on the reproductive system of male mice.
Materials and Methods: In the present animal study, twenty adult Syrian male mice were divided into two groups of 10 mice each. In the test group, components which leached from samples made from Filtek Z250 resin composite into 75% ethanol were daily administered to the mice for 28 days. In the control group, the procedure was repeated in the same way as the test group but without placing composite samples in the solution. Then, the body weight, weights of paired testes, Gonado Somatic Index, sperm viability, sperm motility, epididymal sperm reserve and daily sperm production were recorded. Four male mice in each group were mated with untreated female mice for 10 days. After that, the number of pregnant females and number of infants were recorded. The data were analyzed using repeated measures ANOVA, Chi-square test and t-test.
Results: There was a significant reduction in the sperm viability and sperm motility of male mice in the test group compared to the control group (P=0.001). There was no any significant differences in other parameters between two groups (P>0.05).
Conclusion: This study showed that the leached components from resin composites cannot cause infertility but they could potentially cause some adverse effects on the reproductive system of male mice.

Background and Aims: Endodontically treated teeth are prone to fracture because they loose a big amount of their structure. The treatment plan of those teeth is completed when they are rehabilitated with a strong and functional restoration. The purpose of this study was to evaluate the fracture resistance of endodontically treated teeth restored with amalgam cuspal coverage in comparison with other restorative techniques.

Materials and Methods: 40 human healthy maxillary premolars were divided into 4 groups: group1 (S): sound teeth, group 2(Co): endodontically treated teeth with MOD cavity restored with bonding and composite, group 3(Am-B): endodontically treated teeth with MOD cavity restored with bonding and amalgam and group 4 (Am-CC): endodontically treated teeth with MOD cavity restored with amalgam cuspal coverage. Then the restorations were stored in water and room temperature for 100 days at then thermocycled for 500 cycles between water baths at (5.5 ± 1) and (55 ± 1) ⁰ C. The fracture resistance was evaluated by universal testing machine (Instron, 1195 UK) with the compressive force of about 2000 N in 0.5 mm/min. The fracture modes were evaluated in four groups by a stereomicroscope. Statistical analysis (Scheffe test) was done for all groups (P<0.05 was considered as the level of meaningfulness).

Results: The highest fracture resistance was found in group 4 (Am-CC) (976 ± 23.27 N) that had no significant difference with sound tooth (P>0.05). The lowest fracture resistance was found in group 2 (Co) (384 ± 137.4 N) that had no significant difference with group 3 (Am-B) (P>0.05). The fracture resistance in group 4 was significantly higher than group 2 (Co) and 3 (Am-B). The fracture mode in group 1 was cohesive within tooth and in group 2 (Co) and 3 (Am-B) was mixed cohesive and adhesive, and in group 4 was cohesive within in restorative material.

Conclusion: The highest fracture resistance was found in teeth that received amalgam cuspal coverage.

  Background and Aims: The purpose of this study was research on a new herbal compound (Seidlitzia Rosmarinus) made by Traditional Medicine Research Group, University of shahed to find a safer alternative to HCL-Pumice compound technique.

  Materials and Methods: In this randomized clinical trial seventy two anterior teeth from 9 patients were divided in to three groups according to fluorosis severity: mild (34 teeth), moderate (14 teeth), and sever (24 teeth). In each patient, half of the teeth were treated with “Shahed” compound and other half treated with HCL-Pumice compound. Before and after treatment, photographs were taken in both groups. HCL-Pumice treatment compound was applied for 30 seconds periods and continued for 10 minutes if necessary. In case of herbal Shahed compound the time was determined by clinical symptoms or when labial contour was dismissed, If the result was not esthetistically acceptabale for the patient, HCL-Pumice compound was applied on teeth. NaF was applied after mouth washing. The photographs of the teeth before and after treatment were reviewed by two experienced observer unaware of the treatment modality. The results were analyzed using willcoxon^’s, kruskal-wallis and scheffe test.

  Results: There was over 81.3% acceptance between two observers and no significant differences in intraobservers evaluation (P>0.05). Improvement in beauty indexes were observed in all degrees of dental fluorosis by 18% with HCL-Pumice compound application, but “Shahed” herbal compound induced significant reduction in the amount of white spots in mild fluorosis and stain intensity of moderate fluorosis (P<0.05) , while the reduction in the severity of discoloration in group 2, these two techniques were statistically equivalent but in the remainder, HCL-Pumice compound was more significantly effective (P<0.05) .

  Conclusion: HCL-Pumice compound reduces the severity of the discoloration of the teeth. Shahed herbal compound cannot reduces the discoloration like as HCL-Pumice compound.

  Background and Aims: Hepatitis B is an important infection route in dentistry requiring different disinfectants to prevent its transmission. The aim of this study was to compare the effects of chemical disinfectants (FD366, ISORAPID and 5% sodium hypochlorite 2/100) to remove Hepatitis B infections from the dental surfaces.

  Materials and Methods: In this experimental laboratory trial, serum of 10 HBV patients was poured into microtubes, FD366, ISORAPID and hypochlorite disinfectants were added to them. PCR experiments with viral diagnostic kits were used to diagnose the virus genome. Real time PCR was used to evaluate after incubation with the disinfectants. The reductions occurred in the viral load of Hepatitis B were statistically analyzed using Kruskal-wallis and Mann-Whitney U tests .

  Results: No significant antiviral efficacy was noted following the application of FD366 and ISORAPID disinfectants (P=0/07). However, hypochlorite showed the most efficacy to disinfect Hepatitis B and a significant difference was found among them (P<0.0001).

  Conclusion: Under the study limitations, FD366 and ISORAPID disinfectants did not show adequate efficacy to remove Hepatitis B virus. Hypochlorite was the most effective disinfectant.