Journal of Dental Medicine

Normal 0 false false false EN-US X-NONE AR-SA Replantation means replacement of an avulsed tooth. The most important issue is preserving periodontal health during the process. Therefore, root irrigation or drying should be avoided and tooth should be replaced at soonest time possible. Dental socket should be irrigated by warm normal saline without any curettage. Then, it should be splinted by considering function. After 2 weeks, endodontic therapy should be commenced in order to ameliorating periodontium condition and calcium hydroxide application following splint removal.For approximately 2 years, 2 months follow-ups are mandatory. Calcium hydroxide should be replaced in case of washing out. In general, since avulsion is happened mostly in children and prosthetic treatments are impossible in this age, replantation is an appropriate temporary treatment modality until the patient becomes ready to receive prosthetic treatments.

One of the most common outcomes of pulp inflammation is periapical granuloma formation. Existence of immune cells in these lesions showed involvement of both humoral and cellular immunity in the site. The presence of different antigens in the root canal causes production o various antibodies and consequent immunological reactions. Different theories have been proposed on periapical cysts. The most valid of them is based onimmunologic response which can lead to tissue destruction due to immunological reactions.

Normal 0 false false false EN-US X-NONE AR-SA During the past century, valuable studies were done on maxillary mesiobuccal canals morphology. In general, knowing pulp-chamber floor is a great aid in finding extra root canals. Findings of invivo and invitro canals are highly different which implies difficulties in finding canals in clinical treatments. Therefore in this study by modifying access cavity preparation methods possible orifice areas are introduced. In an invitro analysis, 29% of first maxillary molars canals were found Type 3 and 35% Type 2 in radiographic view of mesiodistal aspect. In intra oral analysis, by modifying access cavity and removing mesial wall dentin, a high percent of these orifices are discovered.

Background and Aim: Preserving canal curvature during different phases of canal preparation is an important point. In Endodontic therapy all efforts are made to prepare canal in a way that final canal follows the primary canal curvature. The purpose of this study was to evaluate the efficacy of root canal preparation performed by students at Endodontic Department of Dental School, Tehran University of Medical Sciences.

Materials and Methods: In this retrospective study, classic method of step- back technique was investigated for preserving canal curvature in mesial roots of first mandibular molars and mesiobuccal roots of first maxillary molars between years 2000 and 2004. A randomly selected sample of 400 dental patient records was investigated by 4 observers (Endodontic department professors), searching for procedural errors. A clear explanation sheet of curvature preservation and procedural errors such as ledge formation, apical foramen transportation, zipping and stripping and a questionnaire were prepared for observers. The observers went through reliability test and kappa value for agreement between every two observers. The results were above 0.8. Data were analyzed by EPI6 statistical computer program, using Chi-Square and Fisher exact test with P<0.05 as the limit of significance.

Results: This study consisted of 152 first maxillary molars and 248 first mandibular molars. The prevalence of curvature preservation in mesial root of first mandibular molars and mesiobuccal root of first maxillary molars were 38.5% and 47.6% respectively. Procedural errors detected consisted of 33% ledge formation, 26.1% apical foramen transportation, 1.8% zipping and 4.1% stripping for mesial root of the first mandibular molars. The results for the first maxillary molars were 27%, 19%, 3.2% and 3.2% respectively.

Conclusion: The study results revealed the efficacy of endodontic education and the proficiency of junior and senior students in preparing curved posterior root canals. The results obtained in this retrospective study are comparable to prospective studies.

Background and Aim: Determining correct working length in root canal therapy is of great importance in successful treatment. The purpose of this study was to compare the accuracy of two electronic apex locators of fourth generation, Raypex4 and Apit7, in determining working length in vivo.

Materials and Methods: In this test evaluation study performed at Dental School of Tehran University, a total of 32 single canal vital teeth planned for extraction because of orthodontic and prosthetic reasons were selected. Working length determination by each of the two electronic apex locators was performed by two different dentists. These measurements were compared with direct visual measurement after tooth extraction. The dentists working with devices and the endodontist who determined the working length of the extracted teeth as well as the statistician, all were blind regarding the results. The data were compared using binominal distribution test with P<0.05 as the limit of significance.

Results: The accuracy of actual length determination of Raypex4 was 68.8% in the limit of ± 0.5 and 83.3% in the limit of ±1. From the actual length measurements, 75.1% were within the tolerance of +0.5 to-1. The accuracy of the working length determination by Raypex4 was 68.8% within the tolerance of ± 0.5 and 84.3% within the tolerance of ± 1. Taking the tolerance of + 0.5 to -1 mm into account, the accuracy of the instrument was about 78.8%. The accuracy of actual length determination of Apit7 was 65.7% in the limit of ±0.5 and 78.3% in the limit of ±1. Compared to the visual length determination, 78.8% of the actual length measurements were within the tolerance of +0.5 to-1. The accuracy of the working length determination was 62.6% within the tolerance of ±0.5 and 81.3% within the tolerance of ±1. Taking the tolerance of + 0.5 to -1 mm into account, the accuracy of the instrument was about 75.1%.

Conclusion: Raypex4 and Apit7 had similar accuracy in determining the actual length. However, they still can not replace the routine methods of actual length determination.

Background and Aims: Selecting an appropriate treatment plan is one of the most critical aspects of dental treatments. The purpose of this study was to compare multimedia system and conventional method in patients' selecting prosthetic treatment and the time consumed.
Materials and Methods: Ninety patients were randomly divided into three groups. Patients in group A, once were instructed using the conventional method of dental office and once multimedia system and time was measured in seconds from the beginning of the instruction till the patient had came to decision. The patients were asked about the satisfaction of the method used for them. In group B, patients were only instructed using the conventional method, whereas they were only exposed to soft ware in group C. The data were analyzed with Paired-T-test (in group A) and T-test and Mann-Whitney test (in groups B and C).
Result: There was a significant difference between multimedia system and conventional method in group A and also between groups B and C (P<0.001). In group A and between groups B and C, patient's satisfaction about multimedia system was better. However, in comparison between groups B and C, multimedia system did not have a significant effect in treatment selection score (P=0.08).
Conclusion: Using multimedia system is recommended due to its high ability in giving answers to a large number of patient's questions as well as in terms of marketing.

Background and Aims: A large number of investigations have revealed that physical and chemical alterations and weight loss could occur in composite materials exposed to acidic phosphate fluoride (APF) gel. The purpose of this study was to assess the microleakage of a fissure sealant and a flow composite exposed to acidulated phosphate fluoride (APF) gel.

Materials and Methods: In this in vitro study, 60 intact human extracted premolar teeth were used. After preparing the occlusal groove, the teeth were divided into two groups (n=30). Teeth were filled with either Helioseal fissure sealant (Vivadent, Germany) or Tetric flow composite (Vivadent, Germany). After that, each group was divided into two subgroups (n=15): 1.23% APF gel (Sultan, U.S.A) was applied in the case subgroups, while control subgroups were preserved in normal saline solution. All of teeth were covered with 2 layers of nail varnish except for the filling zone and 1mm around the border of filling. After submerging in 0.5% fushin solution, specimens were sectioned bucco-lingually. Then dye penetration through the filling and fissure sealant was assessed by means of a stereo-microscope. The depth of dye penetration was scored. The data were analyzed using One-way ANOVA and Levene test.

Results: The mean values of dye penetration were 1.26±1.09, 1.4±1.05, 1.2±1.37, and 1.4±1.35 for fissure sealant+gel, composite+gel, composite+normal saline, and normal saline groups, respectively. No significant difference was found in inter-groups (P=0.96).

Conclusion: Considering the result of the present research, APF gel had no significant effect on the microleakage of Tetric flow composite filling and Helioseal fissure sealant and thus, it can be applied for routine usage.

Background and Aims: The seal provided by a root canal filling may be compromised by post space preparation. The aim of this study was to compare coronal microleakage around cast posts and prefabricated pins.

Materials and Methods: Thirty-eight extracted single-rooted, maxillary human teeth were prepared with step back method and filled with gutta-percha and sealer. After removing 8 mm of coronal gutta-percha with peeso-reamer drills #2 in twenty canals, the teeth were divided into three groups: cast post & core, prefabricated pin,  and gutta-percha (without any post or pin). After thermocycling, the samples were immersed in India ink for seven days. Finally, the specimens were cleared and the coronal microleakage of dye was then measured by the stereomicroscope. The data were analyzed by One-way ANOVA and Tukey HSD tests.

Results: According to the results, the mean dye penetration in cast posts, pins, and group without post or pin was 3.3 (0.39), 5.2 (0.47), and 7.2 (0.15) mm, respectively. There was no statistically significant difference between the groups (P>0.05).

Conclusion: Considering the importance of adequate filling of crown for prevention of microleakage, the method for coronal filling must be selected with caution. According to the results of this study, no significant difference between microleakage of cast posts and prefabricated pins was observed.

Background and Aims: Nursing Caries (NC) is a destructive form of caries because of incorrect nutritional habits in infants that affects deciduous teeth after eruption. Familiarity with the pattern of this type of caries and evaluation of its symmetrical or asymmetrical pattern is necessary for effective and scientific diagnosis and treatment. The aim was to assess the symmetrical or asymmetrical aspects of Nursing Caries in children between 3-5 years old.

Materials and Methods: In this cross-sectional study, 10 kindergartens were randomly selected by the Tehran Welfare Organization. 115 children with NC caries entered to study after examination. Written consents were obtained from the parents. The dmfs in upper primary incisors and upper and lower primary canines, as well as the first primary molars were assessed and the caries pattern in terms of symmetrical or asymmetrical aspects was evaluated. The data were analyzed by ANOVA, LSD, Chi-square and Fisher tests.

Results: In 53.9% of the children with NC, the anterior teeth were affected symmetrically, while 46.1% indicated an asymmetrical pattern. In general, 32.2% of the teeth were affected in a symmetrical pattern and 67.8% of them in an asymmetrical pattern. About the relationship between the breastfeeding from the right or left breast and the symmetrical pattern of the NC, 51% of the children were equally breastfed from both breasts. However, in the asymmetrical NC pattern with more impact in the right side of dentition, 50% of the children had been breastfed from the left side and in children with more caries  in the left side of dentition, 50% of them had been breastfed from the right side (P=0.01).

Conclusion: NC has symmetrical and asymmetrical patterns. Direction of mother for breastfeeding affects the symmetrical and asymmetrical pattern of NC.

  Background and Aims: Electric pulp tester is a valuable instrument to examine tooth’s pulp vitality. There is no agreement about the response of immature teeth to electric pulp tester and the reason is expressed as the failure of nerve fibers’ development. The aim of this study was to investigate the effect of patient’s age on the tooth response to electric pulp tester.

  Materials and Methods: In this cross-sectional study, 300 maxillary central permanent teeth in 150 volunteers were examined by using electric pulp tester. The volunteers were classified in 5 age groups of 7-8, 9-10, 11-12, 13-4, and 30-35 and teeth lacking sound and healthy pulp were excluded. Data were analyzed using SPSS-16 software, one-way analysis of variance, and Tukey post hoc test.

  Results: The average response to electric pulp tester in age groups of 7-8, 9-10, 11-12, 13-4, and 30-35 years old were 2.9±0.1, 2.8±0.1, 2.3±0.1, 2.2±0.1 and 1.8±0.1 ,respectively. This indicated that by increasing teeth age, they responded to lower level of electric pulp tester. In subjects less than 14 years old, there was no significant difference between neighboring groups (P=0.3) however, a significant difference was observed between subjects less than 14 years old and adults (P<0.001).

  Conclusion: This study showed that immature teeth responded at higher levels to electric test however, all teeth responded to electric pulp tester.