Journal of Dental Medicine

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Normal 0 false false false EN-US X-NONE AR-SA Treatment planning for patients with this congenital disorder according to their age, eruption of teeth and anatomical type of the disorder is summarized here. It should be noticed that reconstruction of ear, soft tissue lesions and neurological lesions in patients is done after complete reconstruction of facial bones and functioning of its skeletal parts.

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Normal 0 false false false EN-US X-NONE AR-SA Migraine pains are one of the most frequent types of headaches.  There are two types of migraine: Classic migraine and common migraine. These two are distinguished with the existence of neurologic symptoms (Aura). Although the main etiology of it is related to unstable pericranial condition of vessels during migraine attacks.  Recent studies showed strong effect of treating musculoskeletal disorders of masticatory system in recovery of common migraine. On this account, thorough evaluation of masticatory system and eliminating disorders of jaws and related muscles is recommended as an effective treatment modality in patients with common migraine. since migraine is defined as recurring attacks of headache in a wide range of pain , duration and frequency of attacks.  The headacke is unilateral and associated with anorexia, nausea or vomiting and  in some cases even sensory, motor or psychological disorders are presented.

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Congenital vascular lesions occur most often in children. Parents of these children take them to maxillofacial surgeons directly or during the treatment of other complications such as infection or jaw bone disorders. Various terms now used are unable to describe the pathogenesis and mechanism of the effect of vascular lesions on growth and development of facial bone.  Term of hemangioma is used in almost all cases of congenital and acquired vascular lesions, while fibrosis or shrinkage occurs in some of these lesions over the time. There is also some confusion in describing the vascular lesions which primarily affected bones and soft tissue vascular malformations associated with changes in hard tissues.

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Temporo Mandibular Joint disorders are the most important ethiologic factor for chronic orofacial pain and have a relatively new place in scientific researches and clinical studies in dentistry. Since dentists can play an important role in diagnosis and treatment of these disorders, routine dental examination should include functional examination of osteomatognatic apparatus.

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Normal 0 false false false EN-US X-NONE AR-SA By development of medical technology, new horizons are opened in treatment of patients. Nowadays, laser has become a surgical appliance that has made impossible possible. Physical characteristics of laser as well as specific adjustability of it provided much unbelievable potential to surgeons. The most primary step in order to use this novel technology is to identify its physical and technical characteristics.

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  In this double blind clinical survey, 40 healthy candidates of mandibular thir molar surgery were selected and randomly allocated into two groups of 20. First group was asked to administer Chlorhexidine 0.2% mouth wash prior to the operation while the other group used normal saline for 60 seconds before the surgery. Mouth opening was measured before surgery and in 1^st, 3^rd, 7^th days following the operation. Statistical analysis revealed significantly more mouth opening (lower level of trismus) in patients utilizing chlorhexidine before surgery.

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  Complex mechanisms have been known for keeping blood pressure in normal level. In fact, these mechanisms have inter-related functions and can be dysregulated by both internal and external stimuli while cardiovascular system functions to minimize these changes. Vasoconstrictors can cause clinical and hemodynamical changes as 1-2 cartridges of epinephrine containing lidocaine can has no considerable effects in a normal individual ( unless administered IV) but 3 cartridges can bring about some clinical symptoms, according to a number of investigations. In current study, epinephrine’s effect on heartbeat rate was found more potent than felypressin which is considered as a disadvantage. on the other hand, epinephrine acts on arteries and can cause less bleeding, less drug toxicity and deeper and longer anesthesia. Therefore, it is preferred to felypressin due to its better action. It should be noted that the changes resulted by epinephrine and felypressin are of no significant importance in healthy individuals.

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: Oral lichen planus (OLP) is a chronic and common disease of the oral mucosa, which its etiology, phathogenesis and exact treatment is not definitely known. T-cell mediated immunity is the most probable factor in pathogenesis of OLP. Since TNF-a primarily, as a cytokine, interfers T-Cel mediated immunopathologic reactions, it may also interfere with pathogenesis of OLP.In an observational case- control study, the values of TNF-a in serum of OLP patients were measured and compared with the values of healthy cases. 30 OLP patients and 30 healthy controls have examined with ELISA technique. Data was obtained by observation questionnaire and examination.The mean value of TNF-a in case and control groups were 26.2 and 7.9 pg/ml, respectively, which showed significant difference (PO.005).Considering the TNF-a values with respect to sex and age did not show any significant difference,however the lower TNF-a value was obtained with increasing the age, and higher value observed in females. Higher values of TNF-a found in OLP patients compared with control group. It means TNF-a is an effective factor in OLP. Due to these findings new treatment protocols have been suggested.

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Helicobacter pylori infection causes gastric and duodenal ulcer. However recurrence of infection after eradication would suggest the existence of other reinfecting sources in the gastrointestinal tract (Gl). The aim of this study was to assess the existence ofhelicobacter pylori in dental plaques of patients harboring Helicobacter pylori in their GI tract. Antral biopsies were taken from 40 patients with Gl problems and cultured. Samples were also taken from dental plaques of patients with positive Helicobacter pylori culture under microaerophilic conditions and evaluated by polymerase chain reaction (PCR) reamplification. The mean age of patients was 40 years 24 (60%) male and 16 (40%) female. The results obtained from dental plaque cultures, which analysed by PCR were all negative, however 7 (17.5%) cases were found positive by PCR reamplification. The results showed that Helicobacter pylori could exist in dental plaque and PCR reamplification could be used for its detection as a more sensitive technique. More research should be conducted to examine any relation between the existence of Helicobacter pylori in dental plaques and recurrent GI disorders.

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Statement of Problem:Recurrent aphthous stomatitis (RAS) is a common oral disorder that despite extensive researches, the etiology of this phenomenon is still unknown. Because this phenomenon has been observed more often in families than in individual cases, genetic influence has been investigated in most researches.
Purpose: The aim of the present study was to evaluate the association between Human Leukocyte Antigen (HLA) and aphthous stomatitis more precisely.
Materials and Methods: in this study, 60 patients with RAS were examined for HLA-A and HLA- B types and 37 of them were examined for HLA- DR and HLA-DQ types. The results were compared through Fisher test with those of 25 healthy control subjects, aged more than 30 years.
Results: A significant decrease in the frequency of some antigens such as HLA-DQW 3 and HLA-A 26 in subjects with RAS was observed. Therefore, according to the results of this study, these antigens were considered as resistant antigens to recurrent aphthous stomatitis. In contrast, there was no significant increase in the frequency of any HLA antigens in the test group, compared to the control group. This finding is in contrast with the multiple reports about Behcet's disease. (Because a high frequency of HLA-B 51 has been
found in Behcet's syndrome.)

Conclusion: According to the findings of this study, it is suggested that the pathogenicity of aphthous ulcerations in Behcet's disease and recurrent aphthous stomatitis is not the same. However, further studies are necessary to prove this theory.

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Statement of Problem: One of the best ways for treatment of Aggressive Periodontitis (AP) is identification and elimination of etiologic factors specially two microorganisms Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) in patients harboring them.

Purpose: This study determines the prevalence of Aa and Pg and its correlation with age, sex and the number of family members as well as probing pocket depth (PPD) in active sites of AP patients, referred to department of periodontics, Faculty of Dentistry, Tehran University of Medical Sciences.

Materials and Methods: In this cross sectional, descriptive study, 54 sites (PPD> 5mm) in 15 patients were considered for culture. Marginal gingiva was dried and sampling performed by paperpoint (#30). The selective medium for Aa, was Trypticase Soy Agar-Bacitracin- Vancomycin (TSBV) and for Pg was Brucella agar.Results were analyzed using Fisher and Chi-Square statistical tests.

Results: Thirteen patients or 38 sites (70.4%) were identified as Aa positive and 3 patients or 10 sites (18.4%) were Pg positive. There was no significant relation between the presence of Aa and sex or age (P=0.086). Pg was more prevalent in men compared with women (P<0.0001) but with regard to age there was no statistical difference between men and women. Aa had a significant positive correlation with PPD (P=0.002), which was not true for Pg. In addition, the number of positive sites showed a significant negative correlation with the number of family members.

Conclusion: Based on the present study, the prevalence of Aa in deep pockets in patients with AP is higher than Pg.

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Background and Aim: Black staining after taking iron drops on the primary teeth is always concern of parents. There is not an exact explanation for the mechanism of iron black staining. The purpose of this study was to compare tooth discolorations, atomic absorption and structural changes of primary teeth enamel caused by two kinds of iron drops[ Kharazmi(Iran) and Fer-in-sol(USA)].

Materials and Methods: In this ex-vivo study, 93 sound primary teeth in normal color range were divided into five groups. Two groups of samples were immersed into the Artificial Caries Challenge(ACC) for two weeks before getting exposured to iron drops: Group 1 Control(NS): sound enamel teeth which were kept in Normal Saline environment(NS)(13teeth). Group 2 (NS-KH): NS, kharazmi iron drop (20 teeth). Group 3 (ACC-KH): ACC, Kharazmi iron drop (20teeth). Group 4 (NS-F-in-S): NS, Fer-in-Sol iron drop (20teeth). Group 5 (ACC-F-in-S): ACC, Fer-in-Sol iron drop. Visual tooth discolorations were determined by a specialist in operative dentistry who was not aware of experimental groups. The iron concentration was measured by ICP system (Vista-pro, Australia) and the structural changes were studied by SEM (Philips, Netherland). The data of discoloration were studied with Kruskal-Wallis test and multiple comparison using Bonferroni type test, and with the data of atomic absorption were studied with oneway ANOVA test and Tukey HSD test.

Results: The discoloration in the teeth immersed into the ACC (ACC-KH, ACC-F-in-S) was more severe than the sound enamel surface (NS-KH, NS-F-IN-S) (p<0.001) and Kharazmi iron drop caused more discoloration in the teeth immersed into the ACC (p=0.018). The teeth immersed into the ACC, absorbed more iron than the sound enamel surface (p<0.001) and also the teeth immersed into the ACC absorbed more Kharazmi iron drop (p<0.001). In the Scanning Electron Microscopy study, at low magnification in the sound teeth the perikymata was arranged regular. At low magnification in the teeth immersed into the ACC, many fractures were observed. The fractures in group 3(ACC-KH) were more and deeper.

Conclusion: Being immersed into the ACC, caused more iron absorption, severe discoloration and structural changes in the enamel of primary teeth. Such changes were more distinct in the teeth exposed to Kharazmi iron drop than the teeth exposed to Fer-in-Sol iron drop.

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Background and Aim: Today, one of the most important environmental issues is dental solid wastes which are of great importance because of the presence of hazardous, toxic and pathogen agents. In this survey, solid waste produced in Hamedan general dental offices is evaluated.

Materials and Methods: In this descriptive study, from 104 general dental offices in Hamedan , 10 offices were selected in simple random way. From each offices, 3 sample at the end of successive working day (Sunday, Monday and Tuesday) were analyzed. Samples were manually sorted into different 74 components and measured by means of laboratory scale. Then, measured components were classified in the basis of characteristic and hazardous potential as well as material type.

Results: Total annual waste produced in general dental offices in Hamadan is 14662.67 Kg (9315.45>95.0% Confidence Interval>20009.88). Production percentages of infectious, domestic type, chemical and pharmaceutical and toxic wastes were 51.93, 38.16, 9.47, 0.44 respectively. Main components of produced dental waste were 14 components that consist of more than 80 percents of total dental solid waste. So, waste reduction, separation and recycling plans in the offices must be concentrated on these main components.

Conclusion: In order to dental waste proper management, it is suggested that in addition to educate dentists for waste reduction, separation and recycling in the offices, each section of dental waste(toxic,chemical and pharmaceutical, infectious and domestic type wastes) separately and according to related criteria should be managed.

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Background and Aim: School health workers have an important role in education and prevention of common oral and dental diseases. An organized program can be helpful in training and shaping the proper behavior. This study has evaluated the knowledge, attitude and practice of schools health workers in Tabriz about oral and dental health in 2007-2008.
Materials and Methods: This cross-sectional and descriptive study was performed in primary schools in Tabriz. Questionnaires were sent to the schools that had health workers. Levels of the knowledge, attitude and practice of the health workers who had answered this questionnaire were evaluated. SPSS software and independent T-Test and Paired- Sample T-Test were used for analyzing the results.
Results: Fifty eight out of 64 school health workers were women. Mean age of school health workers was 45 years. Forty four of school health workers had passed special course about oral health and dental health. 49 of them had passed special educational course the mean of acquired knowledge score was 6.77 out of 10 and women's scores were significantly higher. Also women had more work experience than men. The mean of acquired attitude and practice scores were 7.42 and 7.14 out of 10, respectively.
Conclusion: Findings show that performing of the educational courses during work and experience has an effective role in the scales of the health workers. Progress in this situation can be achieved by retraining programs and accessible pamphlets.

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Background and Aim: Sodium hypochlorite can remove the organic phase of the demineralized dentin and it produces direct resin bonding with hydroxyapatite crystals. Therefore, the hydrolytic degradation of collagen fibrils which might affect the bonding durability is removed. The aim of this study was to evaluate the effect of collagen fibrils removal by 10% NaOCl on dentin shear bond strength of two total etch and self etch adhesive systems.
Materials and Methods: Sixty extracted human premolar teeth were used in this study. Buccal surface of teeth were grounded until dentin was exposed. Then teeth were divided into four groups. According to dentin surface treatment, experimental groups were as follows: Group I: Single Bond (3M) according to manufacture instruction, Group II: 10% NaOCl+Single bond (3M), Group III: Clearfil SE Bond (Kuraray) according to manufacture instruction, and Group IV: Clearfil SE Bond primer. After that, the specimens were immersed in 50% acetone solution for removing extra monomer. Then the specimens were rinsed and dried. 10% NaOCl was applied and finally adhesive was used. Then composite was bonded to the treated surfaces using a 4 2 mm cylindrical plastic mold. Specimens were thermocycled for 500 cycles (5-55ºC). A shear load was employed by a universal testing machine with a cross head speed of 1mm/min. The data were analyzed for statistical significance with One-way ANOVA, Two-way ANOVA and Tukey HSD post-hoc tests.
Results: The mean shear bond strengths of groups were as follows: Single Bond=16.8±4.2, Clearfil SE Bond=23.7±4.07, Single Bond+NaOCl=10.5±4.34, Clearfil SE Bond+NaOCl=23.3±3.65 MPa. Statistical analysis revealed that using 10% NaOCl significantly decreased the shear bond strength in Single Bond group (P=0.00), but caused no significant difference in the shear bond strength in Clearfil SE Bond group (P=0.99).
Conclusion: Based on the results of this study, NaOCl treatment did not improve the bond strength in self etch adhesive and caused a significant decrease in the bond strength of total etch adhesive system.

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Background and Aims: The objective of the present study was to investigate knowledge and attitude of senior dental students towards HIV/AIDS. Its result could help in promotion of education.

Materials and Methods: This educational research was carried out in two state dental schools in Tehran. The senior dental students in Tehran and Shaheed Beheshti dental schools were asked to fill in a self-administered questionnaire regarding their age, gender, parents' job, knowledge and attitudes towards treatment of patients with HIV/AIDS in Autumn semester 2007. Fifty five dental students (83%) including 27% male and 73% female in Shaheed Beheshti and fifty five dental students (85%) including 34% male and 66% female in Tehran dental schools were participated. The score for knowledge and attitude of the students were calculated separately. The data were analyzed using Independent sample t-test.

Results: The mean percentage of knowledge and attitude scores were 76.5% (at rang 1-3) and 50% (at range 1-5), respectively. Nearly all of the students believed that all patients should be considered as HIV positive in dental practice, while 49% preferred to refer HIV positive patients. Knowledge and attitude of students were not significantly associated with the gender and knowing HIV positive person (P>0.05).

Conclusion: There is a need to improve knowledge and attitudes of dental students towards HIV/AIDS. It is suggested to emphasize on this subject in dental schools curriculum in Iran.

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Background and Aims: Candida species are opportunistic pathogens which live as benign commensal organisms in the oral cavities. The infants are more susceptible to opportunistic microorganism colonization. This study was design to evaluate the presence and quantity of Candida colonies in infants' oral cavities and its relation with age, gender, and type of diet and mothers' education level.
Materials and Methods: This historical cohort study was performed on two groups of infants 1) infants predominantly on breastfeeding (n=45) and 2) infants on bottle feeding (n=45). Oral samples were collected with swab technique and Candida species were identified using germ-tube test. The data were analyzed by using SPSS software, chi-square, logistic regression and Mann-Whitney tests.
Result: The Candida colony was seen in 53.3% of infants. The difference in oral Candida carriage and mean numbers of Candida colonies, according to the mothers' education level, was statistically significant (P=0.0001, P=0.000, P=0.0001) however, the mentioned two groups were not significantly different in terms of the presence of Candida and non Candida species (P=0.45). Candida colonization was not statistically related to the age and sex (P=0.48, P=0.4). By logistic regression test, it was found that type of diet and mother's education level affected oral Candida colonization (P<0.05).
Conclusion: The oral Candida colonization in breast-feeding infants is less than the bottle-feeding ones that might be attributed to the antifungal effects of mother's milk and the role of bottles in transferring the Candida species. Also increase in mother's education level leads to reduction in oral Candida colonization, which may be the result of improved hygiene. But no relation was seen between oral Candida carriage and age or gender of infants.

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Background and Aims: Fissure sealant therapy is a national program in elementary schools in Iran. Therefore, evaluation of the parents' knowledge and attitude is necessary to improve the program.
Materials and Methods: In this cross-sectional and descriptive-analytic study, Iranian students were chosen in a randomized cluster manner. The questionnaires were filled-out by students' parents to evaluate their general information, knowledge, and attitude. Moreover, students were examined for having any fissure-sealed teeth. Data were collected and analyzed by multiple logistic regression tests.
Results: 414 boy students and their parents were participated in this study. 57.6% of parents knew that fissure sealant prevents the caries and 44.5% believed that fissure sealant is important to prevent caries. However, only 8.9% of children had fissure sealant. Parents' knowledge was significantly related to the source of oral health information and oral health education. Regular dental visits and high level education was effective in increasing the knowledge about sealant therapy. There was a significant relation between parents' attitude toward fissure sealant and level of education, oral health education and numbers and times of dental visit (P<0.001). There were a significant relation between tooth sealing and parents' oral health information.
Conclusion: Regular dental visits and oral health education have positive role in parent's knowledge and attitude and practice. So parents must be encouraged to have regular dental visit and dentists must be emphasized to give them necessary education. School is the best place for giving proper information to parents.

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Background and Aims: Since impression materials usually contact with saliva, blood, and oral soft tissues, their microbial contamination are harmful in immunocompromised patients. The aim of the present study was to determine the bacterial and fungal contamination in common impression materials.

Materials and Methods: In current lab trial study, 5 different samples from each 4 impression materials were homogenized in 1 ml Tween 80 and then 100µl of each sample were cultured onto blood agar, EMB, or sabouraud dextrose agar. Bacterial and fungal cultures were incubated at 37º C and 30º C, respectively. The isolated bacterial and fungal colonies were enumerated and identified using specific diagnostic media and tests. Data were analyzed using Kruskal-Wallis test.

Results: Totally 75% of samples had one or several bacterial contaminations. Iranian alginate and Speedex (putty) were the most contaminated samples. On the other hand, Speedex (light body) and foreign alginate showed lower contamination. Species of Micrococcus, Staphylococcus, Bacilluses, Corynebacteria, gram negative Citrobacter, Actinomycetes and Neisseria were isolated from the analyzed impression materials. Aspergillus, Penicillium, Alternaria, Cladosporium and Sepdonium were the fungi isolated from impression materials. Statistical significant difference was shown between bacterial contamination of Iranian and foreign alginates (P=0.001). There was no statistical significant differences between the bacterial and fungal isolated colonies (CFU/gr) of 4 tested impression materials (P=0.21).

Conclusion: Several opportunistic bacteria and fungi were isolated from impression materials especially from Iranian alginate and Speedex putty which indicated their contamination.

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Background and Aims: Apical root resorption is an adverse side effect of fixed orthodontic treatment which cannot be repaired. The aim of this study was to use panoramic radiographs to compare the root resorption before and after the orthodontic treatment with standard edgewise .018 appliance.

Materials and Methods: The before and after treatment panoramic views of sixty-three patients needed fixed orthodontic treatment included 1520 teeth were categorized into 3 Grades (G0: without resorption, G1: mild resorption with blunt roots or ≤ 1/4 of root length, G2: moderate to severe resorption or > 1/4 to 1/2 of root length. Relationship between root resorption and sex and treatment duration was analyzed with Mann-whitney and  Spearman's correlation coefficient, respectively.

Results: The findings showed that 345 teeth were categorized as Grade 1.  Grade 2 of root resorption was not found in this study. The highest amount of root resorption was recorded for the mandibular lateral incisor. In both gender, the root resorption of the mandible was more than that of the maxilla. The males showed significantly higher rate of resorption than the females (P<0.05). Root resorption was not significantly related to the treatment duration and the side of the jaws (P>0.05).

Conclusion: The mandible and male patients showed higher amount of root resorption. In addition, root resorption was not related to the treatment duration and the side of the jaws.