Journal of Dental Medicine

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One of the major goals of periradicular surgery is to create a good apical sea! at the apex. This is done by sectioning of 2 to 3mm from the apex, preparation of a class I cavity and filling with a biocompatible material.The purpose of this in vitro study was to determine whether ultrasonic units used for root end preparations could change the surface & structure of resected root ends, as competed to common methods of retropreparation. Eighty-five extracted single rooted teeth were divided into five similar groups. Then instrumented and filled with lateral condensation method. Then three millimeter of apex was resected, retropreparaiions in two groups were done with low speed handpiece and round V) ^ur and cavities in two other groups prepared with the highest power of dentspiay ultrasonic unit with TFI-10 tip and in one other group prepared with the highest power of neo sonic ultrasonic unit with diamond coated CT-1 retro tip.Following root resection and retropreparation the surface of resected root ends were examined for the presence of any cracks or structural changes on the surface of resected root ends with stereo microscope 50x.The results of this study showed thai high power settings of ultrasonic units can increase the potential of crack formation on resected root surfaces. In conclusion it is better to use low power setting of ultrasonic for retropreparation.

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Statement of Problem: Central crown fractures of deciduous and permanent teeth lead to unfavorable psychological effects on both children and their parents. Moreover, it can cause malocclusion. So,recognizing tooth fracture reasons plays an important role to prevent its side effects.
Aim: The aim of this study was to investigate the reasons' of permanent central crown fractures in (7-12)years old children.
Materials and Methods: Records of 218 children, with at least one central tooth fracture, referred to pediatric department of faculty of dentistry of Tehran University of Medical Sciences, from 1999 to 2000, were studied. All the related information about fracture such as: reason, location, time, type of occlusion, and type of fracture were recorded.
Results: It was found that falling down (45.4%) and having contact with external objects (21.6%) were the main reasons for permanent centrals fractures. The mean age of these children was 9.78±1.24 and 63.3% of them were boys. It should be noted that 41.3% of them had unsupported lip. The highest rate of fractures belonged to upper centrals. Based on Ellis classification, most fractures were of degree 3 (52.7%). There was no significant relationship between overbite and overjet with the degree of fracture (P<0.05).
Conclusion: Dental skeletal malocclusions such as CI II, Div I, central incisors protrusion and developmental defects of tooth structure should be considered as determinant factors in tooth crown fractures.

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Statement of Problem: In a previous study it was reported that a durable resin-ceramic tensile bond could be obtained by an appropriate silane application without the need for HF acid etching the ceramic surface. Evaluation of the appropriate application of silane by other test methods seems to be necessary.

Purpose: The purpose of this study was to compare the interfacial fracture toughness of smooth and roughened ceramic surfaces bonded with a luting resin.

Materials and Methods: Ceramic discs of 10 mm in diameter and 2 mm in thickness were prepared. Four different surface preparations (n=10) were carried out consisting of (1) ceramic surface polished to a 1µm finish, (2) gritblasted with 50µm alumina, (3) etched with 10% HF for 2 min, and (4) gritblasted and etched. The ceramic discs were then embedded in PMMA resin. For the adhesive area, the discs were masked with Teflon tapes. A circular hole with diameter of 3 mm and chevron-shaped with a 90° angle was punched into a piece of Teflon tape. The exposed ceramic surfaces were treated by an optimised silane treatment followed by an unfilled resin and then a luting resin cylinder of 4mm in diameter and 11 mm in length was built. Specimens were stored in two different storage

conditions: (A): Distilled water at 37°C for 24 hours and (B): Distilled water at 37°C for 30 days. The interfacial fracture toughness (GIC) was measured at a cross-head speed of 1 mm/min. The mode of failure was examined under a stereo-zoom microscope and fracture surfaces were examined under Scanning Electron Microscope.

Results: The mean interfacial fracture toughness values were Group A: 1) 317.1±114.8, 2) 304.5±109.2, 3) 364.5±169.8, and 4) 379.4±127.8 J/m2±SD. Group B: 1) 255.6±134.4, 2) 648.0±185.1, 3) 629.3±182.6 and 4) 639.9 ±489.0 J/m2±SD. One way Analysis of Variance showed that there was no statistically significant difference in the mean interfacial fracture toughness for groups A1-A4 (P>0.05). However, the mean interfacial fracture toughness for group B1 was significantly different from that for groups B2, B3 and B4 (P<0.05). Independent-ٍٍٍSamples T-Test results showed that there was a significant increase in the GIC mean value for groups B2 and B3 after 30 days water storage (P<0.05). The modes of failure were predominantly interfacial or cohesive within the resin. Conclusions: The fracture toughness test method used in this study would be appropriate for analysis of the adhesive zone of resin-ceramic systems. From the results, it can be concluded that micro-mechanical retention by gritblasting the ceramic surfaces could be sufficient with no need for HF acid etching the ceramic surfaces when an appropriate silane application procedure is used.

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Statement of Problem: Because dental amalgam does not adhere to tooth structure, using adhesive cements in amalgam-bonded restorations have been increased.

Purpose: The goal of this in-vitro study was to compare the effects of three types of glass ionomer as adhesive liners as well as varnish liner in increasing fracture resistance of teeth restored with amalgam.

Materials and Methods: Seventy extracted human maxillary premolars were selected and MOD cavities were prepared on them excluding ten intact teeth as positive control group and ten cavity prepared teeth without restoration as negative control group. All the prepared teeth were then restored with spherical amalgam (gs.80) with one of the following liners silver alloy glass ionomer liner, conventional glass ionomer liner, varnish liner, resin-modified glass ionomer and resin-modified glass ionomer with delayed light curing. The teeth were stored in 37C distilled water for 7 days and were then loaded under compressive strength using an Instron testing machine. The force required to fracture teeth were recorded and the data were analyzed statistically using ANOVA and Tukey HSD tests.

Results: Statistically significant differences were observed in fracture resistance between restored and non-restored samples. Comparisons between groups attributed significant effects to resin-modified glass ionomer in increasing fracture resistance of amalgam restored teeth (P<0.05). In most specimens, one cusp was separated from tooth structure whereas amalgam remained bonded to the intact cusp. Conclusion: According to these findings, resin-modified glass ionomer put a statistically significant effect in fracture resistance of amalgam-restored teeth.

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Background and Aim: In recent years, CT scan has become available as an alternative to conventional radiography. To date, the utility of Waters view in detecting midface fractures has been rarely evaluated. The aim of this study was to compare the diagnostic accuracy and reliability of Waters radiography with CT scan in detecting midface fractures.

Materials and Methods: In this tests evaluation study, waters view and CT scan were performed for 42 patients with midface fracture admitted to maxillofacial surgery department of Shariati hospital. All images were observed and interpreted by an oral and maxillofacial radiologist and an oral and maxillofacial surgeon. Sensitivity, specificity and reliability for Waters view in detecting midface fractures were assessed by Cohen’s kappa test.

Results: Sensitivity and specificity for Waters view in detection of midface fratures by the radiologist were 31.79% and 95.35% and by the surgeon were 29.59% and 93.75% respectively. The highest reliability in CT scan and Waters view (in nasal fractures) by the radiologist was 66.67% and was 58.33% by the surgeon in buttress of zygoma. The highest agreement rate between the radiologist and the surgeon for CT scan was in zygomatic arch (78.95%) and for Waters view was in nasal fracture (62.5%).

Conclusion: Based on the results of this study, the specificity of Waters view is sufficient to diagnose fractures of lateral orbital wall, infraorbital rim, orbital floor, zygomatic arch, frontozygomatic suture, lateral wall of maxillary sinus and Lefort II fracture. The specificity is not sufficient to diagnose fractures of medial orbital wall and anterior, posterior and medial wall of maxillary sinus. Detection of these midface fractures needs other conventional radiographies or CT scan.

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Background and Aim: The structural rehabilitation of a pulpless tooth is critically important to ensure a successful restorative outcome following endodontic treatment. A post and core is often indicated for the retention and reinforcement of the final restoration. But, the clinical situation is significantly challenging if the root exhibits immature development or there is a thin root wall that can compromise the prognosis for a long- term successful treatment. The purpose of this in vitro study was to evaluate different methods of intraradicular reinforcement in structurally compromised roots.

Materials and Methods: In this experimental study, seventy two extracted intact maxillary central incisors with similar size, shape and root anatomy were selected. After root canal therapy in 60 teeth, an acrylic laboratory bur was used to thin the cervical area and simulate the thin dentinal walls of immature teeth. The preparation was performed through the palatal access and extended 5mm apical to CEJ. The remaining 12 teeth remained unprepared to serve as positive control group. Cases were randomly divided into six groups of 12 teeth each and restored as follows. In the 12 cervically unprepared teeth (positive controls) the composite resin with dentin bonding agent (DBA) was placed in access cavity and cured for 120 seconds. This technique was also applied to other groups when the access was restored with composite. In the second group, the access cavity was restored with composite only to the level of CEJ. In the third group the cervically prepared teeth were reinforced with cement resin (Enforce) and a prefabricated post was placed in 5mm apical to the CEJ. In the fourth group, the cervically prepared teeth were reinforced with composite resin and DBA by a clear plastic post. In the fifth group the cervically prepared teeth were reinforced with composite resin and dba and a cast post. In the sixth group the cervically prepared teeth were restored with composite resin and dba with a prefabricated post. All of the specimens were mounted by rubberized technique and tested in the Instron universal testing machine. The fracture loads in samples were analyzed with ANOVA and Duncan tests with p<0.05 as the limit of significance.

Results: Significant differences in fracture resistance were observed between the first and second groups compared with others. The highest fracture resistance values were recorded for first group while the lowest were registered for the second group. Fracture resistance of the third, fourth and fifth groups had no significant statistical differences with others and fracture resistance of sixth group was the highest with significant difference (P<0.05).

Conclusion: From this study, it may be concluded that the use of a dba and a composite resin in thin-walled roots reinforces the immature teeth and facilitates the use of post.

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Background and Aim: Considering flexural strength of fiber-reinforced composites (FRC) and also the role of conservative cavities in protecting sound tissue of abutments, the aim of this study was to evaluate the fracture resistance of these bridges by handmade samples in vitro.

Materials and Methods: In this experimental in vitro study, 44 sound newly extracted teeth were used to make 22 fixed inlay bridges including 11 three unit anterior upper inlay bridges substituting clinical model of upper central and 11 three unit posterior lower inlay bridges substituting clinical model of lower first molar. Specimens were prepared with FRC and mounted with artificial PDL in acryl. Cases were exposed to final load by using Universal Testing Machine (Instron 1195) with the speed of 1 mm/min. Statistical analysis was performed by Kolmogorov- Smirnov, independent sample T and Kaplan-Meier tests with p<0.05 as the level of significance.

Results: Based on the statistical tests, the 95% confidence interval of mean was 450-562 N in anterior and  1473- 1761 N in posterior area. Fracture strength was high in the studied groups. Fractures in both groups occurred on composite facing, and the framework remained intact. The highest percentage of fracture in posterior teeth was in the middle of pontic towards the distal connector and in the anterior teeth in the lateral connector, between central pontic and lateral abutment. Using the independent sample T  test a significant statistical difference was observed between two groups (P<0.001). The fracture resistance of anterior samples was lower than the posterior ones.

Conclusion: Based on the results of this study regarding the high fracture resistance in both areas FRC inlay bridges could be recommended for upper anterior and lower posterior teeth in clinical dentistry certainly more studies are needed to ascertain this treatment option.

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Background and Aim: Zygomatic fractures are common among oral and maxillofacial problems and ocular injuries are of great importance, the prevalence of ocular problems following zygomatic fractures in Iran is not clear so we performed this study to evaluate this problem in patients referring to Shariati Hospital.

Materials and Methods: In this descriptive, cross-sectional study, we evaluated the patients who referred to department of oral and maxillofacial surgery of Shariati hospital for ocular complains following zygomatic fractures. The evaluation was performed both clinically and historically.

Results: 115 patients were examined (87 males and 28 females) with the mean age of 26 for males and 32 for females. The prevalence of ocular injuries were as follows: subconjunctival ecchymosis: 23.07% for males and 21.05% for females. Displacement of palpebral fissure: 26.5% for males and 27.6% for females. Unequal papillary levels: 18.37% for males and 15.78% for females. Diplopia: 8.9% for males and 10.5% for females. Enophthalmos: 23.1% for males and 25% for females.

Conclusion: It is strongly recommended to refer patients with zygomatic fracture for an ophthalmologic consultation.

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Background and Aim: Fractured anterior teeth can be restored by adhesive bonding of the separated fragment to the remaining tooth structure. This invitro study evaluated the force required for fracture of rebonded fragments which were dried and rewetted for various time intervals prior to bonding.

Materials and Methods: One hundred and eight human mandibular incisors were selected and were divided into 9 groups and then were fractured. The fragments were stored in air at room temperature and ambient humidity. They were air dried for 30 minutes in group 1, 2 and 3,  6 h in group 4 and 5,  24 h in group 6 and 7, and 3 days in groups 8 and 9. The apical parts of the fractured teeth were stored in water.After storage in air, each fragment in group 1 was bonded to the remaining apical tooth structure with a bonding agent and flowable composite.In groups 2, 4, 6 and 8 after air drying the fragments were stored in water for 30min. The time of storage in water in groups 3, 5, 7, 9 was 24 hours. Then each fragment was bonded to the apical part structure. The mean force required for fracture was measured by a mechanical testing machine. One way ANOVA and Tuckey tests were used for analysis.

Results: There were statistically significant differences between different groups (p<0.001).The highest and lowest force required for fracture belonged to groups 3 and 8 respectively. The force required for fracture in group 1 was lower than group 2, 3, 5 and 7 and 9 and more than groups 4,6 and 8 with significant differences.While there were no significant differences among groups 3, 5, 7, 9 and 4, 6, 8 the force required for fracture in groups 2, 3, 5, 7 and 9 was more than 4, 6, 8 with significant differences.

Conclusion: This research revealed that the force required for fracture was affected by air storage of fragments prior to bonding. Also showed that with an increase in duration of drying the force required for fracture decreased and after a period of time it becomes steady. This study showed that in order to increase the fracture strength after air drying the fragment should be immersed in water for at least 24 hours prior to bonding.

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Background and Aim: Polymerization shrinkage of resin cements during setting leads to stress on teeth receiving indirect esthetic restorations. Some methods like blocking out undercuts during cavity preparation with glass Ionomer can reduce the mass of resin cement and therefore the amount of stress. The aim of this study was to evaluate the fracture resistance of molar teeth, receiving class I ceramic inlays with two different methods of blocking out undercut.

Materials and Methods: In this experimental study, thirty intact molar teeth were randomly divided into three groups of 10 each. One group was maintained intact as the control group. Similar class I cavities with identical undercuts were prepared on the other groups. In group 2 the undercut was filled with light cured glass Ionomer (vitremer 3M) before making impression, and in group 3 they were blocked out in the lab before preparation of the inlay. All the teeth in test groups were restored with indirect ceramic inlays.(vitadur - Alpha/ single bond / Rely X ARC). After thermocycling load causing fracture was assessed by universal testing machine. All the specimens were examined under a steriomicroscope (X40) to determine type of fracture. The results were analyzed by one way ANOVA and Tukey HSD tests. P< 0.05 was considered as the level of significance.

Results: The restored groups showed significantly less fracture resistance than the control group. The difference between two test groups was not significant. The fracture in group2 had less destruction.

Conclusion: According to the findings of this study, blocking out the undercut with two different methods (using glass ionomer/ or blocking it out on the die) made no diferrence in fracture resistance.

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Background and Aim: Because of stable aesthetic and minimum destructive technique, Porcelain laminate veneer has an important role in aesthetic dentistry. But main reason of failure in this treatment is restoration fracture. Therefore tooth preparation have an important role in fracture resistance of porcelain laminate veneer. The aim of this in vitro study was to evaluate the fracture resistance of porcelain laminate veneer dependent on tooth preparation after exposure to dynamic loading.

Materials and Methods: In this study, 30 caries free mandibular incisors were devided into 3 groups. First group (Control group) remained unprepared. In second group (Window preparation) facial surface was prepared with 0.3, 0.5, 0.7 mm in cervical, middle and incisal, respectively. In third group (Incisal lap preparation) the preparation was like second group and included 2 mm of incisal edge. 20 feldespatic ceramic veneer were bonded adhesively with dual-cure luting cement (Rely X). All specimens were subjected to cyclic mechanical loading (720000 cycles, 1.3Hz, 30N) and thermal cycling (5-55 C, dwell time 60seconds, 500 cycles). The specimens were exposed to Universal testing machine until failure occurred with a constant crosshead speed of 1mm/min.

Results: Five specimens of first group, one specimen of second group and two specimens of third group fractured during cyclic loading. The mean failure loads(MPa) after exposure to continues load were as follows: First group: 168/96 (561.01-1115.08), second group: 394.10 (248.92- 641.33) and third group: 273.47 (135.45 - 479.80). Data analysis was performed by ANOVA, LSD and chi Square test.

Conclusion: Significant difference between 3 groups were found. Fracture resistance of control group was significantly higher than other groups and window group preparation was significantly higher than incisal lap group. The samples were under the cyclic loads before they put under the continuous pressures of universal testing machine. It was clear that incisal lap preparation is more resistance against fatigue failure compared to window preparation.

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Background and Aim: A key factor in restoring the endodontically treated teeth is ferrule preparation. When the ferrule is absent, occlusal loads may cause the post or root to fracture. The purpose of this in vitro study was to evaluate the effect of ferrule preparation on fatigue resistance of teeth restored with quartz-fiber posts.

Materials and Methods: Twenty single-rooted lower premolars having similar dimentions were randomly devided into two groups of 10. In control group the teeth were prepared with 3-mm of remaining coronal tooth structure and in test group teeth were prepared with 1-mm of remaining coronal tooth structure. The teeth were endodontically treated. 9-mm long Post holes were prepared, and D.T. light quartz-fiber(RTD,France) posts were cemented with Panavia F2(Kuraray,Japan).Then the core build up was done with Bisco core build up composite(Bisco,USA) and full metal crowns were cemented with Zinc phosphate(Harvard cement, Germany). All specimens were mounted in acrylic resin blocks and intermittently loaded (180 N) at an angulation of 45- degree to the long axis of the teeth at a frequency of 4 loads per second, until failure occurred.

Results: There was significant difference between the loads cycles of two groups studied. (p<0.0001).

Conclusion: The results of this study showed that an increased amount of coronal dentin significantly increases the fracture resistance of teeth restored with quartz-fiber posts.

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Background and Aims: Metal-free and fiber-reinforced composite (FRC) restorations have drawn considerable attention and interest in recent years for restoring in the posterior area due to their improved esthetics. Fracture resistance is one of the most important mechanical properties of materials because of 500-600 N load of occlusion. The restorations should tolerate this load. The purpose of this in vitro study was to compare the fracture resistance of FRC with that of zirconia all-ceramic for posterior partial dentures.

Materials and Methods: Forty extracted human intact teeth (20 first premolars and 20 first molars) selected for fabricating 10 pairs of fiber-reinforced composite and 10 pairs of zirconia all-ceramic bridges. After receiving standard tooth preparation, the teeth were mounted with 7.5 mm distance between each other. The bridges were made and cemented on the teeth. Then the restorations were stored in 37ºC water for 30 days. The fracture resistance was measured using mechanical testing machine with cross-head speed of 1mm/min. Data were evaluated by Independent Sample T test.

Results: The mean fracture resistance in the ceramic group was 1329.41 N and for the F.R.C group was 1118.528 N with significant differences between them (P=0.034). The failure modes were mainly cohesive at pontic area for ceramic samples, but adhesive for FRC samples at pontic area.

Conclusion: Both systems showed sufficient fracture resistance for using in posterior area.

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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.

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  Background and Aims : The root fracture resistance of endodontically treated teeth depends on the types of posts. The aim of this study was to compare the effect of two types of bonded non-metallic posts with different elasticity modulus on the fracture resistance of endodontically treated teeth under compressive loads.

  Materials and Methods: In this in vitro experimental study, 20 fresh extracted mandibular premolars were selected and sectioned adjacent to the CEJ and then were endodontically treated. The specimens were randomly divided into two groups (n=10). After post space preparations, the fiber RTD Light posts (R.T.D, France) and zirconia coated fiber posts (ICE light, Danville) were cemented into the root canals. Composite resin (Lumiglass R.T.D, France) cores were built up. Aluminium foil was used to mimic the PDL, and the specimens were embedded in acrylic resin and tested in a Universal Testing Machine. A compressive load was applied at a 90 degree angle until fracture at a crosshead speed of 1mm/min. Data were analyzed using one-way ANOVA and T test .

  Results: The mean fracture resistance of R.T.D group was (1083.11 ± 156.74 (N)) and the mean of ICE light group was (865.18 ± 106.24 (N)). The highest mean fracture resistance was observed in RTD fiberglass and a statistically significant difference was observed between the two groups (P<0.001).

  Conclusion: FRC posts with zirconia coating due to unfavorable fractures of the teeth should be used with caution, and thus, fiber posts are preferred.

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  Background and Aims: Diagnosis of vertical root fractures often poses a clinical dilemma. Diagnosis of VRF in intraoral radiographs, except in cases where the beam is perpendicular to the direction of fracture is difficult. Misdiagnosis often leads to wrong decisions about the design of teeth future treatment plan. The aim of this study was to determine the diagnostic accuracy of reverse contrast enhancement options in digital radiography, and to compare it with the original images to find a suitable method to detect vertical root fracture.

  Materials and Methods: In this experimental study, digital radiography with phosphor plate detector was taken from 40 extracted single root teeth. From each intact and fractured tooth, the original and reverse contrast images captured and stored. Two expert observers viewed the images twice with an interval of two weeks. Diagnostic criteria (Accuracy, PPV, NPV, Specificity and Sensitivity) in form of absolute and complete for each observer and each images was calculated. Inter and intra observer reliability was obtained using Mc-Nemar test.

  Results: No significant differences in inter-observer reliability between the initial appearance and reverse contrast was observed (P>0.05), but in view of the intra-observer reliability in two cases, the difference was significant (P<0.05). No significant difference in the accuracy, sensitivity, specificity and PPV was observe between the two used images (P>0.05), whereas significant difference between the two images was found in NPV index (P<0.05).

  Conclusion: The use of reverse contrast enhancement option for detection of vertical root fracture did not show significant difference from initial view.

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Background and Aims: Fractures of the facial bones and jawbones could cause functional problems along with social and cosmetic problems. Various factors (including road accidents, assault, falling from height, sport injuries, and getting hit by a hard object) could cause these fractures. Collecting and reporting accurate epidemiologic data regarding the facial fractures are major steps toward planning preventive measures. The aim of this study was to collect the epidemiologic data regarding maxillofacial fractures in two referral centers (Shariati and Sina hospitals) in the city of Tehran.
Materials and Methods: The study was a cross-sectional retrospective investigation. All the necessary data were collected from the patients’ files and analyzed using SPSS 25.
Results: The present study pursued data of 454 trauma admitted patients in oral and maxillofacial surgery wards of Shariati and Sina hospitals in 1397 and 1398. These data showed that a number of 374 patients of all patients were men and the other 80 were women. The ratio of male patients to female patients was 4.5:1. In 290 of cases (64%), the fractures occurred as combined fractures and in 164 cases (36%), the fractures occurred as single fracture. These fractures happened mostly in the mandibular bone and in mandibular body, and the least of these fractures happened in Orbit. This study showed that there was a significant relation (with 95% confidence level) between the mandibular body fractures and mandibular angle fractures. This study also showed that there was another significant relation (with 95% confidence level) between the mandibular angle fractures and LeFort 2 fractures. In addition, this study also showed (by using k2 exam) a relation between the etiology of trauma and the number of fractures.
Conclusion: This present study showed that the maxillofacial fractures happened mostly in men much more than women. If we put motorcycle accidents and car accidents in a group together called road accidents, the most common etiology of maxillofacial fractures is road accidents. The results showed that the most fractures happened in the age range of 15-25 year old.