Journal of Dental Medicine

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Bone marrow transplant (BMT) has increasingly become a common treatment option for patients whom has their bone marrow affected directly or indirectly by any disease. Because of the level of immunosuppression achieved in BMT, any problems the pediatric patient presents in their oral cavity can become life- threatening and increase the length of hospital stay, the patients discomfort and the treatment cost. This paper discusses the important and unique role that pediatric dentistry has in the multi professional bone marrow transplantation team to help bring out a successful outcome through the prevention and treatment of the acute oral complications often seen in these patients.

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Guided Tissue Regeneration (GTR) is the most recent and common method for regeneration of class II forcation molars. However, it requires membrane, which seems expensive for most of the patients. In order to overcome this problem, Coronally Position Flap (CPF) procedure may be applied which arresting the epithelial cell down growth, follow the same aim. This study is aimed to compare GTR technique utilizing bioresorable collagen membrane and CPF utilizing citric acid. Nine patients with grade II forcation defects were selected. Defects were bilateral that randomly assigned into two groups: GTR and CPF groups. Measurements recorded at baseline and after surgery (6 months). Paired-T test was performed on these data. The following results were obtained after 6 months: In both groups significant reduction in probing pocket depth were measured in GTR and CPF groups, 1.55 Ind 1.88 mm, respectively. Also, open vertical probing depth: 0.33, 1.11 mm. Reduction in forcation weight in both groups was 0.22 mm. Bone fill was observed in 0.33% and 51% of defects. No recession was observed in GTR group, in CPF was 0.11 mm. Loss of attached gingiva was 0.34 and 0.78 mm, respectively. No significant difference was found between clinical parameters except OHPD. Comparison of means at the day (0 and 180) in each group showed the success for regeneration of forca. Considering the results, it can be concluded that CPF may substitute for GTR technique.

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In this investigation, the position of hyoid bone was compared in three skeletal groups of class I, II and III. The study was based on evaluating 77 lateral cephalometric radiographs, 40 girls and 37 boys, which were divided into 3 groups. Group 1, 2, and 3 consist of 26, 25, and 26 radiographs. 19 cephalometric landmarks and 10 planes were used in order to tracing the radiographs. In all patients, 9 skeletal and 4 cervical vertebrae parameters were measured to determine the hyoid bone. These parameters were compared between three skeletal groups regardless of sex and then, in another statistical analysis, parameters were compared based on patients sex. Statistical analysis showed that in class III patients, the hyoid bone was positioned more anteriorly than two other groups. Also in this group, the hyoid bone had less inclination and it was more horizontal in relation to mandibular plane. In skeletal class II patients this bone was positioned more superiorly than two other groups. Due to these findings it can be concluded that perimandibular muscles and bones could affect the growth of mandible. In addition, comparison of the parameters between two sexes revealed that the hyoid bone was positioned more anteriorly and inferiorly in boys. Also it was shown that in the girls, the position of hyoid bone was closer to the position of this bone in skeletal class I patients.

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The geometric shape of dental arch (square, tapering, ovoid) is an important factor in stress distribution pattern around dental implant. The aim of this study was to evaluate the role of arch form and the amount of bone loss (normal, moderate, high) in stress distribution around dental implant by considering different load direction. Three arch forms square, ovoid, and tapering with three different stages of bone loss were designed. Models were divided into three-dimensional elements, which made 5500 nodes. The 143N load was applied at two angles (straight, oblique) at the last fixture, 8mm, and 16 mm from the center of implant on l!ie cantilever. The Sap90 software was used for analyzing the stress distribution in this study. 54 different conditions were evaluated. Results showed that stress concentration changed from support toward fixture due to distally changing the load in the square and ovoid arch forms with normal bone. In the tapering arch with normal bone stress concentration was around the fixture. The amount of stress in normal tapering arch was more than physiologic extend, therefore, application of cantilever in tapering arches is not recommended.

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The purpose of this study was to assess the fluoride release of three fluoride- containing materials exposed to fluoride solutions. This study compared the initial fluoride release and release following re-fluoridation (neutral or acidic 2% NaF) of three different filling materials, conventional glass ionomer cement (CG1C), resin- modified glass ionomer cement (RMGIC), polyacid- modified composite resin (PAMCR). Twenty discs of each material, measuring 2mm height and 6mm diameter, were suspended in separate vials of 2" laboratory artificial saliva. The amount of fluoride release was measured over two periods of 28 days each. Fluoride release was determined at 1,3,7,14 and 28 days of each period. Fluoride was measured with a fluoride ion- specific electrode and an ion analyzer previously calibrated with standard solution .T- test and ANOVA were used to evaluate the data. Fluoride release for all products at days 1 and 3 was significantly greater than the rest of the time intervals. Then, the fluoride release decreased significantly. CGIC released significantly more fluoride than the other products. This was followed by RMGIC, which exhibited significantly more fluoride release than PAMCR. In second period of experiment, the specimens were assigned to two subgroups often each. The samples exposed to two different solution of NaF (neutral or acidic). All groups showed the capacity of re-fluoridation and fluoride uptake. The specimens exposed to acidic NaF solution showed statistically more significant rechargeability than the neutral NaF solution. It may be concluded that glass ionomer cements act as a rechargeable slow fluoride release systems and as an effective caries preventive material in caries preventing programs for caries susceptible children.

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Bone osseointegration around dental implant can cause earlier stabilization and fixation of implant and reduce healing time. Hydroxyapatite coating can affect bone osseointegration and enhance its rates. The aim of this study was comparison of osseointegration between plasma sprayed hydroxyapatite coated and uncoated dental implants in cats. Four endodontic implants including, vitallium and two stainless steel with and without hydroxyapatite coating were prepared and placed in mandibular canines of 20 cats after completion of root canal treatment and osseous preparation. After a healing period of 4 months, investigation by scanning electron microscopy showed significant difference in ossointegration between coated and uncoated dental implants and average bone osseointegration of coated implants was more than uncoated implants.

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Oral cancers account for a relatively high percent of neoplasms in the elderly population. Treatment protocols often include anti-neoplastic pharmaco-therapeutics, irradiation of the head and neck region, and surgery. These treatments, specially radiation, have detrimental effects on oral hard and soft tissues. Salivary glands undergo a distinct and longterm dysfunction, which leads to decrease in salivary How. Xerostomia is a common clinical problem in these patients which contributes to dry mouth, mucosites, change in oral ecosystem and dental caries, followed by difficulties in speech, swallowing and use of dentures which cause malnutrition. This phenomenon has an irreversible weakening effect on the patient's health. To prevent this negative impact on oral health in this group of patients, definitive dental treatments prior to the initiation of medical therapies is imperative, and will decrease the morbidity rates. Today's dentistry benefits from improved methods and materials, which enable us to give these patients a better preventive dental treatment. Consultation between dentist and medical team would be the best way to help our sufferer patients.

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The purpose of this study was to evaluate Y shape appliance for expansion on maxillary arch of patients in their mixed dentition age. Eight patients, 6 girls and 2 boys, with maxillary constriction, retrusion of maxillary anteriors, and space deficiency of upper canine were treated by Y-plate expansion. For each patient 8 parameters on upper cast and 7 parameters on lower cast were measured. Statistical analysis was conducted by calculating the mean, standard deviation and p-value, of parameters. Since these parameters change during natural growth, the results were compared to normal growth changes of similar patients group form another study as control. Results showed significant increase in maxillary and mandibular cervical and coronal intercanine and intermolar width (P<0.005). The results also showed significant increase in maxillary arch length and perimeter.

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The idea of using chemical agents in removal of obstructions on the walls of root canals has been existing since years ago. Successful attempts in this area have been made with the introduction of RC-Prep materials in root canal preparations. The aim of this study was to compare the decalcifing potency of two chelating agents in root canal preparations. 30 extracted canines were divided in three groups for use of Re- Prep materials. Group A Rc-Prep (Primer) made in USA, group B Re- Prep (RC-CTF) made in Iran, and group C as control. Root canals were prepared using standard method followed by washing with 5% sodium hypochloride. Then the teeth were divided into two sections of mesial and distal by a special cutting device. The amount of calcium on polished sections was measured using an elemental analysis method (electron beam probe system). The mean value data were analysed using one‌way Analysis of Variance (ANOVA). The mean values for the measured calcium were group A: 28713±1129, group B: 39441+680, and group C: 54458±2024 . Statistical analysis showed that the mean value for group A was significantly different from other groups. There was also significant difference in the mean values for group B and C. The results indicate that the decalcifing potency for Rc-Prep (Primer, USA) is significantly higher (PO.001) than that of Rc-Prep (RC-CTF).

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One of the major factors in a successful root canal therapy is the determination of root length before canal preparation. Radiography has been proved to be useful in this case, but nowadays for reducing radiation, radiovisiography has been recommended. The aim of this study was comparing conventional radiography (CR) with radiovisiography (RVG) in determination of canal length. 101 anterior and posterior extracted human teeth were selected. After mounting in unolit block, K- file (Num. 15) was placed in canal with tactile sense. Working length was measured by C.R and RVG. The results were analyzed by complete, randomized block design. RVG and CR showed shorter length than actual length. But, the measured lengths did not show significant statistical differences. As a result, considering the advantages of RVG, it is recommended in determining canal length.

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The aim of the present study was the histological evaluation of Enamel Matrix Derivative (EMD) effectiveness for regeneration of periodontal defects. EMD activates cementum synthesis, PDL and bone during the maturation stage of follicole. In this research, EMD was used in surgical defects of premolar teeth in four adult sheep. Muccoperiosteal flap was reflected in buccal site of teeth. The buccal bone plate was removed from mesial to distal in 4 mm depth. After eliminating the cementum by bur and its etching, EMD was applied on exposed dentine and flap was sutured. In opposite sites of those teeth (control sites) the same process was performed without etching. After 100 days, sheep were sacrificed and histological study through light microscopic was performed on black sections of operation sites. The results showed that in test sites, regeneration of cementum and bone was 62/5% and 42/5-50% respectively. But in control sites regeneration of cementum and bone was 37.5% and 32/5-42/5% respectively. Also the migration of junctional epithelium in control sites was 8-10% more than test sites. The important point is that in test sites, cementum was completely attached to undermining dentine. But, in control sites, the gap between cementum and dentine was visible. As a result, this study suggests that EMD promotes periodontal regeneration, and EMD application is a successful achievement in regenerative periodontal therapy.

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There are two types of high-copper dental amalgams produced in Iran Cinalloy (lathe-cut particles) and Cinalux (spherical particles). Tarnish is one of the disadvantages of dental amalgam, which precedes corrosion, and in fact it means real destruction of restorative materials. The purpose of this study was to compare the extent of tarnish in Cinalux and Cinalloy amalgams. 32 patients, with at least two carious or poorly restored teeth were selected. Then, each tooth was restored with one of these two types of dental amalgams. The restorations were polished after 24 hours and patients were followed up after 9 months. The restorations were categorized in four groups of no change, one plus (1-30%), two plus (30-60%) and three plus (more than 60%) according to the level of discoloration. The results showed that the level of tarnish in Cinalux group was significantly less than Cinalloy group. The mean of tarnish for Cinalloy and Cinalux was 2.09±0.59 and 1.72±0.68 respectively. In addition, statistical analysis showed that there was no significant relationship between tarnish and Oral hygiene, smoking, operator or type and place of restoration.

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 Polymerization shrinkage of light cure composite resins causes many complications in conservative and esthetic restorations. The objective of this in-vitro study was to evaluate the polymerization shrinkage, degree of conversion and the amount of filler in IDM and tetric ceram composites. Ten disk shaped, uncured specimens (8mm×1.547mm) of each composite were placed on glass slide in the center of the metal attached to it. Then specimens were light cured for 60s from underneath. After 30 minutes, the thickness of specimens, using a micrometer and the percent of the polymerization shrinkage of each sample were measured. Statistical analysis was carried out by t-test (P<0.05). Also the degree of conversion of specimens was evaluated with FTIR and the mineral filler content was measured by burning in electric oven. Polymerization shrinkage in IDM and tetric ceram was not significantly different. Degree of conversion and mineral filler content in tetric ceram was greater than that of IDM.

It is assumed that the low degree of conversion in IDM is due to its chemical composition and filler content. Also, the similarity in linear polymerization shrinkage between IDM and tetric ceram may be caused by the low degree of conversion in IDM.

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Actinomyces species are normal residents of the mouth cavity, gastrointestinal tract and female genital tract. The genus consists of gram-positive bacteria, strictly anaerobic or microaerophilic. The bacteria are opportunists with a low virulence potential that cause actinomycosis only when the normal mucosal barriers are disrupted. The main purpose of this study was the isolation of Actinomyces strains and determining of their role in periodontal diseases. The present study was carried out on 100 patients with periodontal diseases referred to the Periodontic Department of Faculty of Dentistry. The sampling was done in 6 months with isolation of oral Actinomyces from microbial plaque and periodontal pocket. The samples were selected based on the following criteria: periodontal plaque with deep pocket (>3 mm), no antibiotic therapy for a period of at least two weeks, and lack of systemic diseases. One strain of Actinomyces viscosus and two strains of Actinomyces naeslundii were isolated from the patients with gingivitis and periodontitis. Of the 100 patients with gingivitis and periodontitis, aged between 18-57 years old, 46% were males and 54% were females. The peak incidence of the diseases (35%) was in the third age group (31-40) and the lowest incidence (10%) was in the first age group (<20). Forty patients (40%) complained of gingival disease and its bleeding with lower incidence of (42.5%) in female.

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IgA selective deficiency is the most common immunodeficiency. The prevalence of it in different races varies from  to . Since secretary IgA has has a defensive role in the mucosal surfaces, supposing is thought that IgA deficiency will be accompanied by oral manifestations. The previous studies showed controversial results about that. The aim of this cohort study was to finding out oral manifestations in IgA- deficient individuals. As s result oral specialists can find the patients in early stages. 11 IgA- deficient patients (with IgA level < 10 mg/dl in serum) and 11 normal volunteers with the same age and sex were compared. The ages of the people were between 3 and 18 years old and 5 girls and 6 boys were in each group. Their oral examination included DMFT (Decayed, Missed and Filled Teeth), periodontal condition, Plaque accumulation and oral mucosal lesions. Saliva immunoglobulin and secretary component levels were detected by enzyme- linked immunosorbent assay (ELISA) and serum immunoglobulin levels were detected by single radial immunodiffusion (SRID) methods. All of the IgA- deficient patients had the serum IgA level < 10 mg/dl and their immunoglobulin levels were normal.  of these patients didn't have SIgA and the rest of them had a little SIgA in their saliva(<  SIgA levels in sex and age matched normal group). IgA deficient patients showed no statistical significant difference about oral manifestations in comparison with normal group. It may be related to the increase of compensatory SIgM or assistance of other non- immunological defense factors in saliva, phagocytosis and cellular immunity. Thus IgA- deficiency cannot produce any oral manifestations as a criteria to diagnose it.

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The cleaning and shaping of root canals is one of the most important proccesses in endodontics. In many cases, the physiologic or pathologic proccedures can affect the canals. So, using the instruments and materials, which could be applied in cleaning and shaping of narrow canals is necessary. The aim of this study was the evaluation of Iranian and foreign chelating agents on periradicular tissue of cats. After cleaning and shaping of canals in 18 lower canines of cats, the original RC-Prep and an Iranian chelating agents were placed equally in two groups with 9 teeth in each one. The patency of canals preserved for materials leakage. In 3 lower canines of cats, phosphoric acid was placed as positive controls.3 canine teeth as negative controls had nothing in them. The crowns were sealed and the cats were sacrificed in 1/21/42 days periods after conducting vital perfussions. The teeth samples with their surrounding osseous tissues were gathered and placed in three groups each contained 6 samples. Histologic preparations were done and the tissue reactions to these materials were evaluated by counting the proliferative inflammatory cells. Also the morphometric analysis for these samples was done. The inflammatory reactions of these materials (the original RC-Prep. & the Iranian chelating agent) were not statistically different. Both of these materials were different in inducing tissue reactions in comparison with those of positive and negative controls, and these differences were statistically important.

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Whenever the first permanent molar is extracted or its long- term prognosis is poor, before taking any steps, a full clinical and radiographic evaluation associated with patient's dental models investigation is necessary to determine the following cases:The quality and quantity of dentition, teeth missing, occlusion, buds position, orthodontic problems, the level of parents and patient cooperation for future long term orthodontic treatment and finally patient's oral hygiene. On the basis of this information, a decision is taken about the first permanent molar extraction with poor prognosis, either of balancing or compensatory type, especially when future orthodontic treatment is improbable. The aim of this article is to explain the principles of time and sequence of first permanent molar extraction.

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Posterior composite restorations, due to polymerization contraction, result in microleakage. Different methods have presented to reduce this phenomena. The aim of this study is to evaluate the effects of flowable and condensable composites to reduce microleakage. Seventy extracted human teeth were prepared with proximal class II cavities with gingival margin 1 mm below CEJ. The teeth randomly were divided into 7 groups. Groups I & II were restored with a dentin bonding (DB) agent plus a Prodigy condensable (Kerr Co.) composite, placing incremental or bulky, respectively.. In groups IK IV, V a dentin bonding agent was applied and then cavities were restored with Tetric flow composite resin as a base plus either a hybrid composite (Tetric ceram, Vivadent Co.) or a Prodigy condensable composite (Cond), placing bulky or incremental. Groups VI and VII were restored with a resin modified glass ionomer (GI) (Fuji II Lc Co.) as a base plus either Prodigy condensable or Tetric ceram. Restorations were polished, thermocycled, and immersed in 0.3% basic fushin. After that samples were sectioned and studied under a stereomicroscope to evaluate dye penetration. Results showed that all restorations showed some degree of microleakage and according to kruskall- wallis statistical analysis, there were not any significant differences between all groups (P-0.051). Then fore pair comparison, between groups. Mann-Whitney analysis was used and no statistical difference was observed. However. Gh DB- Tetric group showed the least microleakage and DB+ Cond (bulk) the most one. Due to lack of an" statistical difference among different materials methods, it is concluded that no method or restorative material have been able to eliminate microleakage in margins completely yet, and using a flowable composite resin, in place of resin modified glass ionomer or using a condensable composite, instead of conventional In brid composites, do not have any effect

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Tooth loss is a kind of handicap and losing a number of teeth makes an individual susceptible to this disability. Having knowledge about the prevalence of partial tooth loss, provides us with a better understanding of social hygiene. On the other hand, having access to such an information, students can be led properly to treat more prevalent cases. The goal of this retrospective study is to investigate the frequency of partial prosthesis classifications, among patients, referred to Shiraz dental faculty. Sexuality, tooth loss classification and its reason and the presence of additional space were studied about all patients (371 females, 205 males) from (97-98) to the end of (99-2000). The results showed that females were more than males (64.4%), the lower jaw was treated more than the upper jaw (67.9%), dental caries were the most important reason for extraction (55.5%), class I among females (28.79%) and class II mod I among males (29.73%) had the most frequency, meaning that the most cases were free end, so more attention should be paid for the education of free end partial prosthesis, however, preventive steps should be taken to retain abutment teeth.

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Conventional cephalometric analysis, based on intracranial reference line SN and Frankfurt plan, sometimes leads to incorrect diagnostic findings and unpleasant theraputic results, especially in orthosurgery patients, mainly due to the instability of the mentioned references. Natural head position (NHP) is the standardized orientation of the head that its record in lateral cephalometric radiographs, provides us with extracranial references. The aim of this study is to evaluate the necessity for providing a lateral cephalogram in NHP for diagnosis and treatment of severe malocclusion (orthosurgery) in comparison with mild to moderate malocclusions. For this reason, 28 orthodontic and 26 orthosurgery patient's cephalograms, in natural head position, were selected. Diagnosis and treatment planning were based on clinical evaluation and cephalometric analyses especially Harvold and Tweed ones. Each group, based on their growth pattern, was divided vertically and horizontally. The angles between SN and TH planes with TH (True vertical Sine) were measured. Then, the correlation between the angles in two groups and also in relation to the severity of malocclusion, were analyzed in vertical and horizontal directions. The results of two groups were compared by the independent t-test. The findings of this study showed that:1- The SN line was found to be more inclined than FH line and in orthodonthic patients, FH plan is a more reliable reference than SN.2- In orthosurgery patients, the SN-TH and FH-TH angles were strongly different statistically.3- Variation in SN-TH angle, in patients with vertical growth pattern, was high in both groups of patients.These conclusions prove the necessity of a lateral cephalogram in NHP for all orthosurgery patients and those orthodontic patients with vertical growth pattern.