Journal of Dental Medicine

Background and Aims: Bacteria and their products have a major role in pulp and periapical diseases. The purpose of this study was to compare the antimicrobial activity of sodium hypochlorite, iodide potassium iodide and chlorhexidine on the enterococcus faecalis after root canal filling.

Materials and Methods: In this experimental study, 95 single canal human teeth were collected. Then after washing and cleaning and filing, the sterilization done using an autoclave. The teeth were smeared with enterococcus faecalis except five which selected as controls and then divided them into 3 groups which A randomly represented the irrigation by sodium hypochlorite, iodide potassium iodide (IKI) and chlorhexidine solution were done. The teeth were filled with gutta-percha and then incubated in a incubator for 90 days at a temperature of 37° C. The specimens were analyzed for Colony Count. Data were analyzed using Kruskal-Wallis test and Chi-Square.

Results: According to the results of this study, the correlation between the 3 groups of cultured teeth were not significant (P=0.812).The specimens which were washed by IKI had the most positive amount of cultures (23.3%) and the specimens which washed by chlorhexidine had the lowest (16.7%).

Conclusion: The results of this study showed that after the use of different wash solutions, no statistically significant difference exist in their antimicrobial activity after root canal therapy.

Background and Aims: Elongation of styloid process may result in development of Eagle syndrome with associated symptoms. This study aimed to assess the frequency of elongated styloid process (ESP) and to evaluate its prevalence according to sex and age.

Materials and Methods: This study was conducted on digital panoramic radiographs of patients refered to the Oral Radiology Department of dental school, Guilan University of Medical Sciences. Styloid process length was measured and classified as elongated, pseudoarticulated, or segmented. Calcification patterns were determined as A, B, C, and D. ESP was defined as length > 30 mm. Data were analyzed by SPSS using T-test, Chi square, Pearson, and Spearman (P<0.05).

Results: A total of 505 digital panoramic radiographs taken from 227 males (45%) and 278 females (55%) aged 10 to 72 (40.1±12.9) years were evaluated. Elongated styloids were present in radiographs of 230 (45.5%) individuals. There was no significant difference in the ESP frequency between males (46.09%) and females (53.91%) (P=0.63). Type I and calcification B pattern showed more frequency than that of other categories.

Conclusion: According to these findings, elongated styloid process was a common condition among the studied population and had a significant correlation to the age.

Background and Aims: Central odontogenic fibroma is a rare odontogenic neoplasm that originates from odontogenic ectomesenchyme. Most cases occur in the mandible and between the ages of 11 and 39 years. The neoplasm shows a definite female preponderance, with a ratio of 2.2:1 and has a very low recurrence rate. The aim of this article was to report a case of this rare lesion which was accidentaly found.

Case Report: A 11-year-old female, during her orthodontic treatment and without any complain and any sign or symptoms, performed a panoramic image for assessing the permanent teeth buds. In the panoramic view a unilocular radiolucent lesion with well-defined and corticated borders in the right mandibular body region was evident. The lesion was treated with simple excision. Simple type of central odontogenic fibroma histopathologic features was observed in the microscopic view.

Conclusion: Although the central odontogenic fibroma is a rare benign neoplasm, however, a careful evaluation of radiographic images is important for early detection of lesions because the patient may have no clinical symptoms such as swelling, pain and paresthesia.

Background and Aims: Nowadays, oral cancer is considered one of the most important diseases related to oral health. The objective of the present study was to determine the dental students’ knowledge in Isfahan about oral cancer and the comparison of the level of students' knowledge in different years of education.

Materials and Methods: The present study was a cross-sectional-analytical one conducted in 2013. The population of study included the dental students of private and state University of Isfahan which 255 students were randomly selected. The data were collected using questionnaire and were then analyzed using SPSS software program and Kruskal-Wallis and Mann-Whitney.

Results: From private and public dental schools in Isfahan, 56% and 44% of dental students were involved. Regarding performing routine clinical oral examination, 81% of the participants answered positively, which showed no significant difference among the years of education of the participants (P=0.116). Regarding the examination of patients with oral lesions, 46% of them answered positively, which the difference between the years of education was highly significant (P≤0.001).

Conclusion: The findings of the research indicated that the level of knowledge of dental students of Isfahan city regarding the detection of oral lesions was not sufficient. Although, the students did not perform common examinations for exploring oral cancer, they did not have sufficient knowledge regarding some of the risk factors and oral lesions related to cancer. Therefore, it is necessary that a comprehensive curriculum be developed in this regard for their education.

Background and Aims: Taking impression from angulated implants has always been a great challenge in clinic. In this regard, studies on sectional trays are very few. The aim of this study was to evaluate and compare the dimensional and angular accuracy of impressions using full arch and sectional trays.

Materials and Methods: Four implants (4.3 × 12 mm) (Implantium, Dentium) were placed in the first premolar and molar regions of a Kennedy class I mandibular acrylic model with 30° lingual angulation. Twenty open special trays (Full arch & Sectional) were made on the primary cast. The impressions were taken using vinyl polysiloxane (VPS) and were poured with type IV dental stone. The coordinate measuring machine (CMM) was used to measure the dimensional (Z, Y, X) and angular (θ) coordinates of implants. The data were analyzed using and t-test and SPSS 22. Software.

Results: The type of tray had no significant effect on the dimensional accuracy in X, Y and Z axes (P>0.05) and total linear displacement (r); However, it significantly affected the angular accuracy (∆q) (P<0.05).

Conclusion: Sectional tray yields less rotational displacement in impressions made of angulated implants.

Background and Aims: Trauma to the permanent and deciduous incisors is an undesirable common event in childhood. Proper immediate management of injured teeth is depended on the knowledge of unprofessional people, including teachers, who are usually present at the scene prior to dental treatment. The aim of this study was to assess the knowledge and self-reported practice of primary school teachers on the emergency management of traumatic dental injuries (TDIs) in Arak.

Materials and Methods: In this cross-sectional study, 624 primary school teachers were enrolled in census in Arak. An anonymous questionnaire containing demographic data, the history of previous exposure to traumatic dental injuries, teachers’ knowledge regarding emergency management of TDIs and their practice towards TDIs was used. Questionnaires were distributed among all participants and then were collected on the same day. Descriptive statistics and linear regression were performed to analyze the data.

Results: A total of 292 completed questionnaires (response rate 46.8%) were collected. The mean score of knowledge was 2.65±1.69 out of 10. The mean score of self-reported practice was 3.46±2.04 out of 8. Regarding the demographic variables, knowledge had a significant relationship with the education (P<0.001). No significant relationships were observed between the self-reported practice and demographic variables. The correlation coefficients between the knowledge scores and the practice scores of teachers was 0.2.

Conclusion: This study revealed that insufficient knowledge exists among primary school teachers on emergency management of TDIs. Furthermore, a high percentage of respondents enjoy a significant deficiency regarding favorable practice encountering TDIs.

Background and Aims: In modern societies, the incidence of oral cancer is increasing. It may be due to the increased population, life expectancy, and exposure to risk factors. This increase can particularly be seen in women and in our own country, Iran. The aim of the present study was to explore the status of care and treatment of patients with oral cancer referring to Shariati educational hospital in Tehran, during the years 2003-2013.
Materials and Methods: The present study was a cross-sectional descriptive survey on oral cancer patients attending the Shariati hospital in Tehran during a ten-year period. Data were collected through patient records and statistically analyzed by SPSS21 software.
Results: Regression analysis was performed in 5 models, where variables such as age, gender, location of the tumor, stage and grade was entered as independent variables and delay in treatment (time interval from diagnosis to treatment) entered as the dependent variable. The analysis showed that the elapsed time from diagnosis to treatment had a positive association with age of the patients. It means that the higher the age, the more delay in treatment (P<0.05). No relationship was found between the treatment delay and gender, tumor location, grade, and stage.
Conclusion: Considering the consequences of oral cancer for patients, there was necessity to formulate plans for preventing, early detection and improving quality of life in oral cancer patients.
 

Background and Aims: Disabled individuals are involved with several oral health problems. The aim of this study was to assess the knowledge and perspective of dentists towards oral health promotion in disabled individuals.
Materials and Methods: Dentists participating in the fifty-fourth International Congress of Iranian Dental Association in 1392 in Tehran were invited. A valid and reliable questionnaire including the information about age, gender, city of practice, the working experience with the disabled was distributed. There were also 13 questions on knowledge and one question about the importance of training in the field of “oral health promotion of the disabled” in this questionnaire. The data were analyzed by linear regression model by SPSS 18 software.
Results: 117 questionnaires were collected and evaluated. The mean age was 35.5 (10.1) years. Among the participants, 53.8% were male and 46.2% were female. Average score of knowledge was 6.5 of the maximum attainable 13. Among the dentists, 60% believed that receiving education on oral health promotion for the disabled is important. Liner regression model which evaluated the effect of confounding factors showed that aging led to reduction in dentists' knowledge of oral health of the disabled. Furthermore, working experience with the disabled led to the increase in knowledge. Dentists who had previously treated a disable individual were more interested in receiving related training.
Conclusion: Knowledge of dentists in the field of oral health promotion of the disabled is not desirable while most dentists recognize the need for training. This issue emphasizes on the need for a broader educational effort.
 

Background and Aims: For the clinical success of implant-retained prostheses, fitness of matching components and stability of the applied torque to the implant-abutment assembly under dynamic occlusal loading is essential. The aim of this study was to evaluate the torque loss in Co-Cr castable abutments after cyclic loading.
Materials and Methods: 10 castable abutments were cast in Co-Cr alloy with similar size and height. Each specimen was mounted vertically on a separated implant using a 30 Ncm tightening torque. The detorque values of the abutments were evaluated after 10 min. The same tightening torque was applied to the abutments on their corresponding implants and cyclic loading was applied for 500,000 cycles to the implant-abutment assembly. The torque values after cyclic loading were recorded for each specimen. T-test analysis was conducted on scores from the groups.
Resultes: The results of this study showed that the percentage of torque loss in castable abutments was significantly increased after cyclic loading (P<0.001).
Conclusion: Misfit between the castable implant components can cause torque loss before and after cyclic loading. However, it is more appropriate to relate the results of this study to the screw loosening of the above mentioned abutments than judging their clinical performance.

Background and Aims: Marginal gap measurement in all ceramic restorations they are of fundamental important for the successful used. As some studies led to contradiction results, yhe aim of this study is to compare marginal gap restorations between 4 kinds of ceramic restorations Inceram, IPS-e.max Press, Zirconia (CAD/CAM) and PFM.
Materials and Methods: In this In-vitro experimental research, one stainless steel die with deep chamfer finish line design (1 mm depth) was prepared on a maxillary premolar. 40 epoxy resin dies were made, dies were divided in to 4 groups (n=10), Zirconia, IPS e.max press, Inceram, Mental Ceramic systems (MC). Then, the prepared crowns were put on the stainless steel die and observed their marginal mismatch under sterio microscope before cementation. Data were analyzed by One- way ANOVA, and one sample kolmogorosmirnov tests.
Resultes: There was significant difference in the marginal gaps between (MC) (102.92±28.7), Inceram (98.41±24.91), IPS e.max press (128.22±25.48), and Zirconia (69.5±10.9) (P=0.0001).
Conclusion: The comparison of marginal gap for the four groups was significant test. Therefore, it can be concluded that marginal gap, the probability of leakage and recurrence of caries in Zirconia systems is the least and in the IPS e.max press systems is the most.

In recent years, the use of zirconia as a high-strength support for all-ceramic restorations has become widely accepted. The failure of zirconia restorations is mainly due to the weakness of veneering porcelain and other factors such as veneering approach. Except conventional hand layering, other methods such as pressing and digital veneering have been recently introduced and used. Meanwhile, the use of monolithic zirconia with no veneer is also a solution for reducing the rate of failure. The object of this review was to compare the failure of three available methods for veneering zirconia restorations in the literature and to compare with the monolithic zirconia. In the context of this overview, 42 articles were used between the years 2000 through the end of 2016 using the keywords of PubMed, google scholar search engines. In most articles, digital approach is the best way with low failure. mechanical properties of monolithic zirconia are reported to be higher than the zirconia veneered using hand layering method.

Background and Aims: Making dental prostheses is sensitive and accurate work and requires powerful and skilled hands. Because of this, the dental prosthesis technicians may suffer harmful effects such as stress and fatigue during the course. The aim of this study was to investigate fatigue, stress and job performance and their relationship with some demographic variables in this community.
Materials and Methods: The present study was cross-sectional and done in 2016. The study population was a group of dental prosthesis technicians that had participated in a national congress in Tehran. Sampling was done by census Two standardized questionnaires on the subjects of fatigue and stress which were distributed among 100 female and male participants and sampling was done by census. Then, the obtained data was analyzed using SPSS16 software and applying descriptive statistics, Pearson correlation test, and ANOVA, T-test.
Results: From the 100 samples, there were 16 females and 84 males with mean age 34.71±7.90 and average work experience of 10.82± 9.01 years. 82 percent of the subjects were married and 42 percent of them were smokers. The results showed that 100 percent of dental prostheses technicians were facing with moderate to severe stresses. The stress and fatigue scores in married ones were higher than the single ones. The results showed a significant relationship between smoking, stress, and fatigue scores (P<0.05).
Conclusion: According to the high level of job stress in the dental prostheses technicians, this problem must be considered, minimized, and more attention should be paid to their psychological and emotional problems.

Background and Aims: Caregivers’ oral health literacy (OHL) can be effective in increasing their children’s knowledge, and can improve their oral health-related behaviors. This study aimed to investigate the relationship between mothers’ OHL and children’s oral health status.
Materials and Methods: We conducted a cross-sectional study on 202 6-year child/mother dyads in Semirom, Iran, applying a cluster sampling method. Self-administered questionnaires (Oral Health Literacy-Adult Questionnaire) requested information about mothers’ OHL. Children’s oral health status (dmft and pufa) was recorded via clinical examination. Pearson correlation coefficient, spearman correlation coefficient, independent T-test, and a linear regression model were used for statistical analysis.
Results: Among 202 pre-school children, 99 were girls (49%). The mean OHL score of mothers was 63.2 (Max achievable score=100, SD=18.9). Higher score of OHL among mothers was associated with their children’s less missing teeth (mt) and more filled teeth (ft) (P<0.05). No significant the association existed between the mothers OHL and their children’s dt, dmft, and pufa. Childrens of younger mothers, more educated mothers, and those with better oral health behaviors in terms of daily flossing and tooth brushing, showed lower scores of dmft and pufa (P<0.05).
Conclusion: A significant association revealed between mothers’ OHL and the oral health status of their children. Thus, it is recommended to increase mothers’ OHL to improve their children’s oral health status.

Background and Aims: The emergence of social web and impact on the communication of the individuals and the scientific activities of various communities has created serious research links among researchers. This issue that how Iranian researchers keep up to date themselves with new technologies and use them to engage in scientific issues has been a challenge that is constantly being addressed in the digital world. Therefore, the purpose of this study was to evaluate the scientific production of dentistry in Tehran University of Medical Sciences in the networks of ResearchGate and Mendeley using the Scopus citation database between 2015 and 2016.
Materials and Methods: The study population included all scientific articles in the field of dentistry of Tehran University of Medical Sciences which were indexed in Scopus database between 2013-2016. The results were presented using descriptive statistics in the form of charts and tables.
Results: In this study, it was determined that the scientific outputs of the researchers from Tehran University of Medical Sciences increased in 2015 and 2016. It was also found that the coverage of articles in the field of dentistry published by researchers at Tehran Medical Sciences Universities in the Scopus citation database in the mentioned years, were in a good position in both the Mendeley and ResearchGate networks. In addition, the number of references to the articles by researchers at Tehran University of Medical Sciences on the ResearchGate network in the field of dentistry was more than the Mendeley network.
Conclusion: Based on the results of this study, it can be concluded that the performance of the researchers of the Tehran University of Medical Sciences in the field of oral and dental care and the extent of their coverage in the social networks of ResearchGate and Mendeley was high and desirable.

Background and Aims: Gypsum products are used for several different purposes. Adaptation and success of casting restorations are dependent on dimensional accuracy, strength, and reproduction of details of dental gypsums. This study was designed to evaluate the dimensional changes and accurate details reproduction of three type IV dental gypsums.
Materials and Methods: 60 samples in 3 groups of dental gypsums of G30,Yeti Rock and FujirockEP were evaluated. The detail reproduction of 50 micron scratched line was analyzed by a microscope at 12× magnification. The samples were assayed for dimensional changes at 2 and 24 hours and 1 week after pouring. Photograph images were taken from samples in fixed distance by a camera (Canon D600) and analyzed in corel draw software. Data were analyzed using ANOVA and chi-square (P<0.05).
Results: There were significant differences in the details reproduction between three gypsums (P≤0.05) and the highest values was for Fujirock EP, Yeti Rock. The G30 did not reconstruct the details. There was no significant difference in the dimensional changes of the evaluated gypsums based on time (P≥0.05).
Conclusion: All three different gypsums evaluated in this study showed the dimensional stability during one week. Fujirock EP and Yeti Rock could reconstruct the details and G30 gypsum could not.

Background and Aims: Xerostomia is a clinical condition that can affect the quality and quantity of saliva. Saliva is considered an important factor in retention of edentulous patient’s denture wearers. Thus, increasing the prevalence of xerostomia in modern societies is considered a limiting factor in the quality of denture retention. This article reviews the most common techniques of denture manufacturing in edentulous patients with xerostomia and investigates the advantages versus disadvantages of each.
Materials and Methods: In this review, PubMed and google scholar search engines were searched for the following keywords: Flexible Denture, Artificial Saliva Reservoir, Hyposalivation, Hypofunction, and Xerostomia. We evaluated the flexible dentures and dentures with artificial saliva reservoirs in both jaws along with their advantages and disadvantages. 10 articles, specifically discussing complete denture fabrication in patients were selected.
Conclusion: Follow-up results showed that the flexible dentures and split dentures with saliva reservoirs to be effective in improving the quality of life of these patients and therefore can be a considered as a successful treatment option in the prosthetic rehabilitation of these patients.

Background and Aims: Dental caries is a multifactorial and common disease that leads to a decrease in the quality of life of individuals. The aim of this study was to determine the relationship between serum vitamin D and dental caries in the third year-to-last year students of dental school of Tehran University of Medical Sciences.
Materials and Methods: This descriptive cross-sectional study was conducted on 123 dental students. Demographic and health information were completed through a checklist. The level of vitamin D in individuals was measured by blood sampling. We recorded caries by ICDAS (international caries detection and assessment system) in two levels of D(1-6)MFT (total of decayed, filled and missing tooth) and D(3-6)MFT (total of progressive decayed, filled and missing tooth). Data analysis was done by the SPSS package version 25 using statistical tests of correlation and regression.
Results: The results showed that the correlation coefficient between vitamin D and caries index D(1-6)MFT was -0.89 with a P-value of 0.3328 which was not statistically significant. Based on the backward logistic regression, there was a positive significant statistical association between the D(3-6)MFT with vitamin D deficiency (P<0.001), weight (P=0.012), dental visit (P=0.023) and frequency of sweet snack consumption (P=0.03). In addition a significant and inverse statistical association was reported between the D(3-6)MFT and milk consumption (P=0.026).
Conclusion: Among dentistry students, no relation between vitamin D deficiency and early stages of decay was seen, however this relation was statistically significant in regard with progressive dental caries.

Background and Aims: Periodontal diseases are prevalent and are not only a threat to oral and dental health of patients and community, but also affect the quality of life associated with oral health. Therefore, the present study aimed to evaluate the effects of non-surgical periodontal therapy on the quality of life associated with oral health in patients with periodontitis and gingivitis.
Materials and Methods: 47 patients with gingivitis and moderate to severe chronic periodontitis referred to the periodontology department of Yazd Dental School in 2019 were studied. OHIP-14 validated questionnaire was used to assess the quality of life related to oral health. At the beginning of the study, both groups completed the questionnaire. Then scaling and root planning for periodontitis group and scaling for gingivitis group were done. Patients completed the questionnaires again 9-12 weeks after periodontal treatment. Data were analyzed by SPSS software version 22 using independent T-test, Chi-square, Mann-Whitney and Wilcoxon tests.
Results: The mean score of quality of life in patients with gingivitis was 19.18±11.68 before the treatment and 13.26 ±11.41 after treatment. The mean score of quality of life in patients with periodontitis was 23.29±9.80 before treatment and 13.95±9.68 after treatment. All the differences between groups before and after treatment were statistically significant (showing better quality of life after the treatment) (P<0.05). There was no statistically significant difference between the mean score of quality of life related to oral health in the studied patients according to the age and sex (P>0.05).
Conclusion: According to the results of this study, treatment of periodontal diseases improves quality of life related to oral health in patients with gingivitis and moderate to severe chronic periodontitis.

Background and Aims: Anxiety is a common problem in patients referred to dental clinics that is associated with underlying personality factors. The purpose of this study was to determine the role of personality traits in predicting dental anxiety.
Materials and Methods: In this study, 211 patients (110 men and 101 women) referred to the dental clinics in Tabriz in 2019, were selected by available sampling method. The method of this study is descriptive- correlative. The research instrument was a short-form NEO-personality inventory and a dental anxiety inventory. Data were analyzed by correlation and regression analysis using SPSS22.
Results: The research findings showed that the average age of women and men was 30 and 31 years, respectively. 49% of the clients were single and 51% were married, and the education of most of the clients was undergraduate. Also, Regression analysis showed that dental anxiety had a positive correlation with personality trait of neuroticism (r=-0.49, P<0.01), and it had a negative relationship with extroversion (r=-0.19, P<0.05), agreeableness (r=-0.21, P<0.01), consciences (r=-0.35, P<0.01); and two factors of neuroticism (t=4.71, P<0.01) and conscience (t=2.44, P<0.01), and predicted dental anxiety (P<0.05).
Conclusion: From the results, it can be concluded that anxiety with a sense of danger that was observed in many people in the face of dental interventions, occurred within individuals. By recognizing root factors, it can be partly strengthened by deterrent and suppressor personality factors for anxiety, and thus, taking advantages of the dental services and preventing from avoiding dental treatments.