Journal of Dental Medicine

Background and Aims: Electric pulp testing is used for diagnosis of the pulp status. This test is technique sensitive and hence may elicit positive or negative false response in case of inaccurate use. The optimal site for placement of the probe tip has not been determined. The aim of this study was to evaluate the effect of pulp tester probe placement site on the response of maxillary teeth.
Materials and Methods: A total of 378 teeth (126 central incisors, 126 lateral incisors and 126 canines) in 67 voluntary 20-35 year-old patients were selected. Three sites on each tooth (incisal edge, labial and lingual surfaces) were tested with an electrical pulp tester and responses were recorded. Data were analyzed by Repeated Measure ANOVA test.
Results: The central teeth showed significantly lower sensation threshold than lateral and canine teeth (P<0.001). The incisal edge of tooth were significantly more sensitive compared to labial and lingual surfaces (P=0.008).
Conclusion: This study showed that the optimum site for placement of pulp tester probe was incisal edge.

Background and Aims: Although composite resin restorations have many advantages, they can lead to several clinical problems. The primary reason for these problems is microleakage. The aim of this study was to compare the rebonding effect on microleakage of class V composite restorations using two low viscosity resins.
Materials and Methods: In this in vitro study, 60 class V composite restorations were performed in buccal and lingual surfaces of human extracted premolars with the occlusal margin in enamel and the gingival margin in dentin/cementum. The teeth were randomly divided into 3 groups: (I) restorations with no rebonding, (II) restoration margins rebonded with an enamel adhesive (Margin Bond), (III) restoration margins rebonded with a specific unfilled resin. The specimens were then thermocycled and immersed in 0.5% fuchsin dye solution. The samples were sectioned longitudinally and observed under a stereomicroscope for assessment of microleakage. The data were analyzed by Kruskal-Wallis, Wilcoxon and Mann-Whitney tests. P<0.05 was considered as the level of significance.
Results: Statistical analysis showed a significant difference in the microleakage of gingival margins (P<0.0001), but not in enamel margins (P=0.148). Microleakage at the gingival margins of group (III) was significantly less than that of group (II). Group (I) showed the highest amount of microleakage.
Conclusion: Rebonding by a low viscosity resin reduces microleakage at the gingival margins of class V composite restorations, but has no significant effect on the occlusal margins.

Background and Aims: Calcium hydroxide has a pronounced antimicrobial activity against most of the bacterial species found in infected root canals and endodontic infections. It is one of the most frequently used intracanal medications in endodontic therapy. The objective of this study was to determine the antimicrobial efficacy of six calcium hydroxide formulations (mixed with saline, lidocaine 2%, chlorhexidine 2%, chlorhexidine 0.2%, Iodine Potassium iodide (IKI) 2%, and glycerin) on Enterococcus faecalis using agar diffusion test.
Materials and Methods: Twelve culture plates were incubated with Enterococcus faecalis. Five cavities were made in each plate with 5 mm diameter and 4 mm depth. Two plates were randomly considered for each calcium hydroxide formulation and filled completely with creamy mixture of tested materials. The plates were incubated at 37ºC for 48 hours. The diameter of inhibition zone around each well was recorded in millimetres and data were submitted to ANOVA and Tukey tests.
Results: The results of this study showed that all tested calcium hydroxide pastes had good antimicrobial activity. The antimicrobial activity of calcium hydroxide mixed with lidocaine, chlorhexidine 2% and IKI 2% were significantly greater than that of calcium hydroxide mixed with saline (P<0.001). No significant differences in the antimicrobial  were found between the other groups (P>0.01).
Conclusion: Considering the results of this study, lidocaine 2%, chlorhexidine 2% and IKI 2% are suggested to be used for preparation of calcium hydroxide paste. Further studies with different methods are needed for confirming these results.

Background and Aims: Packable composites with high viscosity might not adapt properly to internal surfaces and cervical areas. The aim of this study was to assess the microleakage of class II posterior composite restorations performed using different methods.
Materials and Methods: Ninety proximal cavities were prepared in extracted sound premolar teeth, divided into three groups and filled as follows: 1- packable composite (3M filtek P60), 2-Hybrid composite (Z250) + P60 composite and 3- Resin-modified glass ionomer liner + P60 composite. Afterwards, the samples were immersed in 0.5% Foushin solution and sectioned. Gingival microleakage was then graded. Obtained data were analyzed using paired t-test and analysis of variance.
Results: In regard to distal cavities, significant difference was seen between the groups 1 and 3 (P=0.01) as well as groups 2 and 3 (P=0.03). Comparing microleakage of mesial and distal cavities, there was a significant difference in groups 1 (P=0.003) and 2 (P=0.005).
Conclusion: Based on the findings of this study, application of Z250 composite had no effect on reduction of microleakage of class II posterior composite restorations. Vitremer liner decreased microleakage in dento-gingival margins.

Background and Aims: Passive fit of prosthetic frameworks is a major concern in implant dentistry. Impression technique is one of the several variables that may affect the outcome of dental implants. The purpose of this study was to compare the three dimensional accuracy of direct and indirect abutment level implant impressions of ALL-ON-4 treatment plan.
Materials and Methods: A reference acrylic resin model with four Branemark fixtures was made according to All-On-4 treatment plan. Multiunit abutments were screwed into the fixtures and two special trays were made for direct and indirect impression techniques. Ten direct and ten indirect impression techniques with respective impression transfers were made. Impressions were poured with stone and the positional accuracy of the abutment analogues in each dimension of x, y, and z axes and also angular displacement (Δθ) were evaluated using a Coordinate Measuring Machine (CMM). Data were analyzed using T- test.
Results: The results showed that direct impression technique was significantly more accurate than indirect technique (P<0.001).
Conclusion: The results showed that the accuracy of direct impression technique was significantly more than that of indirect technique in Δθ and Δr coordinate and also Δx, Δy, Δz.

Background and Aims: Periodontitis is one of the most common oral diseases with the various incidence rates in different populations. A number of bacteria are considered as the major etiologic agents of periodontitis. The aim of the present study was to determine the prevalence of periodontopathogen bacteria in patients using both PCR and culture techniques.
Materials and Methods: In this study, one-hundred patients (including 62 females and 38 males with an average age of 49±11.5 years) with adult periodontitis referred to periodontics department of School of Dentistry/Tehran University of Medical Sciences were investigated. The samples were taken and sent immediately to the laboratory for culture and molecular evaluation. The PCR was performed using specific primers and the statistical analysis of data was performed using SPSS statistic software and McNemar test.
Results: The results demonstrated that the total detection rate in culture method was 64%. The rate of Aggregatibacter actinomycetemcomitans (Aa) was 28% which was significantly higher than that of Porphyromonas gingivalis (Pg) (6%) and Prevotella intermedia (Pi) (3%). 27% of cases showed mixed bacterial growth. 65% of patients were positive using molecular method. The rate of Aa (30%) was significantly higher than that of Pg (7%) and Pi (5%). The mixed PCR positive rate containing of Aa, Pg and Pi was (23%).
Conclusion: In this study, it was found that most of the bacteria isolated using culture and molecular methods were Aa, Pg and Pi, respectively. Although the detection frequencies of both techniques were similar, the specificity, sensitivity and bacterial detection speed of the PCR technique is obviously higher. Therefore, the use of molecular techniques is strongly recommended. However, both techniques seem to be suitable for microbiological diagnostics.

Background and Aims: There is concern that leached components from dental composites may cause adverse changes in the reproductive health. This study aimed to assess the effects of leached components from a hybrid resin composite on the reproductive system of male mice.
Materials and Methods: In the present animal study, twenty adult Syrian male mice were divided into two groups of 10 mice each. In the test group, components which leached from samples made from Filtek Z250 resin composite into 75% ethanol were daily administered to the mice for 28 days. In the control group, the procedure was repeated in the same way as the test group but without placing composite samples in the solution. Then, the body weight, weights of paired testes, Gonado Somatic Index, sperm viability, sperm motility, epididymal sperm reserve and daily sperm production were recorded. Four male mice in each group were mated with untreated female mice for 10 days. After that, the number of pregnant females and number of infants were recorded. The data were analyzed using repeated measures ANOVA, Chi-square test and t-test.
Results: There was a significant reduction in the sperm viability and sperm motility of male mice in the test group compared to the control group (P=0.001). There was no any significant differences in other parameters between two groups (P>0.05).
Conclusion: This study showed that the leached components from resin composites cannot cause infertility but they could potentially cause some adverse effects on the reproductive system of male mice.

Background and Aims: Internal derangement of the Temporomandibular joint (TMJ) is the most common form of Temporomandibular disorders, which represents an abnormal internal strucural and functional change of the disk, as well as an abnormal relationship of the disk to the condyle, glenoid fossa and articular eminence when the teeth are in the closed- mouth position. The aim of this study was to evaluate the correlation between eminence steepness and condyle disk movements in TMJs affected by internal derangements using magnetic resonance imaging (MRI).

Materials and Methods: In this cross-sectional study, digital MRI files of 90 joints belong to 45 patients in open and closed-mouth positions were evaluated. Patients were subdivided into two groups: 64 individuals with anterior disk displacement with reduction and 26 individuals with anterior disk displacement without reduction. Appropriate oblique sagittal sections were selected and printed. Outlines of the fossa, eminence, condyle and disk were traced on matte acetate sheets and evaluated by an oral and maxillofacial radiologist and a postgraduate student of oral and maxillofacial radiology. Disk rotation, condyle rotation, condyle translation and eminence steepness were measured. The data were analyzed using T-test.

Results: In this study, no significant difference was found in measurements between the two groups, (for steepness P=0.64, for Disc rotation P=0.77, for condyle rotation P=0.28 and for condyle translation P=0.12). Disk rotation showed statistically significant correlation with eminence steepness in the anterior disk displacement with reduction group
(P=0.034). Although this correlation was weak (r=0.27) no statistically significant correlations were found between other variables and eminence steepness in this group (for condyle rotation P=0.3 and for condyle translation P=0.98). Disk rotation and condyle translation had statistically significant relationship in the anterior disk displacement without reduction group (P=0.011, r=-0.49). In addition, a significant difference was found between disk rotation and condyle rotation in this group (P=0.004, r=0.54). The relationship between other variables and eminence steepness were not statistically significant (for disc rotation P=0.06, for condyle rotation P=0.72 and for condyle translation P=0.73).

Conclusion: According to the results of the present study, there is no obvious relationship between eminence steepness and movements of the condyle- disk assembly in patients with TMJ internal derangements. Therefore, the hypothesis that a steep articular eminence of the TMJ is a predisposing factor for disk displacement without reduction could not be verified. Performing prophylactic Eminectomy as a part of patient treatment plan is doubtful and need further evaluations.

Background and Aims: This study was conducted to assess the psychological health status of dentists in Shiraz city.

Materials and Methods: In this cross-sectional study, subjects consisted of 106 dentists and 94 general practitioners (comparison group) from private and public clinics in Shiraz city. Subjects were requested to complete the standard general health questionnaire and a questionnaire on demographic variables. The data were analyzed by appropriate statistical tests. Chi-Square test and independent sample t-test were used to compare demographic and occupational variables of both groups. The questionnaires were scored and the overall score of each individual determined his/her psychological health status. Means of GHQ scores of both groups were compared using statistical tests.

Results: Both groups were similar in all demographic variables, except for age. The mean total score of GHQ-28 for both dentists (17.9) and physicians (16.34) groups were significantly lower than the cut-off point value of 23 (P <0.01). The means of scores for somatic problems, depression, anxiety and insomnia as well as unusual social performance scales were significantly different between both groups (P<0.05). A significant positive association was found between GHQ total score and job tenure.

Conclusion: Our findings revealed that psychological health status of dentists was poorer than that of physicians. Additionally, dentists' scores were significantly different from those of their counterparts in all GHQ sub-scales.

Background and Aims: The aim of this study was to investigate the prevalence of diabetes and other risk factors in patients with dental infections.

Materials and Methods: A cross-sectional study was conducted among 50 patients who preferred in maxillofacial word of shariaty hospital with acute dental infections in 9 months. A self-administered questionnaire was administered during a dental appointment in order to gather demographic information and recorded past history of systemic disease, OPG radiography, gingival examination, and the result of lab tests such as CBC , FBS , PT, Bilirubin , Creat, T3, T4, TSH, HIVAb and HBSAg.

Results: 28% of the subjects and diabetes, 28% Anemia, 4% Hepatitis and 4% suffered from thyroid deficiency. 28% were smokers and 18% declared using alcohol. 6% of this population was addicted to narcotic substances. There was a significant correlation between age, education, diabetes and dental infections (P<0.05). DMFT for people with dental infections without any systemic disease were 8, for diabetic patients, smokers and alcohol users were respectively 17.16, 17 and 14.

Conclusion: Diabetes found highly prevalent in patients with dental infection and high DMFT.It indicates a need to establish a comprehensive oral health promotion program based on whole examination and blood glucose control in diabetic patients who have acute dental infection by collaboration between dental and general health care professionals. Moreover, it is recommended that all patients should be educated in dental and oral health for prevention of dental infections.

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

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

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

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

Background and Aims: The vitality pulp tests are necessary for diagnosis of pulpal disease and differentiation between endodontic and non-endodontic diseases. Thermal and electrical tests are conventional methods for evaluation of pulp vitality. The purpose of this study was to evaluate the effect of thermal changes on the tooth response to the electric pulp tester.

Materials and Methods: In this study, 160 intact maxillary central incisors of 40 voluntaries were evaluated. After isolation, electric pulpal response threshold in patients were recorded. After heat and cold tests, the electrical pulp test was repeated. The degree of response was recorded. The data were analyzed using pair T-test and independent T-test.

Results: The result of this study demonstrated that the average of teeth response to the electric pulp tester before and after cold test was 1.3 and 1.7, respectively. The average was 1.4 and 1.7 before and after heat test, respectively. There was no significant difference (P<0.001) between the pulpal response before and after thermal tests (heat and cold tests). In addition, no significant difference was found between pulpal response after heat and cold tests (P=0.25).

Conclusion: The response of tooth to the electric pulp tester was influenced by heat and cold tests.

Background and Aims: Re-application of microbrush may affect the micro tensile bond strength of adhesives to dentin. The aim of this study was to evaluate the effect of re-application of microbrushes on the micro tensile bond strength of an adhesive to dentin.

Materials and Methods: Thirty freshly extracted molars teeth were collected and enamel of occlusal surface were removed to expose superficial dentin. Then superficial dentin was etched, washed and partially air dried. According to the times of application of microbrush, teeth were divided into two test groups. In group 1, new microbrushs were used, but in group 2, the ones that were already used for twice were included. Ambar dentin bonding agent (FGM/Brazil) was applied to the etched dentin with microbrushes according to the manufacturer's instructions. Then the crown of teeth was built up with LLiss (FGM/Brazil) composite resin. The teeth were sectioned in buccolingual direction to obtain 1mm slabs. Then 50 hourglass- shape samples were made from 30 teeth (25 Specimens per group). The microtensile bond strength of the specimens was tested using MTD500 (SD Mechatronik, Germany). The data were statistically analyzed by T-test.

Results: The mean values for the microtensile bond strength were 30.49±7.18 and 23.61±9.06 MPa±SD for the first and second groups, respectively. There was significant difference between the groups (P=0.005).

Conclusion: Microbrushes should not be used for more than one cavity preparation.

Background and Aims: Approximately 5% of cancers involve structures of oral cavity. Partial resection of maxilla (maxillectomy) may be performed in these cases. Maxillectomy often results in significant functional disabilities such as inability in mastication, deglutition and speech with adverse impact on psychological status and social life of patients. Obturator prosthesis is a prosthodontic treatment to separate nasal and oral cavities and restore the critical above mentioned functions. The assessment of speech is considered to examine speech function restored by the treatment. The purpose of this study was to evaluate the speech in patients with resected maxilla who have been treated by obturator prosthesis from a pool of related patients in the Prosthodotnics department of dental faculty, Tehran University of Medical Sciences. The evaluation was performed with computer software using sentence intelligibility (SI) test.

Materials and Methods: This cross sectional study was conducted on 10 subjects (23-66 years) referred to the Prosthodontics department of the faculty and received an obturator. After primary examination of the prosthesis, the patients completed SI test in an acoustic room under guidance of a speech therapist. The performed tests were analyzed by the speech therapist. In addition, the SI with and without the prosthesis was evaluate by lay audience. The statistical analyses were performed using Wilcoxon-signed rank test and Weighted Kappa.

Results: Significant differences were found between SI tests with and without the obturators (P<0.001). Two of 10 patients showed problems in speech function using obturator.

Conclusion: Within the limitations of the present study, obturators had significant effect on improvement of the speech outcomes of examined patients. Improvement of the quality of life could be predicted.

Background and Aims: One of the decisive factors on the final esthetic results of implant treatment is the abutment material. Ceramic abutments are nowadays very popular in this regard. The purpose of this study was to compare the fracture resistance of three zirconia abutments with titanium abutment.

Materials and Methods: Four groups of abutments (five specimens in each) were prepared. The abutments were prefabricated titanium, prefabricated zirconia, zirconia-metal, and copy-milled zirconia abutment. After securing the abutments to the implant using a torque of 24 Ncm, they were mounted into a mounting jig using the 30º tilt. The force was applied on the assembly till the failure occured. Facture resistance and mode of failure were recorded for each specimen. The data were analyzed using One-way ANOVA.

Results: The mean values recorded for fracture resistance of different zirconia abutments varied between 426 to 688 N however, there was no significant differences among the groups (P=0.14). Body fracture was observed only in prefabricated zirconia abutments. Screw fracture and screw bending were the common failures observed in other groups.

Conclusion: Zirconia abutments of any type could be successfully used in regular plateform implants.

Background and Aims: Different mechanisms have been developed for connecting abutment to implant. One of the most popular mechanisms is Tapered Integrated Screw (TIS), which is a Tapered Interference Fit (TIF) with a screw integrated at the bottom of that. The aim of this study was to investigate the mechanism of TIS and effective factors in employing TIS during design and implementation processes using an analytic method.

Materials and Methods: Relevant equations were developed to predict tightening and loosening torques, contact pressure and preloads with and without bone tissue in this analysis. The efficiency is defined as the ratio of the loosening torque to the tightening torque. The effects of the change in elastic modulus and thickness of the bone on operation of this mechanism were investigated.

Results: In this study, 14 independent parameters such as taper angle, friction coefficient, abutment and implant geometry that are effective on performance of TIS mechanism were presented. The role of some factors was shown in the performance of ITI implant using sensitivity analysis.

Conclusion: It was shown that friction coefficient, contact length, and implant radius play major roles on tightening and loosening torques and efficiency of the mechanism. Furthermore, the results revealed that the change in the elastic modulus and thickness of the bone influenced the efficiency of the mechanism less than 15%.

Background and Aims: The purpose of this study was to evaluate the sealing ability of different thicknesses of orthograde MTA plugs in comparison with 5 mm gutta-percha.

Materials and Methods: Fifty extracted single rooted human teeth were collected. After root canal preparation, the samples were randomly divided into 4 experimental (n=10) and two control groups (n=5). In group 1, the apical 5 mm of the canals were obturated using laterally condensed gutta-percha and sealer AH26. Groups 2, 3 and 4 received 2, 3 and 4-mm thick orthograde MTA plug, respectively. Thereafter, the coronal portion of specimens was exposed to the microbial solution containing streptococcus sanguis and the root tips were placed in phenol red lactose broth. The color changes were observed within 60 days. The data were analyzed with Fisher exact test.

Results: The leakage was found in all samples (100%) in group 1 and 72.7%, 30.8% and 50% of the samples in groups 2, 3 and 4, respectively. Significant difference was found between 3 mm thickness of MTA plug and gutta percha and sealer (P=0.02).

Conclusion: According to the findings, it seems that 3 mm thickness of orthograde MTA plug had better sealing ability than the other thicknesses of MTA plug as well as the 5 mm of gutta-percha.

Background and Aims: Candida Albicance is one of the most common oral opportunistic infection. Antifungal drugs have several side effects as well as bad taste. Licorice is one of the oldest drugs in Iranian traditional medicine. It has antibacterial and antiviral effects however, there are a few studies about its antifungal. Therefore, this study was designed for in vitro evaluation of the antifungal effect of licorice.

Materials and Methods: Candida Albiance (TIMM 2640) was cultured. After licorice extract was prepared, its antifungal effect was compared with that of nystatin using agar diffusion method.

Results: Diameter of inhabitation zone was 32.60±0.84 mm in nystatin group and almost zero in licorice groups. There was statistically significant difference between nystatine and licorice extract (P=0.002).

Conclusion: Based on the result of this in vitro study, licorice extract did not show any antifungal effect.

Background and Aims: The Panoramic radiography is one of the routine techniques in implant imaging. Although there are some limitations with this technique, panoramic radiography is radiographic choice for basic evaluation for implant treatment. Many studies have been designed to determine magnification in panoramic images but most of them were performed on dry skulls or radiographic phantoms. In recent studies CT or CBCT are used as gold standard. The aim of this study was to determine vertical magnification of panoramic images using renovated CT sections in anterior and posterior regions of both jaws.

Materials and Methods: 30 panoramic radiographs (Planmeca EC or CC Proline) were selected from patients of implant department and Particular anatomic landmarks were selected in those images. Vertical dimensions of these landmarks were measured in both panoramic and renovated cross sectional CT images by a digital caliper and vertical magnification was calculated as the ratio of image dimensions to the real dimensions.

Results: The mean vertical magnification of panoramic radiographs in anterior and posterior maxillae were 1.22±0.02 and 1.16±0.02, respectively. The mean vertical magnification of panoramic radiograph in anterior and posterior mandible were 1.20±0.02 and 1.13±0.02, respectively. The differences between magnification in mandible and maxillae were significant (P<0.001). The differences between magnification in anterior and posterior regions of both jaws were not significant (P=0.11).

Conclusion: Vertical magnification of panoramic images (Planmeca EC or CC Proline) in different regions in both jaws were between 1.13 to 1.22.

Background and Aims: The exfoliated human deciduous tooth contains multipotent stem cells [Stem Cell from Human Exfoliated Deciduous tooth (SHED)] that identified to be a population of highly proliferative and clonogenic. These cells are capable of differentiating into a variety of cell types including osteoblast/osteocyte, adiopcyte, chondrocyte and neural cell. The aim of this study was to evaluate the differentiation of SHED to osteoblast in standard osteogenic medium and comparing the results with medium which supplemented with glucosamine in form of chitosan.

Materials and Methods: Dental pulp cells were isolated from freshly extracted primary teeth, digested with 4 mg/ml collogenase/dispase, and grown in Dulbecco's modified Eagle's medium with 10 percent fetal bovine serum. The clonogenic potential of cells was performed after 3 weeks of culture. Flowcytometric analysis, performed at day 21 of culture to identify surface markers of mesenchymal stem cells. The cells from 3rd passage were used for osteogenic differentiation in routine osteoinductive medium. Chitosan (10 μg/ml) was added to the culture medium of case group. Alizarin Red Staining and Alkaline Phosphatase (ALP) activity were done to evaluate osteogenic differentiation in the developing adherent layer on the third passage. The results were analyzed using T-test. For the analysis of normal distribution of data, non-parametric Kolmogrov-Smirnov test was used.

Results: The colonogenic efficiency was more than 80%. Flowcytometric analysis showed that the expression of mesenchymal stem cell marker CD90, CD105 and CD146 were positive in SHED, while hematopoietic cell marker CD34, CD45 and endothelial cell marker CD31 were negative. Quantitative analysis of Alizarin Red Staining demonstrated that: mineralized nodule formation was higher in the group supplemented with glucosamine (chitosan). Results from Alkaline Phosphatase activity test, on day 21, demonstrated a significantly higher ALP activity in the group supplemented chitosan (P<0.001).

Conclusion: Stem cells isolated and cultured from exfoliated deciduous teeth pulp can be differentiated to osteoblast. Addition of chitosan can be beneficial to promote osteogenic differentiation of these cells.