Journal of Dental Medicine

Background and Aims: One of the most effective methods in reducing the prevalence of caries is oral health education. The aim of this study was to evaluate of two educational interventions regarding prevention of early childhood caries on self-reported practice of parents of 2-5-year-old children receiving dental treatment under general anesthesia.

Materials and Methods: In this interventional study, the effects of two different educational interventions
(pamphlet and pamphlet along with reminder) on self-reported practice of parents of 2-5-years-old children receiving dental treatment under general anesthesia was assessed. Thirty seven couples of children and mothers in two groups were randomly selected. Before and three months after interventions, a standard questionnaire regarding self-reported practice of mothers on prevention of early childhood caries was completed by respondents. Moreover, oral examination including Simplified oral hygiene index (S-OHI), dmft, and white spot lesions were rerecorded at the beginning and three months after interventions. At this time in one of the groups reminder phone calls were made every month. Finally, the answers were scored and data were statistically analyzed to be compared in pre- and post-test.

Results: Comparing each of the groups before and after interventions showed that in both groups there were significant differences in mothers’ perception of perceived ability to make child brush his teeth twice a day (P=0.001), and child’s tooth brushing frequency more than once a day (P=0.03). S-OHI had no significant difference after the intervention between two groups. But each group had a significant decrease three months after intervention (P=0.003). Also the mean number of white spots showed a significant decrease before and after intervention in each groups. Regarding mothers’ self-reported practice no significant difference was observed between two groups (P>0.05).

Conclusion: Using pamphlets along with or without reminder as educational measures had similar enhancing effects on the mothers’ self-reported practice on oral health of children within three months.

Background and Aims: Gender determination is an important step in identification. For gender determination, anthropometric evaluation is one of the main forensic evaluations. The aim of this study was the assessment of sphenoid sinus volume in order to determine sexual identity, using multi-slice CT images.

Materials and Methods: For volumetric analysis, axial paranasal sinus CT scan with 3-mm slice thickness was used. For this study, 80 images (40 women and 40 men older than 18 years) were selected. For the assessment of sphenoid sinus volume, Digimizer software was used. The volume of sphenoid sinus was calculated using the following equation: v=∑ (area of each slice × thickness of each slice). Statistical analysis was performed by independent T-test.

Results: The mean volume of sphenoid sinus was significantly greater in male gender (P=0.01).The assessed Cut off point was 9/35 cm³, showing that 63.4% of volume assessments greater than cut off point was supposed to be male and 64.1% of volumetry lesser than cut off point were female.

Conclusion: According to the area under Roc curve (1.65%), sphenoid sinus volume is not an appropriate factor for differentiation of male and female from each other, which means the predictability of cut off point (9/35 cm³ ) is 65/1% close to reality.

Background and Aims: In the field of orthodontics, gaining comprehensive information around dento-skeletal complex is necessary to choose the best treatment plan for each patient. The aim of this study was to investigate the linear and angular parameters in panoramic radiographs to find a path to correlate transvers to sagittal dimensions.

Materials and Methods: Total number of sixty two, 8-14 years old children who sought for orthodontic therapy were selected (32 skeletal Class III and 30 skeletal Class I). They were exposed to x-ray to obtain the panoramic and lateral views in a controlled condition. Various linear and angular parameters were measured after tracing the landmarks on the panoramic radiograph. Data were obtained and analyzed using T-test. The level of significance was set at 0.05 (P<0.05).

Results: Linear parameters of Co-Co, Go-Go and PTM-PTM were significantly lower in class III patients than class I ones (P=0.04, 0.04, 0.02, respectively). The ramus width value was also lower in class III patients. Angular parameters of  Me^˄ and N^˄ also showed the same results (P<0.001). Go^˄ angle was significantly lower in the class I than class III patients (P=0.002, 0.007).

Conclusion: Some traceable linear and angular parameters were found in the panoramic radiographs which had the potential to correlate the transverse with sagittal dimension.

Background and Aims: This study aimed to assess the severity of tooth decay and related factors in children 5-7 years old, in 2016, in Tehran.

Materials and Methods: A descriptive and cross-sectional study was performed on 572 children aged 5-7 years old (300 girls and 272 boys) in public schools in Tehran, Iran. Severity of dental caries (number of decayed, missing, filled surfaces) recorded for C, D and E teeth according to WHO criteria. Data analysis was performed by Backward Linear Regression Analyses using SPSS 20 (P≤0.05).

Results: Assessment of dental caries severity according to the number of decayed surfaces showed generally higher figures in upper jaw. The order of average severity of carious teeth was C, E and D from low to high in both jaws. According to the results of Linear Regression Analysis, severity of dental caries was more than other children in boys (OR=1.83, 95%CI: 0.81-2.8), those visited dentist due to dental problems associated with pain (OR=1.17, 95%CI: 0.73-1.6), and those without fluoride therapy (OR=1.64, 95%CI: 0.58-2.6) in C, D and E teeth.

Conclusion: Flow the results, it was concluded that gender, level of mother's education, type of snack consumption, start age of tooth brushing, reason for dental visit and fluoride therapy affected severity of tooth decay.

Background and Aims: The first permanent molar is susceptible to caries, endodontic complications and developmental anomalies. Compromised teeth with poor prognosis could cause the clinician to face dilemmas. The aim of this review article was to assess recent guidelines on the treatment planning of compromised first permanent molars in mixed dentition period.

Materials and Methods: The design of the study was based on review of literature by searching the MEDLINE, Web of science and Google scholar. Key words (permanent first molar, extraction, treatment plan) were used. This search was limited to the English articles published after the year 2000.

Conclusion: A number of factors influenced decision-making process regarding compromised first permanent molars including the restorative status of the tooth, dental age of the patient, degree of crowding and occlusal relationships were assessed. The ideal time for removal of these teeth was 8-9 years of age. However, the current evidence for managing compromised first permanent molars demands clinical trials.

Background and Aims: According to the research background and need to print CBCT images in case of emergency, this study has been done to compare the quality and accuracy of the two methods of film and paper printing for CBCT images.

Materials and Methods: The study of CBCT images taken from 5 patients was done and the cross-sectional slices on Fotolusio DNP papers and film AGFA were printed. Afterward, the images was exmined by a maxillofacial radiologist. The images’ quality were identified and recorded with anatomical, from 1 to 4 on forms. The accuracy was determined by the diagnosis of alveolar canal area and the comparison with the gold standard. Data were analyzed using independent chi-square and Fisher exact tests’.

Results: The images quality in anatomical landmarks consisting PDL (P=0.02), lamina dura (P=0.006), the inferior alveolar canal (P=0.01) and the filling (P=0.006) had a significant difference. There was no significant difference. For the lower border of the mandible landmark, there was no difference between the two methods of printing. In comparing the diagnostic accuracy between the two methods (P=1).

Conclusion: The results showed that the diagnostic quality in film printing is better than paper printing and the diagnostic accuracy is the same in both methods.

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.

Geriatric is a growing phenomenon which recently rises so fast. With increasing age, the biological and physiological changes occur in different organs. Socioeconomic situation with emerging multiple diseases, disability and changes in oral status can all affect the quality of life of people. The aim of this study was to overview on aging process and consideration on oral changes in particular.

This study was carried out by reviewing different scientific sources from Pub Med, Google scholar and Iranian articles (SID) since 2005 to 2016. Oral condition may be according to the systemic diseases or solely. The changes in the hard tissue and soft tissue occur. Each of these changes is the result of damage due to the people’s situations which sometimes make it difficult to repair.

Nevertheless, rising age in global and in Iran have to be considerd. Periodic visits are important because they reduce the risk of some diseases, including cancers in the mouth. Also, the influence of maintaining the oral and periodontal health conditions not only specifically in oral health but more broadly on some systemic diseases such as heart disease, lung disease, diabetes and etc. are quite important.

Background and Aims: Despite the reduction of incidence of dental caries in recent years, this disease is common and many efforts were conducted to decrease the prevalence of dental caries. On the other hand secondary caries lesions are the main reason for replacement of direct restorations. Therefore, the aim of the current study was to evaluate suitable methods of preparation and restorative materials to reduce caries recurrence.

Materials and Methods: In this experimental study, eighty human teeth were collected and stored in normal saline. The teeth were soft-tissue debrided and cleaned with water/pumice slurry and rubber cups in a low-speed handpiece. Speciments were randomly divided in two main groups. Cavities were prepared with diamond burs or Er:YAG laser (10 Hz, 300 mJ, 3W). Each group was divided into 4 sub-groups, and restored with a glass-ionomer cement (Fuji IX), resin modified glass-ionomer (Fuji II LC), total etch bonding + composite resin or self-etch bonding + composite resin. The specimens were submitted to pH cycling. Speciments were then sectioned, polished and Vickers microhardness measurements were performed on each specimen. Differences among the medians were analyzed using two way ANOVA test at a 95% confidence level and Tukey test.

Results: Statistical analysis showed significant difference in the type of substrate (enamel, dentin) in both main groups (P<0.0001) but no differences in the caries lesion development between the cavities restored with the same material and prepared with diamond burs or Er:YAG laser.

Conclusion: The Er:YAG laser used for cavity preparation and different types of restorative materials used did not show the ability to guarantee significantly more acid-resistance tooth structure against demineralization.

Background and Aims: Dental caries is the most common infectious diseases. Among the oral bacteria, Streptococcus mutans and Streptococcus sobrinus are considered as the main causes of tooth decay. The aim of this study was to evaluate the production of hyperimmune bovine colostrum containing specific antibodies against cariogenic bacteria and its antimicrobial effects on the growth and adhesion of Streptococcus mutans and Streptococcus sobrinus in the laboratory.

Materials and Methods: In this experimental study, three pregnant bovine immunized with killed antigens of strains of Streptococcus mutans, Streptococcus mutans with Streptococcus Sobrinus and Streptococcus sobrinus through intramuscular injections. After delivery, The colostrum samples were collected, and the changes of anti-streptococci antibodies titers in colostrum and serum were determined by agglutination. Also,their antimicrobial effects against the growth and adhesion of oral streptococci were surveyed by the microtiter plate method. Data were analysed by One-Wey ANOVA in SPSS software.

Results: The results showed that in hyperimmunized bovine , the antibodies titers against injected bacteria were from 1.1000 to 1.3000 in sera samples and from 1.320 to 1.1280 in whey of colostrum samples. Colostrum of hyperimmune cows reduced the attachment of Streptococcus mutans and Streptococcus Sobrinus about 69 and 43 percents, respectively and also, the low dilutions of it reduced bacterial growth.

Conclusion:  According to the antibacterial effect immune colostrum on two strains of cariogenic bacteria in vitro, It appears that this material could be useful in the prevention and control of dental caries.

Background and Aims: The purpose of this study was to evaluate the relationship between the mandible anatomy with age and gender in panoramic radiography of patients.

Materials and Methods: In this descriptive-sectional study, 322 panoramic radiography of patients at the age of 25-55 years old were evaluated. The patients were devided in three groups of 25-34, 35-44, 45-55 years old and the radiomorphometric indexes in panoramic radiography of the patients were measured. The collecting data were analyzed using independent two-sample t-test, one-way anova and multiple linear regression using SPSS statistical software (version 18).

Results: The average of radiomorphometric indexes don’t show a meaningfull statistical defference between different age groups. The average of all angles higher in females than that of males and other measured indexes were higher in males than females. Also, the mandibular foramen moved forward with the increase of age.

Conclusion: Based on the result of this study which was done on limited numbers, it can be concluded that the measured radiomorphometric indexes in this study didn’t have a high accuracy to predict Age and Gender.

Background and Aims: Acurate measurements of variables are crucial in epidemiological studies. Therefore, even the best design cannot prevent bugs caused due to the lack of reliability and validity measurement in studies. The aim of this study is to determine the validity of teeth-canal measurement.

Materials and Methods: This methodological study used available data of patients referred to dental clinics at Hamadan University of Medical Sciences in Hamadan with sample size or 58 cases in 2012. In order to determine the reliability of measuring the length of canals and introduce the most appropriate measure met of the actual data, Bland-Altman plot and intraclass correlation coefficient (ICC) were used and finally compared.

Results: In this study, the mean ± SD of channel length in the apex locator Root ZX were 21.93 ± 2.28 mm and in X-ray PA were 22.4 ± 2.38 mm. ICC between the length of canals by the apex locator and radiographic in all teeth was 0.989. Bland-Altman plot showed that absolute agreement between the two methods of measurement.

Conclusion: The findings of this study ensure dental professionals that measuring the length of channels by PA method is more practical and easier and prove different approaches of the reliability and validity. However, we recommend using ICC and Bland Altman methods due to their informative nature and consideration of absolute agreement instead of consistency.

Background and Aims: Traumatic dental injuries (TDIs) are of the most common dental problems in children and adolescents, which usually occur in the anterior segment and have a significant role in patient’s physical and psychological health. Immediate intervention for damaged teeth can elevate the success rate of treatment in TDI. Thus, general dentists’ knowledge and their effective intervention in TDI are important factors in prognosis of traumatized teeth. The objective of this study was to assess the general dentists’ knowledge and awareness regarding the diagnosis and management of traumatic dental injuries.

Materials and Methods: In this cross-sectional study, the questionnaire data were collected from 130 general dentists, including the demographic data and general dentists’ knowledge about TDIs. The data were analyzed using the Student t-test and Analysis of Variance (ANOVA), Spearman’s and Pearson’s correlation coefficient.

Results: The mean score of general dentists’ knowledge was 8.5 ± 1.5 (total score:10) and it was the same between both males and females (P=0.083). Dentists’ work place does not have any influence in their knowledge (P=0.133). Also, there was no statically significant relationship between the age, job experience and dentists’ knowledge (P=0.805). The relationship between the frequency of TDI managed cases and dentists’ knowledge was not significant (P=0.507).

Conclusion: Considering that the overall knowledge of general dentists regarding the management of TDI was sufficient, it could be a good opportunity in treating these injuries. As TDI is a developing science, it is important to motivate general dentists being up to date regarding this matter.

Masticatory muscle pain is the second most frequent cause of orofacial pain after dental pain. Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular joint dysfunction. MPDS is a pain that triggers from [sensitive] points in the muscles and fascia and is followed by spasm, tenderness to palpation, restricted movement, fatigue, and sometimes dysfunction. The researchers intended to collect comprehensive information about therapeutic interventions for myofascial pain through the conduction of a critical study based on evidence in the literature. In this review, 51 English articles, published between 1981 and 2013, were extracted from PubMed, Medline, Ovid, and Google Scholar. These articles were then reviewed in detail in two categories, namely pharmaceutical and non-pharmaceutical treatments. MPDS treatment should be first focused on the identification and correction of underlying causes. Thiocolchicoside (TCC), non-steroidal anti-inflammatory drugs (NSAIDs), and Cox-2 inhibitors are among promising pharmaceutical methods. On the other hand, ultrasound and laser therapy are among promising non-pharmaceutical methods. The complex mechanism of MPDS, along with its underlying peripheral and central nervous mechanisms may make MPDS, difficult to treat, especially in its chronic form.

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: There is an increased risk of periodontal diseases in patients undergoing fixed orthodontic treatment. Chlorhexidine (CHX) is frequently used to promote oral hygiene; however, it is associated with several complications. Herbal mouthwashes can be used as the substitute without having similar complications. The aim the present study was to compare the effects of herbal mouthwashes (Matrica and Persica) with CHX 0.2% on the periodontal parameters of patients under fixed orthodontic treatment.

Materials and Methods: In a double-blind randomized clinical trial, 84 patients under fix orthodontic treatment were selected. After receiving oral hygiene instruction, the patients were randomly assigned to four groups (group 1: Matrica, group 2: Persica, group 3: CHX 0.02%, group 4: normal saline). Dental plaque scores (PI), gingival inflammation (GI) and papillary bleeding (PBI) indices were measured at the beginning, 1 week after receiving oral hygiene instructions and 30 days after mouthwash consumption. The scores of the periodontal indices were statistically analyzed by Kruskal Wallis, ANOVA the paired Mann-whitney U test and Tukey test.

Results: All of the indices were significantly reduced in study groups (except for the control). Matrica and Persica mouthwashes were similarly effective in improving the periodontal parameters. Their efficacy in decreasing the PBI scores was significantly higher than CHX 0.2% (P<0.01).

Conclusion: Application of the two herbal mouthwashes was effective in improving the periodontal parameters in patients undergoing fixed orthodontic treatment.

Background and Aims: Tooth decay has high prevalence in the world. The use of plant material for the prevention and treatment of this disease for various reasons is considered, due to the increasing resistance of bacteria to antibiotics, the high cost and adverse effects of some chemicals used in dentistry. This study was aimed to determine the antimicrobial effect of alcoholic extract of Pepper (Capsicum annuum) and eggplant skin and cap on the cariogenic streptococci.

Materials and Methods: In this study, the antimicrobial activity of ethanol extract of Capsicum annuum and eggplant skin and cap on the cariogenic streptococci, including Streptococcus mutans, Streptococcus sobrinus, and Streptococcus sanguis by microtitre plate method for MIC (Minimum Inhibitor Concentration) was performed. Data were analyzed by one-way analysis of variance using Prism 5 Graph Pad software.

Results: MIC for the Capsicum annuum and eggplant skin for Streptococcus mutans was 250 mg/ml (SD=0.052), and for the Streptococcus sobrinus and Streptococcus sanguis was 125 mg/ml (SD=0.027). The MIC for the cap eggplant for Streptococcus mutans and Streptococcus sobrinus was 500 mg/ml (SD=0) and for S. sanguis was getting 125 mg/ml (SD=0.159).

Conclusion: This study showed that the herbal extracts of Capsicum annuum and eggplant skin and cap had beneficially antimicrobial effects on all three strains of cariogenic streptococci.

Background and Aims: The exact placement of impression copings in making accurate prosthesis is very important. In some cases, the implants need to be placed deeply subgingival, which could reduce the direct vision and ultimately reduce the precision of impression copings and subsequently, delivered prosthesis. This would be the cause of multiple complications such as delivery of ill-fitting prosthesis. The aim of this study was to evaluate the effect of the dental implant placement depth on the accuracy of impression coping connection by students.

Materials and Methods: This in-vitro and experimental study was conducted by 50 senior dental students. Four implants at different depths (0, 2, 4 and 6 mm) were placed in a model. After learning how to mount impression coping on implants, the students were asked to mount impression copings on all four implants. The samples were examined by an experienced prosthodontist using a magnifier with 4x magnification. Data were analyzed by statistical Cochran test (P<0.05(.

Results: The proper adapting rate of transfer copings, in subgingival implants with the depth of 0, 2, 4 and 6 mm were 100%, 62%, 58% and 20%, respectively. Statistically significant differences were observed between all groups (P<0.001).

Conclusion: The results showed that there was an inverse relationship between the increasing depth of the implants in the gingiva and the dentist’s ability to connect the impression copings properly.

Background and Aims: Cervical tooth hypersensitivity (CTH) is defined as a sharp pain of short term that occurs in dentin exposed to the oral environment. The aim of this study was to evaluate the efficacy of a desensitizing toothpaste containing potassium nitrate (Sensodyne®) for relieving of CTH, when used locally or as tooth paste.

Materials and Methods: 36 patients were enrolled in this study. They were randomly divided into three groups I) Tooth brushing without toothpaste, II) Local application of toothpaste containing potassium nitrate 5%, III) Tooth brushing with toothpaste containing potassium nitrate 5%. Assessment of CTH was done by evaporative (using air and water spray) and cold stimuli at baseline, 1, 3, and six weeks after the treatment. To compare pain changes over time, due to the interaction between the variables of the studied groups and time, one-way ANOVA was used at any time. Due to the difference of variance between groups to compare pairs of groups, Dunnett T3 test was used.

Results: During the study period, no adverse event observed. In all three groups, pain decreased gradually. Local application of toothpaste had the most favorable effect on CTH. Therefore, when compared with that of the first group, the percentage reduction in pain were statistically significant (P=0.03).

Conclusion: Local application of toothpaste containing potassium nitrate as a desensitizing ingredient is a better choice for treatment of CTH than that of application with toothbrush.