Journal of Dental Medicine

Background and Aims: Periodontitis is an inflammatory multifactorial disease in oral tissues and many genetic reasons and environmental factors responsible. Vitamin D deficiency has been determined to be related to periodontal disease. This aim of this study was to investigate the association between rs7975232 polymorphism in vitamin D Receptor gene and periodontitis in 100 patients (as patient and control groups).
Materials and Methods: Blood samples from 50 patients and 50 control groups were selected and DNA from the samples was extracted by the DNA extraction kit. Genotyping was used by Tetra Arms-PCR method. The use of sequencing was confirmed by the Tetra Arms-PCR genotyping results. Then, statistical analysis was performed using SPSS statistics 20 software and T-test.
Results: Frequency of AA, AC, and CC Genotypes were 25 (50%), 14 (28%), and 11 (22%) in patients’ cases, and 26 (52%), 16 (32%) and 8 (16%) in controls, respectively. AA genotype was the highest genotype between the patient and control groups. Statistical analysis showed no significant association between this type of polymorphism and periodontitis disease in the studied samples (P=0.67).
Conclusion: This finding showed there was not significant association between rs7975232 polymorphism in vitamin D Receptor gene and periodontitis disease in the studied samples. To confirm the results of this study, further studies with large sample size and different types of population are recommended.

Conclusion: The high prevalence of TMD and related factors, such as a history of jaw dislocation, posterior edentulousness, earache, and clenching, requires attention to be identified and treat these problems.

Conclusion: Powerful authoritarin and authoritative parenting practices have a clear impact on the oral health status of children. Therefore, parenting paratices can be considered as one of the main factors affecting the oral health of children.

Conclusion: The trend of publishing scientific articles in Iran in the field of dentistry has been increasing during the selected period. The keywords oral, dental, and pediatric surgery have the most effective and decisive role in the scientific network of dentistry. These keywords provided strong scientific communication amongst the dental scholars in Iran.

Conclusion: The data of this study in proving the anti-biofilm and antibacterial effects of aloe vera extract showed that the expression of the target gene is reduced. It seems that this substance can be used as an alternative to oral hygiene chemicals.

Conclusion: The data of this study in proving the anti-biofilm and antibacterial effects of aloe vera extract showed that the expression of the target gene is reduced. It seems that this substance can be used as an alternative to oral hygiene chemicals.

Conclusion: According to the results of this study and the application of anaerobic conditions, forced anaerobic bacteria can be isolated from clinical specimens of oral infections and by Tetra Arms-PCR no significant relationship between TGF-1β genomic polymorphism and periodontitis was observed. In addition, therer was no significant difference in the frequency of alleles and genotypes between the control and patient groups.

Background and Aims: The increase in life expectancy and decrease in birth rate enhances the elderly population in different societies and consequently, the demand from the health system for providing the treatment needs has been elevated. It has been proposed that dentists must improve their attitude, knowledge, and practice to meet these needs. The present study aimed to assess the knowledge, attitude, and practice of general dentists regarding geriatric oral health.
Materials and Methods: In this descriptive-analytic cross-sectional study, 150 general dentists participating in the annual congress of the Iranian Dental Association in 2018 were selected and completed a valid and reliable self-administered questionnaire including 5 parts about knowledge, attitude and practice regarding old age and oral health of elders. SPSS23 and multiple regression were used for data analysis.
Results: The mean age of dentists was 34.3 (SD: 9.1) and 92 (61.3%) of participants were women. The mean knowledge score about the old age was 16.67 (of maximum: 26, SD: 4.31) and the mean knowledge on the geriatric oral health was 11.01 (of maximum: 18, SD: 2.81). The mean general attitude about elderly was 19.1 (of maximum: 30, SD: 4.26), the mean attitude on geriatric oral health was 13.09 (of maximum: 20, SD: 2.65), and the mean practice about geriatric oral health was 6.5 (of maximum: 10, SD:2.96). Age was significantly associated with knowledge regarding the elderly (P<0.034); i.e. with increase in age lower scores in knowledge were gained.
Conclusion: General dentists participating in the congress of the Iranian Dental Association demonstrated a medium level of knowledge, attitude, and practice regarding the oral health of elders. Proper educational programs should be planned in dental schools to improve dental student's knowledge, attitude and practice about geriatric oral health.

Background and Aims: Supporting the preventive approach is important in training future dentists. The purpose of the present study was to evaluate the knowledge, attitude and practice of senior dental students regarding non-invasive management of dental caries.
Materials and Methods: A cross-sectional study was conducted in 2019 using total sampling method and a valid and reliable questionnaire. Knowledge, attitude and self-reported practice of senior dental students regarding caries risk assessment (CRA) and management of lesions in two paper patients were assessed. The data analysis was performed using SPSS20 and the descriptive and analytical statistics were reported.
Results: In overall, 86 students (response rate=91%) were responded. In the knowledge section, caries history in the previous year, having frequent fermentable carbohydrate, xerostomia, and low socio-economic status were considered by more than half of students as factor for caries risk assessment. More than 90% of students had a positive attitude towards CRA in children. Nearly 50% of students tend to restore enamel lesions in proximal and occlusal surfaces in high-risk scenarios. There was significant association between the OHI instruction and debris index improvement (P=0.04) in the integrated comprehensive care clinic (TUMS). The linear regression analysis showed that there was no significant association between the demographic characteristics, place of education, previous course on the level of knowledge and attitude.
Conclusion: Senior dental students despite their general knowledge and positive attitude toward caries risk assessment, tended to aggressively manage the incipient lesions in the enamel and DEJ. Delivering prevention as integrated in the comprehensive care unit in order to improve oral hygiene status of patients is recommended.

Background and Aims: Nowadays, new techniques are used to control dental caries that have the ability to kill cariogenic bacteria. Recently, the addition of antibiotics to glass ionomers has been proposed to reduce the overall number of saliva bacteria. The aim of this study was to compare the antimicrobial effect and compressive strength of resin- modified glass ionomer (RMGI) containing different antibiotics on Streptococcus mutans.
Materials and Methods: A total of 120 specimens were prepared in 3 groups (n=40) including RMGI containing doxycycline with a concentration of 1.5%, RMGI containing a combination of ciprofloxacin, metronidazole and minocycline with a concentration of 1.5%, and RMGI without antibiotics as control group. To measure the antibacterial effect, the disk diffusion method and counting of Streptococcus mutans bacterial colonies were used and then the compressive strength test was performed. Data were collected into SPSS25 and analyzed by ANOVA and Kruskal-Wallis tests and the significance level was considered α=0.05.
Results: The mean number of bacterial colonies in the RMGI group containing doxycycline in all three time intervals 1, 24 hours and 7 days was significantly lower than the specimens in the RMGI group containing the triple antibiotic (P<0.001). The mean compressive strength of the two experimental groups was lower than the control group but was not statistically significant (P=0.326).
Conclusion: The addition of antibiotics at a concentration of 1.5% to RMGI resulted in a favorable antibacterial property with no significantly change in the compressive strength.

Conclusion: According to the results of this study, it seems that dentists should pay more attention to the components of emotion regulation and emotions in order to prevent and reduce job burnout.

Background and Aims: Survival of periodontal ligament (PDL) cells after avulsion is an important factor in treatment prognosis. Grapefruit Seed Extract (GSE) can be a proper environment for preserving periodontal ligament cells. The objective of this study was to analyze the effect of different concentrations of GSE on the proliferation of fibroblast PDL cells.
Materials and Methods: In this study, the undifferentiated PDL fibroblasts were obtained from two human premolars teeth and cultured in Dulbecco’s modified Eagle’s medium (DMEM). The cultured cells were exposed to different concentrations of GSE. The positive and negative control groups were cultured in fetal bovine serum (FBS) 10% and in a medium without FBS 10%, respectively. The plates were incubated for 1, 6, 12, 24, and 48 hrs. The PDL cell viability was assessed by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Statistical analysis of data was accomplished using repeated measure ANOVA with Post HOC Tukey, P<0.05 was considered statistically significant.
Results: We found out that among different concentrations of GSE, 1:128 had the most impact on undifferentiated PDL fibroblasts. Although, the cell vitality was higher in the twelfth hour, 1:128 GSE and in the forty-eighth hour, 1:1024 GSE than the positive control group but they were not statistically significant (P>0.05). Furthermore, all the samples were similar to the positive control group in three of the five timeperiods (P>0.05).
Conclusion: GSE was more effective in fewer concentration and longer periods and it had no toxic effect on PDL cells. Therefore, GSE can be considred as a promoting medium in PDL regeneration of avulsed permanent teeth in the future.

Background and Aims: The stress, job satisfaction and depression can affect the performance of dental professionals in various fields. The aim of present study was to examin the level of stress, depression and job satisfaction among different specialized fields of dentistry in Zanjan provinc, Iran.
Materials and Methods: In this cross-sectional study, the depression, anxiety and stress scale questionnaire (DASS-21) and the Herzberg questionnaire were used to assess job satisfaction. The questionnaires were completed on the web, and the relevant link was sent to all specialists in different fields of dentistry in Zanjan province. Finally, 33 people participated in the study. Data were analyzed after appropriate code allocation using independent T-test and U-Mann Whitney tests and SPSS16.
Results: The results showed the mean of stress (24.4), depression (17.48) and anxiety (13.28) among specialists. The mean of stress and anxiety among female dentists was higher than male specialists, but there was no significant difference between these two variables between the two sexes (P>0.05). In terms of job satisfaction, 21.2% were dissatisfied with their job. By gender, 26.6% of female specialists and 16.7% of male specialists were dissatisfied with their jobs.
Conclusion: Despite the general perception that work conditions are suitable for dental specialists, these people suffer from the stresses, anxiety and depression and may not be satisfied with their job. As these conditions can affect the performance of these people in the workplace, it would be necessary to take measures, to identify, and to increase mental health and job satisfaction.

Background and Aims: In impacted third molar surgery, panoramic radiography is a preliminary technique for assessing the consequences associated with inferior alveolar nerve injury. However, this technique cannot provide enough information to determine the true risk in all cases. The aim of this study was to compare the accuracy of panoramic and CBCT radiographs in evaluating the relationship between the mandibular impacted third molars and the inferior alveolar nerve.
Materials and Methods: In this cross-sectional study, the relationship between mandibular third molar and inferior alveolar nerve in 15 patients referred to the oral and maxillofacial radiology department of Birjand dental school including 20 mandibular third molars were evaluated using two panoramic and CBCT radiographs. Data were analyzed using descriptive statistics and chi-square test and sensitivity analysis in SPSS22.
Results: In the evaluation of the teeth using panoramic radiography, the highest frequency was related to root darkening (65%) and root deflection (65%), and the lowest frequency was related to root narrowing (20%) and canal deviation (5%). The highest sensitivity of panoramic criteria was related to the root darkening with 100% sensitivity and the lowest sensitivity was related to the canal deviation with 17% sensitivity. On the other hand, the highest specificity of panoramic criteria between the mandibular third molars with the inferior alveolar nervewas was related to the two criteria of bifid apex and canal deviation with 100% specificity. The lowest specificity was related to the root deflection with 21% of specificity.
Conclusion: According to the results of this study, the probability of observing relationship between the mandibular third molars with the inferior alveolar nerve in CBCT radiography was very high.

Background and Aims: Dental aesthetics has become an important issue in contemporary society. This study was designed to evaluate the patients’ satisfaction with their dental appearance and tendency to improve dental aesthetics.
Materials and Methods: In this descriptive study, a questionnaire with 17 questions was used to collect data from 200 patients referred to the dental school of Isfahan University of Medical Sciences from April-July 2019. A valid and reliable self-administrative questionnaire consisted of questions about the appearance of anterior teeth, receiving cosmetic treatments, and favorite aesthetic dental treatments was designed and used. Data were fed into SPSS22 and analyzed by Mann-Whitney, Kruskal Wallis and Spearman correlation tests (α=0.05).
Results: Among the participants, 27.5% (n=45) were dissatisfied with the appearance of their anterior teeth and the major reason for this dissatisfaction was related to the tooth color (35.8%, n=71). It was also observed that approximately 84% (n=168) of the patients had a history of smile concealment because of their teeth appearance. Among cosmetic dentistry treatments, aesthetic restorations were more commonly used than other treatments (20.5%, n=41). However, the most desired cosmetic treatments were teeth whitening (78.4%, n=156). There was no significant relationship between the satisfaction with the appearance of teeth and interest in the orthodontic treatment with age and education level (P=0.6).
Conclusion: Teeth color was the most important factor determining the degree of satisfaction with the appearance of teeth. Most of subjects desired to receive an aesthetic dental treatment and teeth whitening was the most popular aesthetic dental treatment.

Background and Aims: Due to the review of general dental courses, it was necessary to assess the students' satisfaction with this curriculum. The aim of this study was the assessment level of students’satisfaction with the new educational curriculum of the Ministry of Health at the department of restorative dentistry of Tehran university of medical sciences in 2019-2020.
Materials and Methods: In this descriptive cross-sectional trial,72 sixth year dental students of Tehran University who passed the restorative dentistry courses based on the new curriculum were studied. A questionnaire was developed and for validity content assessment, it was presented to 5 professors and then revised. For reliability approval of the questionnaire, test-retest approach was used. The questionnaire was given to the 30 students of the main pilot group in one session and two-week later and agreement percentage and Kappa index were calculated.  After conducting the "test" process and re-testing, the "questions" were statistically analyzed using STATA software.
Results: The most level of satisfaction regarding to practicality of subjects was found for fundamental of restorative dentistry including principles of amalgam class I cavity preparations and restorations on the dentic (81.94% and 76.39% acceptable respectively) and the principles of amalgam classII cavity restorations on the dentic (72.22%). The least satisfaction levels were obsereved in the first and second theoretical restorative courses including tooth-colored restorations (47.22%), onlays and inlays (47.22%) and tooth-colored classII cavity preparations and restorations (48.61%). The amount (P-value or error of the first type) was reported in all questions>0.001.
Conclusion: Despite the limitation of this study, final-year dental students’ satisfaction of theoretical restorative dentistry courses was medium, while it was high for the fundamental and practical restorative courses of 2017 educational curriculum.

Background and Aims: Studies have shown that dental anxiety may be caused by various factors such as child mood, age, maternal emotional maturity, previous dental anxiety and parenting styles. Therefore, the aim of this study was to investigate the possible relationship between the parenting styles and pediatric dental anxiety and the predictability of this variable through parenting styles.
Materials and Methods: The present study was a cross-sectional correlational study. The study population was children aged 7 to 12 years who had referred to the dental clinics of Tehran in 1400. Sampling from one of the clinics was done randomly. A total of 100 questionnaires of modified child dental anxiety scale and parenting style inventory were given to the children and their parents and 95 of them could have been analyzed. The questionnaires were analyzed using SPSS22 software and Pearson correlation and regression tests.
Results: The results showed that dental anxiety had a negative and significant relationship with authoritative parenting style (r=-0.286, P<0.01) and a positive and significant relationship with authoritarian parenting style (r=0.342, P<0.01). Authoritarian parenting style can be a predictor of dental anxiety.
Conclusion: Knowing the predictors of dental anxiety can help a pediatric dentist analysing who is most prone to dental anxiety. Based on this approach, a relationship based on trust can be established between the dentist and parents to make the necessary recommendations to parents in the office, reduce dental anxiety and improve oral health conditions in children.
 

Background and Aims: Periapical diseases are the end result of untreated pulpitis and necrotic dental pulp. The aim of this study was to determine and compare the prevalence of radicular cysts and periapical granulomas in young adults and old patients referred to Oral Pathology department of Isfahan dental school.
Materials and Methods: In this cross-sectional study, all recorded samples with a diagnosis of radicular cyst and periapical granuloma were considered by the census method in a 14-year period from 2006 to 2019 in the archives of the Oral Pathology Department of Isfahan dental school. The data were extracted including age, gender, location of the lesion and histopathologicaldiagnosis.
The prevalence of cases in terms of age range was classified into two groups of young adults (20-35 years) and older (over 50 years). Then, Chi-square test and t test were done using SPSS24 and P<0.05 was considered significant.
Results: The results showed that 49.4% (430 cases) of lesions were observed in males and 50.5% (439 cases) in females. Of all lesions, 51% (444 samples) were periapical granulomas and 49% (426 samples) were radicular cysts. Chi square test showed a significant difference between the prevalence distribution of the two lesions based on gender. Radicluar cysts were more prevalent in males and periapical granulomas were more prevalent in females (P<0.001). According to t-test, there was no significant difference between the mean age of patients based on gender (P=0.176). The prevalence of lesions in the third and fourth decades of life was higher than in other decades. Also, in the third and eighth decades, the prevalence of periapical granulomas was higher than radicular cysts.
Conclusion: The prevalence of periapical cysts and dental granulomas were higher in young adults than in elderly patients.

Background and Aims: Although dental implants have become a successful and predictable ong-term treatment for patients, not all implant treatments are necessarily successful and pre-implant diseases are spreading. The aim of this study was to determine the prevalence of peri-implantitis in patients one year after prosthetic loading in Khorramabad in 2021.
Materials and Methods: In this cross-sectional study, 53 patients who had implants and undergone prosthetic loading for one year were studied. In each of the 53 patients, the probing depth (PD) and bleeding during probing (BOP) around the implant and the characteristics of the surrounding soft tissue, including gingival redness and tissue sensitivity were evaluated and recorded. To assess the bone level or possible bone resorption, a P.A. graph was taken from the patient using a parallel technique. Information such as demographic characteristics and specialized information about the disease were collected through a checklist. Data were collected using SPSS22 software. Frequency tables and chi-square and t-tests were used to analyze the data.
Results: The mean age of patients participating in the present study was 46.5±10.63 years. The number of women was 33 (62.3%). The prevalence of peri-implantitis was 17% at the patient level and 9.3% at the implant unit level. There was a significant relationship between the age (P<0.03) and systemic disease (P<0.03) with the prevalence of peri-implantitis. However, there was no statistically significant relationship between the prevalence of peri-implantitis and other demographic variables (P<0.05).
Conclusion: The results of the present study showed that the prevalence of peri-implantitis was higher in people with a higher mean age. In addition, systemic diseases are a protective factor for peri-implantitis.

Background and Aims: The need to use a highly effective sealer in order to create a complete seal along the canal is essential for the basic treatment of tooth roots. Therefore, the aim of this study was to investigate the sealing ability of cold ceramic and gutta-percha with sealer by applying the bacterial leakage and electrochemical method.
Materials and Methods: In this in-vitro experimental study, fifty human single-rooted teeth were selected and their crowns were cut from the cervical region. The canals were prepared and washed with 17% EDTA. Then the teeth were randomly divided into four groups: group 1 gutta-percha with AH26 sealer (Dentsply Detrey, Germany) (n=20), group 2 cold ceramic (Yazd, Iran) (n=20), negative and positive control groups which each consisted of 5 teeth. Samples were kept in an incubator at 37° C for 48 hrs. Two coats of nail polish were used for covering the root, except for the last 2 mm, and microleakage in the fillings was measured by the bacterial leakage and electrochemical methods. The microleakage of the two groups was statistically analyzed in the electrochemical technique by Student's t-test, and in the bacterial leakage method by Fisher's exact test.
Results: In bacterial leakage method, in the first group (gutta-percha) 7 samples (35%) and in the second group (cold ceramic) 3 samples (15%) had bacterial leakage, but no significant difference was observed between the two groups on different days (P>0.05). The mean microleakage based on the electrochemical technique in gutta-percha was significantly higher than that of cold ceramic (P=0.0001).
Conclusion: According to the lower microleakage values in the use of cold ceramic compared to gutta-percha, cold ceramic  can be used to fill root canals to reduce microleakage, although further studies are needed.