Journal of Dental Medicine

Background and Aims: Radiopacity is an essential requirement for all restorative materials. Radiopaque materials allow the dentist to diagnose and assess radiographically the restoration, primary caries, assessment of contours, overhang and secondary caries. The aim of this study was to evaluate the radiopacity of two types of dental bases and liners in comparison whit dental structure using a digital radiography system.
Materials and Methods: Two classes of materials were prepared: 1 mm and 2 mm thickness disks for glass inomer and 1 mm and 0.5 mm thicknesses for dycal. Specimens of enamel and dentine with the same thicknesses were obtained. As a control, an aluminum step wedge was used. Samples were positioned over a phosphor-ray, plate of min ray soredex system, exposed, and the images were analyzed using the contour dent software. ANOVA analysis was used to investigate the significance of differences among the groups. For pairwise comparisons, the Bonferroni test was applied (P<0.005).
Results: 0.5 mm diameter of self-cure and light cure dycal and enamel, presented radio-opacity higher than that of dentine, except for the light cure dycal that had radiopacity lowers than enamel. 1 mm diameter of all the groups presented higher radiopacity than dentin. Light cure and self-cure glass inomer and self-cure dycal presented radiopacity higher than enamel. Enamel showed radipacity higher than light cure dycal in 2 mm diameter self-cure. Light cure glass inomer presented radiopacity higher than that of enamel and dentin.
Conclusion: The increased thickness of the materials evaluated increased their radio-opacity. It was concluded that all the materials had lower radiopaaty than dentin. Only enamel showed higher radiopacity than light-cured dycal.

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.

FTIR spectroscopic imaging is a chemical imaging method that can be employed to a broad range of applications. This powerful technique is suitable for determining the functional groups and chemical structures of the samples. The advantage of infra-red spectroscopy is that it can be used for various modes of physical samples. The aim of the current paper was to review the recent advances and the potential uses of Fourier Transform Infra-red Spectroscopy in dentistry via exploring related literature during 1960 till 2017 in Science Direct and PubMed databases. One of the most popular applications of infrared spectroscopy is to calculate the degree of conversion in the resin based dental materials. It has also been used to investigate the chemical structure of the teeth and bones, synthesis calcium phosphate, the diagnosis of microorganisms, and pathological conditions. In this paper, we mentioned the principles of this technique and recommend this method as a simple and fast way to determine the structure of the materials and their alteration.

Background and Aims: A suitable restorative material must have acceptable mechanical properties. The aim of this study was to evaluate the effect of conventional acidic drinks on the micro-hardness of two dental resins.
Materials and Methods: 48 samples of each of P60 and G-aenial composites were prepared and randomly divided into six groups: Coca-Cola, Fanta, yoghurt drinks, soft beer, Sprites and control groups. The study was in 3 steps: after one day in distilled water and after one day and one week of immersion in beverages per day
(6 hours). The Vickers micro-hardness was then evaluated. Finally, data were analyzed by, t-tests, ANOVA and Tukey tests.
Resultes: Comparing the results between the two groups, a significant difference between the two composite was found. After one day in the water, the average micro-hardness for P60 was of 27.12 (kgf/mm²) and 16.51 (kgf/mm²) for G-aenial amount and these differences were found statistically significant (P=0.0001). For the
6-hour maintenance interval, the average micro-hardness between P60 and G-aenial was statistically significant (P=0.0001). For 42 hours, the average micro-hardness ranged between P60 and G-aenial that were statistically significant (P=0.0004). The stiffness of the P60 composite after 42 hours’ storage in soft beer significantly decreased compared with the control group (P=0.03). G-aenial composite hardness after 42 hours of soaking in the Coca-Cola was reduced significantly compared to yogurt drinks (P=0.02).
Conclusion: As a result, the hardness of P60 composite was higher than that of G-aenial. The hardness of both composites reduced in acidic drinks after one week.

Background and Aims: While there are a lot of information about an illness risk factors, there are still some gaps in understanding factors influencing the progression of disease. Given the important role of psychological factors in physical conditions, the purpose of this study was to compare the cognitive emotion regulation, stress, depression, anxiety, and stress related to life events in people with and without periodontal disease.
Materials and Methods: The type of this study was causal comparative. Research society was all clients referred to dental clinics in Lamerd and Mehr cities, then 50 people with and 50 people without periodontal disease (male and female, 15-49 years old) were selected using purposive sampling. The group without periodontal disease was matched with patient group in terms of demographic characteristics. Both groups completed cognitive emotion regulation questionnaire (CERQ), Depression Anxiety Stress Scale (DASS), and life events questionnaire. Data analysis was conducted with SPSS version 17 using multivariate analysis of variance (MANOVA).
Resultes: Data analysis showed that people with periodontal disease had more stress, depression, anxiety, and stress related to life events than matched control group. The groups had significant differences in the components of self-blame, rumination, positive attention to evaluation and catastrophizing (P<0.05). People with periodontal disease had higher scores in self-blame, rumination and catastrophizing and lower scores in positive attention to evaluating compared with matched control group.
Conclusion: The results showed people who were vulnerable to stressfull situations, depression, and anxiety during their lives, and also use maladaptive emotion regulation strategies, were more susceptible to periodontal disease.

Background and Aims: In 1978 WHO (World health organization) formulated a histopathological definition for diagnosis of OLP (oral lichen planus). Previous studies showed that diagnosis of OLP with these criteria are not reproducible. In 2003 Van der Meij et al. represented new clinical and histopathologic definition for diagnosis of OLP known as modified WHO criteria. The purpose of this study was to evaluate the interobserver and intraobserver variability in the histopathological assessment of OLP based on the modified WHO criteria.
Materials and Methods: Fifty five microscopic slides which OLP and OLL (Oral Lichenoid Lesion) were recognized in their clinical differential diagnosis were given to 6 pathologists in two phases with 3 months interval. Each reviewing pathologist was asked to apply the modified WHO definition of OLP and to categorize each case as either OLP, or compatible with OLP. Then, the interobserver and intraobserver variability were assessed by calculation of repeatability coefficient and Kappa statistics.
Results: The results of this study demonstrated that interobserver variability based on modified WHO criteria was 0.77 (strong), while the intraobserver variability varied from 0.58 (moderate) to 0.82 (strong).
Conclusion: In the present study, the interobserver and intraobserver variability in the histopathologic assessment of OLP based on modified WHO criteria was stronger than previous studies which assessed WHO criteria. However, in order to propose the replacement of WHO criteria with modified WHO criteria, further studies with more cases and comparing the two methods is required.

Background and Aims: The dentistry profession is one of the most injuring professions that causes most pains and hurts for dentists because of their lack of knowledge about the ergonomic position through the work. The purpose of this study was to assess the ergonomic position of dentists with RULA method in dentists of Bojnord.
Materials and Methods: In this cross-sectional study, all of the Bojnord’s county dentists were selected. RULA method and Nowerdik questionnaire were used for investigating the agronomical position, and muscular-skeleton position, respectively. The analysis was done by SPSS22 using regression and chi-square test. A P-value of less than 0.005 was assumed as significant.
Results: The most muscle-skeleton reports were 55.6% (35 persons) related to back, 54% (34 persons) related to shoulders, 50.8% (32 persons) related to waist, and 47.6% (30 persons) related to neck aches. In the last 12 months, 90.5% of dentists reported pains from at least one of organs of their bodies and 27% were supposed to leave their works which the sex (P=0.84), length (P=0.75), and weight (P=0.38) were not significantly related to this case.
Conclusion: According to the results of this study educational interventions is essential to prevent the musculoskeletal disorders in dentistry.

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: Increased tooth sensitivity is a common dental problem. One of the mechanisms of dentin hypersensitivity treatment is blocking dentinal tubules. The aim of this study was to compare the average closing dentinal tubules affected by carbonated Nano-hydroxyapatite and fluoride toothpaste using scanning electron microscope (SEM).
Materials and Methods: The enamel of gingival buccal crown surfaces of 42 sound maxillary premolars teeth were removed until the dentin surfaces were exposed. The dentine specimens of 3×3 mm were prepared. The specimens were washed by distilled water after etching and randomly divided into 6 groups. 3 groups were interfered with the carbonated nano-hydroxyapatite toothpaste and the other three groups interfered with Colgate toothpaste in 3, 7 and 14 days. The samples were examined by SEM to check the status of dentinal tubules. Then, they were evaluated by two researchers according to the Hulsmann index. Data were analyzed by using SPSS23 software and Kruskal-Wallis statistical test. The significance level of 0.05 was considered.
Results: The amount of dentinal tubules closure by the two toothpastes was significantly different. This difference was higher in the hydroxyapatite toothpaste than fluoride which were (P=0.024, 0.004 and 0.000), respectively. There were no significant differences among the groups in 3,7 and 14 days (P=0.230, 0.069, 0.537).
Conclusion: The toothpaste containing carbonated nano structural hydroxyapatite was more successful in closing dentinal tubules than Colgate toothpaste in short period of time.

Background and Aims: Cancer is the 3rd cause of death after heart disease and injuries in Iran. Radiotherapy and chemotherapy are the most effective procedures in cancer therapy, but their side effects are still unknown for many patients. The main goal of this study was to evaluate the patients’ knowledge with head and neck cancer regarding the complications of radiotherapy and chemotherapy.
Materials and Methods: This descriptive-analytical research was based on the information extracted from personal questionnaires and files of cancer patients who referred to the centers of Kerman University of Medical Sciences during a 6 months period in 2017. The data were analyzed by chi-square test at the significance level of 0.05.
Results: Our findings showed that most of the patients (76.48%) had low information level. There was no statistically significant association between the knowledge with demographic variables (P>0.05). However, patients with chronic disease had higher level of information. Only 10% of patients had received information by their physicians.
Conclusion: It seems there is not effective education regarding the rated radiotherapy and chemotherapy complications, because their knowledge was not in acceptable level. Considering the importance of this issue, it is necessary to perform educational program to improve patients' ability and skills to cope whit the chemotherapy and radiotherapy complications and their side effects.

Background and Aims:The erosive and ulcerative forms of Oral lichen planus causes pain and irritation, affects the nutrition and biological quality of the patient. Considering the high prevalence of the disease, the complications of conventional treatments and the resistance to classical drug therapy, the aim of this study was to compare the effect of infrared low level laser and triamcinolone acetonide mouth rinse on treatment of oral lichen planus lesions.
Materials and Methods:In this double blind clinical trial, 24 patients were selected randomly according to the inclusion and exclusion criteria and divided into two groups of 12. Before and after the study, pain and burning sensation index (VAS), apparent shape and score of the lesion and size of the lesion were recorded in the patients. We treated the first group with low level infrared laser (810 nm) twice a week with 0.5-2 j/cm² energy density and 300 mW/cm² power density up to a maximum of 10 sessions. For the second group, we prescribed a mouth rinse of triamcinolone acetonide 0.2% four times a day with antifungal drugs for a month. Then, the study`s criteria were recorded after the completion of treatment. All data were statistically analyzed using the repeated measure ANOVA test to compare the quantitative changes over time, The Mann-Whitney U test was used to compare the rank variables between two groups at any time and Friedman test for each group between different times.
Results: There was no significant difference between the groups in terms of severity of pain (P=0.255), score and size (P=0.186), and appearance (P=0.178) of the lesions among two groups. Although the two groups showed a significant decrease in all three indicators.
Conclusion:Considering that in both groups, all three indices were improved and these improvements were similar, it seems that laser therapy can be effective. It could be used as a therapeutic alternative in treating patients with OLP (Oral Lichen Planus) especially in cases with contraindication in corticosteroid administration or lack of appropriate therapeutic response or when there is resistance to treatment.

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: In recent years, the dentistry workflow has developed considerably. By the introduction of computers and their various applications, the effectiveness and efficiency of treatment has increased enormously. Considering engineering concepts in the workflow, it is necessary for participants to assess different steps and data transferring between various software and hardware devices. This research investigated the interaction between dentists, laboratories and production centers through the required steps for accomplishing treatment by different applications of software and digital hardware devices.
Materials and Methods: Review in this article was based on searching Google scholar database considering key words: digital dentistry, workflow, computer aided design and manufacturing, dental CAD/CAM. This search was limited to the English articles published after the year 2000.

Conclusion: It is necessary in dentistry to use digital technologies to improve the efficiency of treatments. Thus, the participants in this field must have appropriate knowledge to choose and apply these tools. Moreover, the participant should help providers of digital solutions for better development of software packages and related hardwares.a

Background and Aims: In endodontically treated teeth, the fiber posts are used to retain a core restoration. The purpose of this study was to evaluate the effect of different resin cements on the bond strength of fiber reinforced composite posts to root canal dentin, and comparing the bond strength in different sections of root.
Materials and Methods: In this in-vitro experimental study, 48 extracted single-canal central incisors were endodontically treated. For the push out test, the posts were divided into 3 groups according to one of the following three different cement materials (n=16) (Bifix SE, Bifix QM, Rebilda). Three slices with a thickness of 2-mm were prepared of each root. The push-out tests were performed at a cross-head speed of 1 mm/minute using a universal testing machine. Data were analyzed by two-way and one-way ANOVA test followed by Tukey post hoc test (α=0.05).
Results: There was no significant differences between the mean push out bond strength of three experimental groups (P=0.650), but there were significant differences between the mean push out bond strength of root dentin regions (P<0.001).
Conclusion: Under the conditions of this study, there was no significant difference between the mean push out bond strength of 3 different resin cement systems. The coronal region of root dentin showed significantly higher mean bond strength values than that of the middle and apical thirds.

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.

The Guided Bone Regeneration (GBR) treatment concept advocates that regeneration of osseous defects is predictably attainable via the application of occlusive membranes, which mechanically exclude non-osteogenic cell populations from the surrounding soft tissues, thereby allowing osteogenic cell populations originating from the parent bone to inhabit the osseous wound. The use of membrane to exclude non-osteogenic cells, is a key principle of guided bone regeneration. A large number of membranes have been evaluated in clinical and experimental studies. The object of this study was to review the literature regarding guided bone regeneration and all types of membranes that were used in this technique. 72 articles between the years 1968 through the 2016 from PubMed, Medline and Google Scholar using the related keywords, were selected. Finally, we concluded that the modification of mechanical and physico-chemical properties of membranes could improve the process of new bone growth. However, determination of the exact role of membrane porosity in this process, still needs to be clarified. Optimization the chemical composition of membrane with the focus and attention to obstructive property and bioactivity, is an important point in this research field. Various factors such as flexibility, mechanical strength and degradation rate determine the type of membrane used for bone tissue regeneration.

Background and Aims: Glass ionomer cements are among direct restorative materials which are used in an environment saturated with moisture. Therefore, having the ability to prevent water contamination is crucial. The aim of this study was to determine the water sorption and solubility of five glass ionomer restoratives with and without two nanofilled resin coating agents.
Materials and Methods: Five glass ionomer cements (Fuji BULK/GC, EQUIA Forte Fil/GC, Fuji II LC/GC, riva self cure/SDI, riva light cure/SDI) and two resin-based coating (G-COAT PLUS/GC and EQUIA Forte Coat/GC) were used in this study. Water sorption and solubility were measured in accordance with the ISO 4049's. For each material, 15 disc-shaped specimens were prepared using a polyethelyn mould. The specimens of each material were randomly divided into two groups: 10 coated and 5 uncoated. For the coated groups of each material, 5 specimens were coated with G-COAT PLUS, and 5 with EQUIA Forte Coat. Data were analyzed using SPSS software version 18 (SPSS Inc., Chicago, IL, USA). Two-way ANOVA was applied to investigate if there were any interactions between materials and coatings. One-way ANOVA was used to compare different variables between the materials, and post-hoc Tukey’s test was performed to show significant differences in subgroup comparisons.
Results: A significant interaction effect was obsevred between materials and coatings (P<0.05) using two-way ANOVA. The uncoated groups showed higher mean sorption and solubility values compared to the coated groups, and the groups coated by G-COAT PLUS showed less mean sorption and solubility values than that of EQUIA Forte Coat. In general, the lowest mean sorption and solubility values among glass ionomer cements belonged to Fuji BULK.
Conclusion: The water sorption and solubility values of glass ionomer cements could be reduced by the use of a protective coating.

Background and Aims: Despite the increasing application of intra-oral scanners, the effect of finish line position on gingival margins adaptation is still discussed. The purpose of this clinical study was to evaluate the fitness of cobalt-chromium copings obtained from intraoral scanning in two depth of finish lines.
Materials and Methods: Thirty teeth prepared for single premolar metal-ceramic crowns were included. Fifteen teeth had supragingival and fifteen had sub-gingival finish lines. Digital impressions were made using an intraoral scanner (Trios-3shape). Computer-aided design and computer-aided manufacture (CAD/CAM) cobalt-chromium copings were fabricated from the scan files. The copings were evaluated intraorally and after adjustments, the internal and marginal discrepancy were measured using silicone replicas and a stereomicroscopy. Internal and marginal discrepancies were analyzed using the Multivariate test (P<0.05).
Results: The mean internal and marginal gap were 52.1 and 56.27μ, for supragingival group and 49.72 and 62.98μ for subgingival group, respectively. The evaluation of finish line position showed no significant effect on obtained results (P>0.05).
Conclusion: CAD/CAM chrome-cobalt copings fabricated by digital impressions provided acceptable marginal and internal precision. However, the finish line position had no significant effect on the internal and marginal adaptation.

Background and Aims: Lichen planus is a chronic inflammatory mucocutaneous disease with unknown etiology. One of the most common manifestations of patients with oral lichen planus is gingival involvement in the form of generalized erythematous areas. The aim of this study was to review the articles evaluating the role of plaque control on the gingival manifestations of oral lichen planus.
Materials and Methods: Motor searches of Ovid Medline and EM base databases, PubMed, Google Scholar, and Science Direct were searched for article published between January 1990 and December 2017 using of relevant key words. After reviewing the abstracts of articles, 20 full articles were selected and among them, 7 relevant articles were reviewed in this study.
Conclusion: From the literature, it was concluded that effective plaque control is the main part of lesions treatment and improvement of symptoms and gingival manifestations of oral Lichen planus.

Background and Aims: One of the important fields of dentistry is surgery for dental implants. In this field, dentistry has developed considerably in recent years amongst other fields of medicine from the perspective of digital device and software application. Surgical guides help dental surgeon for more precise, confident, easier and shorter surgery. Process of producing these tools are full digital and to somehow complex due to the application of many technical devices, software and protocols. To achieve efficiency, all participants in the workflow must be aware of all steps and data requirements for production of guides. This paper investigates the production process of surgical guide comprehensively, and also, encompass all the steps in process with details.
Materials and Methods: This review article was based on searching Google scholar and PupMed databases considering key words: Surgical Guide, Guided surgery, digital dentistry, dental CAD/CAM, Additive manufacturing. More than 90% of the references were in English language and published after year 2010.
Conclusion: Today dentistry uses many digital solutions for dairy workflow and most of these solutions are developed by engineers in various fields of knowledge. Thus, this information is essential for dentists, surgeon, clinician and laboratory technician, etc. for better collaboration and participation. Amongst, advances in surgery of dental implant have been highly significant and patients benefit from better treatment and less inconvenience. In addition, dentists do surgery more precise and easier because of considering all conditions before of surgery. Thus, it is substantial inform of all steps of production process.