Journal of Dental Medicine

Background and Aims: This study aimed to collect reports and HIS in a web-based system due to the problems of paper recording of student activities in practical courses, as well as the lack of computers in the departments for observing graphs and treatment plans.
Materials and Methods: The initial graphic design of the website was done after the assessment of needs and the necessary planning for designing the website. The main template of the website was designed after consulting with the faculty and the designer company. A combination of HTML, CSS, JQuery, and Java script was used for static coding and what the user sees or interacts with. Then, the basic information entered the website and the content designer put the website in the designed layout. In the end, a sample hosting space was prepared and the website was fully provided to the professors and faculty officials to work with as an administrator and a user. They conveyed all their opinions and the corrections were made based on the feedback given.
Results: The use of the internet and software with a central database played a significant role in monitoring and evaluating the long-term information of the student and the evaluation of the entire department, universities, and patients in each region up to macro-national evaluations. This could give the expansion and advancement of science in addition to the central registration of documents and radiographs, as well as their ease to access.
Conclusion: The designed website was well received among the students and the attending staff. Introducing a web based logbook and HIS system can optimize the clinical teaching. These logbooks could help both students and staff saving time and resources, and to facilitate providing better personalized care for patients.

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.

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: 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: 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: School teachers have key role in providing the basic health information for their students, and their knowledge, attitude, and practice affect children's oral health through developing of the healthy behaviors. The goal of this study was to evaluate the effectiveness of an oral health education program for primary school teachers on their knowledge, attitude, and practice fields in the framework of oral health promoting schools.
Materials and Methods: This quasi-experimental pre-post study was conducted among five oral health promoting schools in Isfahan city in 2019. A validated and reliable questionnaire including four sections of demographic data, knowledge, attitude, and practice was applied for data collection. The questionnaire contained 24 knowledge, 9 attitudes, and 5 practice questions. It was distributed among 63 enrolled teachers at base line and two months later after two educational-emotional workshops. Before and after data were analyzed by SPSS21 (α=0.05) by related samples Wilcoxon signed rank test and background variables by Kruskall-wallis test.
Results: After the educational intervention, their knowledge score increased significantly from 14.1±3.8 to 18.5±3.7 (P<0.001). About 34% of teachers had a high level of knowledge proficiency at the beginning of the study which eventually rose to 76%. Teachers’ attitude decreased significantly from 34.6±5 to 31.4±4.6 (P<0.001). At the beginning of the study, 89% of them had a positive attitude towards oral health programs which decreased to 84% at the end of the study. In the performance part, 63.5% of the teachers paid attention to the fluoride in their toothpaste which reached 87.3% after the workshop and the teachers' performance score increased from 3.07 to 3.39 after the intervention (P<0.012).
Conclusion: The package of educational intervention for teachers in oral health-promoting schools improved the level of knowledge and practice, but slightly reduced the level of attitude. However, due to the importance of changing attitudes in teachers and the existence of structural and programmatic barriers to integrate the health issues into school education, other models need to be evaluated and compared.

Conclusion: Many elderly people avoid the treatment of oral diseases during coronavirus pandemic due to fear of coronavirus, high dental costs, lack of access to appropriate services, and this causes irreparable problems in their health. Therefore, it is recommended to provide practical solutions to facilitate the dental treatment of elderly patients.

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: 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.

Background and Aims: Restoration of non-carious cervical lesions (NCCLs) is challenging due to the difficulty of adhesion of dental tissues. The aim of this study was to investigate the effects of three methods of surface treatments using diamond bur, Er: YAG laser and sandblasting on the microtensile bond strength of resin composite to the noncarious dentin in cervical lesions.
Materials and Methods: In this in vitro study, 48 canine and premolar extracted human teeth with NCCLs at the buccal surface were selected and randomly divided into 4 groups of twelve each: control group without any treatment, Er: YAG laser group, diamond bur group and sandblasting group. For all groups, the bonding agent used was Clearfil SE Bond and then the cavities were filled with
the Filtek Z250 resin-composite. After this step, the teeth were cut and then subjected to the microtensile bond strength test. Data were analyzed by the Kruskal Wallis test.
Results: According to the obtained results, the microtensile bond strength, from the highest to the lowest values were in the sandblast group (24.57±10.24 MPa), the diamond bur group (19.19±10.8 MPa), laser group (18.59±9.05 MPa) and the control group (18.56±9.27 MPa), respectively. Although, no statistically significant difference was found between any of the groups (P=0.266).
Conclusion: It seems that in teeth with NCCLs, the sandblasting method had a much better effect on the bond strength, although no statistically difference between surface treatment methods was found.

Background and Aims: Different factors play a role in causing tooth decay. Modern dentistry is looking for a way to prevent tooth decay and suggests different ways to increase remineralization. The aim of this study was to evaluate the effect of nanohydroxyapatite toothpaste and mouthwash on remineralization of primary enamel lesions and obstruction of tubules.
Materials and Methods: In this study, 90 human extracted central teeth were used. Artificial decay was induced by placing the specimens for 72 hrs in a demineralization solution in an incubator at 37 °C. Hardness of the specimens was determined by a microhardness test before any surface treatment. The specimens were then divided randomly into 6 groups of 15. For 1-6 groups, the specimens were subjected to a pH cycling for 14 days, which included 3 hrs of demineralization and 21 hrs of remineralization. At the same time, 1-3 groups were in contact with diluted toothpaste in a ratio of 1:3 with deionized water at a rate of 5 ml twice a day for two min. Eac specimen of 4-6 groups was exposed to 5 ml of three types of mouthwashes for one min. Then, the specimens were cut in the buccolingual direction in order to simultaneously evaluate the dentinal tubules and Vickers microhardness test was performed again and the before and after microhardness values were compared. Then, the percentage of deposition on the surface and tubule obstruction were analyzed using SEM (Scanning electron microscope) (P=0.006). Data were analyzed using SPSS24 software bu the descriptive statistics, ANOVA analysis of variance, and multiple Tukey comparisons.
Results: The results of analysis of variance test showed that there was a statistically significant difference in the microhardness changes between study groups (P=0.006). Also, in-group analysis of microhardness changes, there was a significant difference (P<0.0001). Besides, only in the group containing 0.5% nanohydroxyapatite toothpaste, more than 50% tubule deposition and obstraction was observed (P<0.05).
Conclusion: According to the present study, nanohydroxyapatite can be one of the treatment strategies to repair incipient lesions of teeth and the addition of nanohydroxyapatite, preferably to toothpaste, increases the dental microhardness.

Background and Aims: Cathepsin-D is a well-known protease that promotes invasion in tumoral lesions. Considering the cystic neoplasm nature of odontogenic keratocyst (OKC), the aim of this study was to compare the expression of cathepsin-D in this lesion with the unicystic ameloblastoma (UA) and orthokeratinized odontogenic cyst (OOC) for better understanding of its behavior.
Materials and Methods: In this descriptive-analytical study, we used paraffin blocks available in the archives of oral and maxillofacial pathology department of dental school (8 unicystic ameloblastoma (UA), 8 odontogenic keratocyst (OKC) and 8 orthokeratinized odontogenic cysts (OOC)) which they were stained immunohistochemically with cathepsin-D. Then, the samples were observed simultaneously by two oral pathologists for detection the intensity and pattern of epithelial and stromal cells staining. Data were analyzed by SPSS20 and Kruskal-Wallis, Mann-Whitney and Chi-square test (P<0.05).
Results: The staining intensity of the epithelial cells of UA group was significantly more than OOC and OKC (P=0.02). The staining intensity of the stromal cells of UA was more than the other two groups, although this difference was not statistically significant (P=0.32). The pattern of cell staining in epithelium and stroma did not show any significant difference between the three groups in this study (P=0.15, 0.22).
Conclusion: The results of this study regarding the intensity expression of cathepsin-D in these three odontogenic lesions could be considered as a probable evidence for the new odontogenic lesions classification (WHO2017) in terms of reintroducing OKC as an odontogenic cyst. If this idea is rejected, it seems that cathepsin-D expression is not associated with the invasive behavior of this cyst, and further investigation of other markers in the epithelium and stroma simultaneously is suggested for a better understanding of its biological nature.

Background and Aims: Recently, the addition of nanoparticles into the restorative materials and tooth preparation by laser for improving the bond strength have been concidered by researchers. The aim of this study was to investigate the shear bond strength of the bioactive glass ionomer containing titanium particles and a conventional glass ionomer with two surface treatments by Er-YAG laser and conventional methods.
Materials and Methods: In this in-vitro study, 64 sound extracted premolars were collected. For conventional method, the specimens were prepared in such a way that dentin surfaces with a depth of 0.5 millimeter created at distance of 2 mm from the joint of CEJ at the root or crown.  In the laser group, after preparing the teeth, the surface area was prepared by Er-YAG laser. Then, in the middle part of the buccal surface, a cylindrical mold with dimensions of 3.5 mm in diameter and 4 mm in height was placed and for each group was filled with its own glass ionomers. The  specimens  were divided into 8 groups by simple random sampling (n=8): A (laser, conventional glass ionomer, coronal dentin)/ B (laser, glass ionomer containing titanium nanoparticle, coronal dentin)/C (conventional, conventional glass ionomer, coronal dentin)/ D (conventional, glass ionomer containing titanium nanoparticle, coronal dentin)/ E (laser, conventional glass ionomer, root dentin)/ F (laser, glass ionomer containing titanium nanoparticle, root dentin)/ G (conventional, conventional glass ionomer, root dentin)/ H (conventional, glass ionomer containing titanium nanoparticle, coronal dentin). Finally, the shear bong strength by a universal testing machine was measured at a cross-head speed of 1 mm/min. For data analysis, Two-way ANOVA test was used to evaluate the effect of each variable and their interaction on the shear bond strength and Tukey test was used to compare the two groups.
Results: There was significant difference only between groups B with C (P=0.002), E (P=0.007), G (P=0.001) and H (P=0.01). The highest bond strength was found for group B (laser, glass ionomer containing titanium nanoparticle, coronal dentin) and the lowest bond strength for group G (conventional, conventional glass ionomer, root dentin).
Conclusion: All three factors of Er-YAG laser, glass ionomer containing titanium nanoparticle and coronal dentin had a positive effect on the improvement of the bond strength.

Background and Aims: The objective of this study was to evaluate the knowledge, attitude, and practice of ergonomics during dental treatment among students of Urmia university of medical sciences in 2020.
Materials and Methods: In this descriptive-analytical study, self-administered questionnaires were given to 78 dental students of Urmia University in 2020 and the knowledge, attitude, and practice of every participant were evaluated. Demographic data including sex, age, and University grade were recorded as well. Data were analyzed by SPSS software24 with One Way ANOVA and t-test and the significance level of P<0.05.
Results: 78 students (44 males and 34 female) by Mean Age 23.9±2.12 were included in the study. The difference between the attitudes of different age groups was significant (P=0.006). The age group of 20 to 24 years had a more positive attitude than other age groups. However, the results of this study did not show a significant r elationship between the participants' knowledge and practice with their age (P>0.05).
Conclusion: According to this study, the knowledge, attitude and practice of Urmia dental students were in the desired range. 20-24 year students had significantly higher attitude in comparison to others. Therefore, more endeavors should be taken to improve these parameters in ergonomics.