Journal of Dental Medicine

Dental enamel is the end product of amelogenesis, which can be considered to take place in three interrelated phases. When this complex sequence of cytological and physicochemica! events disrupted by genetic or environmental factors, the function of the ameloblasts may be disrupted permanently or temporarily. The result shows qualitative and quantitative defects that may range from a complete absence of enamel or a slight discoloration. The aim of this study was to determine the prevalence of enamel defects by DDE index in a randomly selection group of 1637 students age 7-12 years old in Isfahan (0.2-0.3 PPMF"). Enamel defects were present on one or more teeth in 27% of the cases. The most common affected tooth was the central maxillary and then first molar of maxilla. The most common affected surfaces were buccal. Hypoplastic defects were found in first molar however premolar and canine were affected by diffuse white lines opacity.

Background and Aim: With the introduction of porcelain veneers to fulfill patients’ esthetic needs, question raises about the ability of the veneers to cover the substructure discoloration. It seems that using shade modifiers under the porcelain veneers can neutralize the discoloration. The goal of this study was to determine the efficacy of shade modifiers in correcting tooth discoloration, when used with resin cements under porcelain veneers.

Materials and Methods: In this experimental study, 60 porcelain discs with two thicknesses of 0.7 mm and 2 mm (30 porcelain of each thickness) were made from ceramco porcelain powder. 40 of them were in A2 shade and 20 were made by the mixture of A2 shade porcelain powder and porcelain stain to represent tooth discoloration. Then all the laminate discs (0.7 mm) were cemented over the 2 mm thick discs to make groups of 10 samples as followed: 1- The first group: laminate discs + resin cement + 2mm thick discs with A2 shade. 2- The second group: laminate discs + resin cement + 2mm thick discolored discs. 3- The third group: laminate discs+ resin cement+ shade modifier+ 2mm thick discolored discs. The color of 30 specimens was measured by spectrophotometer in 2 conditions. 1- To include the specular reflection (SCI). 2- To exclude specular reflection (SCE). In each condition the specimens were measured on both a white background (W) and a black one (B). The mean color differences (E) of each specimen in the second and third group with the specimens of the first group were calculated. Data were analyzed using Paired sample t-test and P<0.05 of significance.

Results: Color measurements showed that in SCIW condition L was significantly different among the three groups except the first and the third. In SCEW condition all the parameters showed significant differences. In SCIB condition, E was not significantly different between the second and the third groups. Hue (h) parameter wasn’t different between groups one and three neither was chroma (c) among the three groups. In SCEB condition, E was not statistically different between groups two and three.

Conclusion: Considering the statistical results, shade modifier couldn’t completely match the color of the specimens in the third group with the first one. But, the lower E for the third group comparing to the second one means that shade modifier was successful in reducing the effect of substructure discoloration.

Background and Aim: An important purpose of adhesive dentistry is restriction of cavity preparation to carious dentin removal and conservation of sound dentin. Application of caries disclosing agents and cavity disinfectants can help achieving this goal. The aim of this study was to evaluate the effect of caries disclosing agents and cavity disinfectants on microleakage of composite resin restorations.

Materials and Methods: This experimental in-vitro study was performed on class V cavities in 48 extracted human sound premolars. The teeth were randomly divided into four equal groups. In group 1 caries detector dye (Seek, Ultradent, USA) and in group 2 cavity disinfectant (Consepsis, Ultradent, USA) were applied on dentinal surfaces. In group 3 both mentioned materials were applied. Group 4 was considered as control group. PQ1 bonding agent and Amelogen composite were used to restore the cavities. Gingival microleakage was assessed by dye penetration. Data were analyzed by Kruskall Wallis and Dunn tests. P<0.05 was the level of significance.

Results: Group 2 showed the least and group 4 showed the highest microleakagehowever no statistical significant difference was found among the groups.

Conclusion: The use of caries disclosing agent (Seek) and cavity disinfectant (Consepsis Liquid) did not adversely affect the sealing ability of dentin bonding resins.

Background and Aim: An important criterion for success assessment of implant-supported prostheses is marginal fit. Vertical and horizontal discrepancy can result in loosening of the prosthetic screw, crestal bone resorption, peri-implantitis and loss of osseointegration. Despite careful attention to waxing, investing, and casting, marginal discrepancies are inevitable. The aim of this study was to evaluate the marginal gap and overhang in three casting methods with two different alloys in ITI implants.

Materials and Methods: In this experimental in vitro study 48 analog abutments were randomly divided into six groups as follows: 1) burn out cap + BegoStar, 2) impression cap + BegoStar, 3) conventional wax up + BegoStar, 4) burn out cap + Verabond2, 5) impression cap + Verabond2, 6) conventional wax up + Verabond2. Waxing was done in 0.7 mm thickness verified by a digital gauge and a putty index was made for all groups. Reamer was used for correction of the finish line after casting in all groups. Castings were seated on analog abutments and embedded in acrylic resin. Specimens were sectioned by isomet instrument and polished and cleaned by ultrasonic cleaner for 10 min. The marginal gap and overextended margins of castings were examined under a  Scanning Electron Microscope (SEM) (X200). The mean gap and margin overextension were calculated for each group. Data were analyzed by multivariate analysis and Bonferroni post-hoc test with p<0.05 as the level of significance.

Results: No significant difference in gap size was observed among the three casting methods with two alloys (P=0.056). The marginal gap was not different in the studied casting methods (P=0.092). Gold alloy crowns showed lower marginal gaps compared to base metal alloy crowns (P<0.001). No significant difference in overhang size was observed among casting methods with two alloys (P=0.093). Base metal alloy crowns showed less overhang compared to gold alloy crowns (P<0.001). There was a significant correlation between overhang and use of impression cap in base metal alloys (P<0.001).

Conclusion: Based on the results of this study, vertical discrepancy of frameworks made with gold alloy were less than those made with base metal alloy. Base metal alloy demonstrated less overhang. Conventional wax up or using burn out caps produced less horizontal discrepancy.

Background and Aim: Black staining after taking iron drops on the primary teeth is always concern of parents. There is not an exact explanation for the mechanism of iron black staining. The purpose of this study was to compare tooth discolorations, atomic absorption and structural changes of primary teeth enamel caused by two kinds of iron drops[ Kharazmi(Iran) and Fer-in-sol(USA)].

Materials and Methods: In this ex-vivo study, 93 sound primary teeth in normal color range were divided into five groups. Two groups of samples were immersed into the Artificial Caries Challenge(ACC) for two weeks before getting exposured to iron drops: Group 1 Control(NS): sound enamel teeth which were kept in Normal Saline environment(NS)(13teeth). Group 2 (NS-KH): NS, kharazmi iron drop (20 teeth). Group 3 (ACC-KH): ACC, Kharazmi iron drop (20teeth). Group 4 (NS-F-in-S): NS, Fer-in-Sol iron drop (20teeth). Group 5 (ACC-F-in-S): ACC, Fer-in-Sol iron drop. Visual tooth discolorations were determined by a specialist in operative dentistry who was not aware of experimental groups. The iron concentration was measured by ICP system (Vista-pro, Australia) and the structural changes were studied by SEM (Philips, Netherland). The data of discoloration were studied with Kruskal-Wallis test and multiple comparison using Bonferroni type test, and with the data of atomic absorption were studied with oneway ANOVA test and Tukey HSD test.

Results: The discoloration in the teeth immersed into the ACC (ACC-KH, ACC-F-in-S) was more severe than the sound enamel surface (NS-KH, NS-F-IN-S) (p<0.001) and Kharazmi iron drop caused more discoloration in the teeth immersed into the ACC (p=0.018). The teeth immersed into the ACC, absorbed more iron than the sound enamel surface (p<0.001) and also the teeth immersed into the ACC absorbed more Kharazmi iron drop (p<0.001). In the Scanning Electron Microscopy study, at low magnification in the sound teeth the perikymata was arranged regular. At low magnification in the teeth immersed into the ACC, many fractures were observed. The fractures in group 3(ACC-KH) were more and deeper.

Conclusion: Being immersed into the ACC, caused more iron absorption, severe discoloration and structural changes in the enamel of primary teeth. Such changes were more distinct in the teeth exposed to Kharazmi iron drop than the teeth exposed to Fer-in-Sol iron drop.

Background and Aims: Disc displacement is the most common temporomandibular joint disorder and magnetic resonance imaging (MRI) is the gold standard in its diagnosis. This disorder can lead to changes in signal intensity of magnetic resonance (MR). The purpose of this study was evaluation of correlation between relative signal intensity of MR images of retrodiscal tissue, superior and inferior head of lateral ptrygoid muscle with type of anterior disk displacement and condylar head flattening in patients with temporomandibular disorder (TMD).

Materials and Methods: In this retrospective study, 31 MR images of patients who had anterior disc displacement were evaluated. After relative signal intensity measurement for retrodiscal tissue, superior and inferior head of lateral ptrygoid muscle, the correlation between relative signal intensity and type of anterior disc displacement was evaluated with repeated measure ANOVA test. In each of these 3 areas, t-test was used to compare the groups with and without condylar head flattening.

Results: The correlation between relative signal intensity of MR images and type of anterior disc displacement in retrodiscal tissue, superior and inferior head of lateral ptrygoid muscle was not significant. There was also no statistically significant correlation between relative signal intensity of MR images and flattening of condylar head in retrodiscal tissue, superior and inferior head of lateral ptrygoid muscle (P>0.05).

Conclusion: According to findings of this study, relative signal intensity of MR images in retrodiscal tissue, superior and inferior head of ptrygoid muscle is not a good predictor for type of anterior disc displacement and flattening of condylar head. It seems that this cannot be used as a diagnostic marker for TMD progression.

Background and Aims: Because of high prevalence of TMJ dysfunctions , increased promotion of diagnostic and treatment methods is necessary. In many cases, in addition to disc position, morphology of other joint components such as articular eminence can be changed and therefore the probable correlation between disc position and morphology of hard tissue components can be used for prediction of internal derangements. The aim of this study was to evaluate the correlation between the position of disc and morphology of articular eminence of TMD`s patients using magnetic resonance imaging (MRI).

 Materials and Methods: In this cross sectional study by evaluation of digital MRI files, ultimately 78 joint images were identified which had sufficient quality and resolution for review. Then the MRI images, were observed and evaluated by 3 oral and maxillofacial radiologists to determine the disc position (normal, anterior displacement with and without reduction, and posterior displacement) and morphology of articular eminence (Box, Sigmoid, Flattened). Ultimately the results that were reported at least by 2 observers were included as the final results and were recorded in the check list. Data were analyzed using Chi-Square test and Fisher test.

 Results: In this study, no case of posterior disc displacement was found and therefore was excluded from the study. Articular eminence morphology (Flattened versus Sigmoid) showed statistically significant correlation with anterior disc displacement with and without reduction (P-values for anterior displacement with and without reduction were 0.03 and 0.002, respectively). No significant difference was found between the sigmoid and box types in relationship with disc displacement (P-values for anterior displacement with and without reduction were 0.72 and 0.70. In this study, no significant difference between the anterior disc displacement with reduction and anterior disc displacement without reduction in relationship with the morphological changes of articular eminence in any of the cases were found.

 Conclusion: The results showed that flattening of articular eminence had significant relationship with anterior disc displacement.

Background and Aims: Marginal accuracy is a crucial factor influencing the clinical long-term reliability of implant-supported fixed dental prostheses (FDPs). The aim of this in vitro study was to evaluate the marginal fit of three-unit zirconia bridge frameworks fabricated using two different computer-aided design (CAD)/
computer-aided manufacturing (CAM) systems (AmannGirrbach and Zirkonzahn).

Materials and Methods: The master model of 3-unit FDP was made of two implant abutments (AmannGirrbach and Zirkonzahn) from canine to second premolar. Twelve frameworks were manufactured using each fabricating system from semi-sintered zirconia blanks, which had to be sintered for final density after milling. After manufacturing, the absolute marginal discrepancy in each abutment were determined by means of Video Measurement System (VMS). The data were analyzed, using independent and paired t test (P=0.05).

Results: For the premolar abutment, the absolute marginal discrepancy of frameworks fabricated by AmannGirrbach system was significantly greater than those of the other system (P=0.005). There was no significant difference between the marginal discrepancy of canine and premolar abutments (P>0.05).

Conclusion: Within the limitations of this study, it could be concluded that the marginal fit of zirconia FDPs was significantly dependent on the CAD/CAM system used, but the abutment size was not an effective factor.