Journal of Dental Medicine

---

Regard this, that majority of Diabetic patients that soffer from periodontal disease. Now, most of espesialist belive that these patients need to control their diabets with new methods for decreasing and controlling thier periodontal disease.Today, most of physician, majority of periodontal for controlling of HbAlc Test.This test does not need to patient's cooperation and can do in any time.This test estimate,s the irreversible bound of hemogloboiin with glucose and from this point that half- life of red blood cell is 90-120 days the resuolt of this test is useable for every 5 months.

---

This study is for appointment the dose of systemic 4 groups of patients selected for this study.First group had sealling, root planing and planing and periodontal surgery and no drugs. Second group had sealling, root planing and periodontal surgery with 1 gr per day of tetracycline for two weeks and third group for 3 weeks and fourth group for 4 weeks.The fourth group was.the best clinical improvement. The indexes were PPD, CAL, PI, GI.

---

Periodontitis affected root surfaces are hypermineralized and contaminated with cytotoxic and other biologically active substances.The instrumented surface will inervitably be coverd by a smear layer following root planing with or without flap.Smear layer is resistant to saline rinsing, but may be removed with agents such as acids (e.g.citric acid), tetracyclines, EDTA, and laser.Low pH aqueous solutions such as citric acid have been used in surgical periodontal therapy mainly for two reasons, It dissolves smear layer after a relatively short exposure time and it has been claimed to selectively remove root surface associated mineral exposing collagen to varying degrees. A root surface coated with collagen appears to be a preferred surface for fibroblast attachment, a cellular event fundamental to successful periodontal wound healing.Several studies indicate the potential of tetracycline (TTE-HCL) in periodontal regeneration. Its acidic pH suggest that it can be used as a demineralization agent and removing the smear layer and exposing collagen matrix of the dentin.Chalating agent (EDTA) working at neutral pH appears preferable with respect to preserving the integrity of exposed collagen fibers, early colonization, and wound healing. In addition, etching at neutral pH has been reported preserve adjacent tissue- vitality, while etching at low pH necrotizes the fiap and adjacent periodontium.Clinical and subclinical studies have demonstrated laser waves can remove calculus and bacterial plaque and pocket epithelium and strile the root surface and can expose the dentin collagen and dentinal tublules, and leads to pronounce reducing of probing depth around teeth diseased with periodontitis.

---

Up to now, no complete study was carried out about the prevalence and location of periapical granuloma and radicular cysts from the point of view of clinical symptoms (e.g. pain and swelling fistula) in Iran. The data was collected from the files available in the Department of Pathology, faculty of Dentistry, Tehran University of Medical Sciences. With a consideration on different therapeutic methods. a proper method was selected. Radicular cyst occurred in 59.3 percent of 324 cases while 45.7 percent were granuloma. The most common incidence of these lesions was in the range of 24-25 years old. The most common location of lesions was the maxillary anterior. Sinus tracts occurred in 74 of all cases. 47.3 percent of these patients have been previously received root canal therapy. It is noticeable that 24 percent of all patients were treated endodontically before surgery. Higher incidence of granuloma occurred in small lesions while cysts were more common in large lesions. 232 of all cases showed one of the clinical symptoms, 16% pain, 35.8% swelling and 22.8% fistula. No symptoms were found in 92 cases.

---

In recent years the use of titanium implant have received special attention in dentistry. In 1994 an implant clinic has established in Faculty of Dentistry, Tehran University of Medical Science and since then, 289 implants have been placed for 120 patients. In literatures a success rate of 93% and 84% of implants placed in mandible and maxilla respectively, have been reported. The purpose of this study was to evaluate implant success rate at implant clinic of Faculty of Dentistry, Tehran University of Medical Science. This study was based on reviewing the patients' charts. Results showed that success rates for Branmark, ITI, and IMZ implant systems were 94%, 95%, and 97% respectively. The higher success rate achieved in this clinic might be due to shorter period of time which implants were placed. Researches showed that care in patient selection, treatment planning, and following exact surgical and prosthetic principles will lead to a higher success and lower failure rates.

---

In this investigation, the position of hyoid bone was compared in three skeletal groups of class I, II and III. The study was based on evaluating 77 lateral cephalometric radiographs, 40 girls and 37 boys, which were divided into 3 groups. Group 1, 2, and 3 consist of 26, 25, and 26 radiographs. 19 cephalometric landmarks and 10 planes were used in order to tracing the radiographs. In all patients, 9 skeletal and 4 cervical vertebrae parameters were measured to determine the hyoid bone. These parameters were compared between three skeletal groups regardless of sex and then, in another statistical analysis, parameters were compared based on patients sex. Statistical analysis showed that in class III patients, the hyoid bone was positioned more anteriorly than two other groups. Also in this group, the hyoid bone had less inclination and it was more horizontal in relation to mandibular plane. In skeletal class II patients this bone was positioned more superiorly than two other groups. Due to these findings it can be concluded that perimandibular muscles and bones could affect the growth of mandible. In addition, comparison of the parameters between two sexes revealed that the hyoid bone was positioned more anteriorly and inferiorly in boys. Also it was shown that in the girls, the position of hyoid bone was closer to the position of this bone in skeletal class I patients.

---

One of the special kinds of periodontal disease is rapidly progressive periodontitis (RPP). This form of periodontitis is an aggressive disease, which results in bone destruction and loss of periodontal attachment 4 to 5 times more than adult periodontitis or slowly progressive periodontitis. The purpose of this study was to investigate the presence of Actinobacilius actinomyct-em comitans (Aa) in RPP patients. A total number of sixty samples was collected from 15 patients with RPP and cultured inanaerobic conditions. Results showed the presence of Aa in 13 patients (86.7%), while 29 samples were Aa positive (48.3%). Two of the RPP patients (13.3%) were Aa negative even after two times bacterial culturing.

---

Dry socket is one of the most common complications of teeth extractions. Etiology and pathogenesis of dry socket are not clearly known but many related predisposing factors have been discussed. According to this, a cross- sectional study was conduced at the department of oral and maxillofacial surgery (Tehran University of Medical Sciences, Oct. 97- Jul. 98). 4880 teeth were extracted which 25 of them recalled with dry socket. The relationship between the effective factors and dry sockets was evaluated. The effective factors were as follows: age, sex, site of extraction, and trauma during exctraction, infection, oral hygiene, smoking, and systemic diseases. Results showed that the incidence of dry socket was %0.5, and the number of cases observed in women was two times more than men. Also, mandibular third molars were involved more than any other areas.

---

Different methods can be used to treat the malignant disease surgery, radiotherapy, chemotherapy, and even cryotherapy are different approach to reach the best treatment for patients. The aim of this cross sectional study was to evaluate the prevalence of oral side effects followed by chemotherapy of cancerous patients in Imam Khomeini hospital. This study was conducted on 80 patients who were under chemotherapy more than once and their oral lesions were evaluated considering their physical conditions. Mucositis was the common problem (66.2%) and the most involvement area was observed in tongue (55%). High percentage of this lesion in adult and senile might be due to deficiency in their immune system.

---

Actinomyces species are normal residents of the mouth cavity, gastrointestinal tract and female genital tract. The genus consists of gram-positive bacteria, strictly anaerobic or microaerophilic. The bacteria are opportunists with a low virulence potential that cause actinomycosis only when the normal mucosal barriers are disrupted. The main purpose of this study was the isolation of Actinomyces strains and determining of their role in periodontal diseases. The present study was carried out on 100 patients with periodontal diseases referred to the Periodontic Department of Faculty of Dentistry. The sampling was done in 6 months with isolation of oral Actinomyces from microbial plaque and periodontal pocket. The samples were selected based on the following criteria: periodontal plaque with deep pocket (>3 mm), no antibiotic therapy for a period of at least two weeks, and lack of systemic diseases. One strain of Actinomyces viscosus and two strains of Actinomyces naeslundii were isolated from the patients with gingivitis and periodontitis. Of the 100 patients with gingivitis and periodontitis, aged between 18-57 years old, 46% were males and 54% were females. The peak incidence of the diseases (35%) was in the third age group (31-40) and the lowest incidence (10%) was in the first age group (<20). Forty patients (40%) complained of gingival disease and its bleeding with lower incidence of (42.5%) in female.

---

Conventional cephalometric analysis, based on intracranial reference line SN and Frankfurt plan, sometimes leads to incorrect diagnostic findings and unpleasant theraputic results, especially in orthosurgery patients, mainly due to the instability of the mentioned references. Natural head position (NHP) is the standardized orientation of the head that its record in lateral cephalometric radiographs, provides us with extracranial references. The aim of this study is to evaluate the necessity for providing a lateral cephalogram in NHP for diagnosis and treatment of severe malocclusion (orthosurgery) in comparison with mild to moderate malocclusions. For this reason, 28 orthodontic and 26 orthosurgery patient's cephalograms, in natural head position, were selected. Diagnosis and treatment planning were based on clinical evaluation and cephalometric analyses especially Harvold and Tweed ones. Each group, based on their growth pattern, was divided vertically and horizontally. The angles between SN and TH planes with TH (True vertical Sine) were measured. Then, the correlation between the angles in two groups and also in relation to the severity of malocclusion, were analyzed in vertical and horizontal directions. The results of two groups were compared by the independent t-test. The findings of this study showed that:1- The SN line was found to be more inclined than FH line and in orthodonthic patients, FH plan is a more reliable reference than SN.2- In orthosurgery patients, the SN-TH and FH-TH angles were strongly different statistically.3- Variation in SN-TH angle, in patients with vertical growth pattern, was high in both groups of patients.These conclusions prove the necessity of a lateral cephalogram in NHP for all orthosurgery patients and those orthodontic patients with vertical growth pattern.

---

This review was focused on investigations in the relationship between human leukocyte antigens and periodontal disease. Several studies have looked for relationship between HLA phenotypes and early onset periodontitis (EOP). There have also been reports on both positive and negative relationship between specific HLA antigens and periodontal disease. Positive relationship has been reported among HLA-A1, A9, A24, A28, A33, B15, B22, B35, B44, C4, DR2, DR4, DR7, DR53, DRB1, DQ3 and DQB1 antigens and different forms of EOP. Several studies have reported negative relationship with HLA-A2, A5, A10, A28, A68, B5, DR2 and DR6. Two antigens that appear to be more related to EOP are HLA-A9 and DR4. Evidence suggests that genes in this area are not genes with major effect for early-onset periodontal diseases. It is possible that genes in the MHC region of chromosome 6 may function as modifying genes that affect clinical expression of periodontal disease. However, additional documents are needed to evaluate the relationship of HLA antigens with periodontal disease. These documents should have adequate controls, which account for racial differences in HLA type and well-defined patient groups whose state of disease is described

---

Diagnosis and treatment of patients with periodontitis as a manifestation of systemic diseases is of especial concern to the periodontist, especially those associated with genetic disorders, which have poor prognosis. With aggressive progression of periodontal bone and attachment loss, a patient could be a partial or total edentulous early in life.The aim of this article was to report a case of Papillon-Lefevre syndrome (PLS) with generalizedprepubertal periodontitis (GPPP). A ten-year old boy for whom active periodontal treatment and subsequent maintenance recalls was performed for five years since the diagnosis of PLS. Treatment procedures included: precise mechanical instrumentation at several visits, periodontal surgery, adjunctive serial systemic antibiotic therapy, professional irrigation of pockets with 0/2% chlorhexidine solution and periodic maintenance recall visits. In spite of all of these, progressive course of the disease continued until the patient was fifteen and edentulous. Unfortunately association of GPPP with systemic unmanageable condition or diseases has caused refractory periodontitis, which yet has no proven and reliable treatment protocol. Besides, this article has discussed more successful treatment modalities for PLS with GPPP and the genetic aspects of host susceptibility, which is a complicated and challenging field.

---

In the past two decades, replacement of the missing teeth with implant borne prosthesis has become a treatment modality, accepted by the scientific community for fully and partially edentulous patients. The aim of the present study is to evaluate retrospectively, 502 ITI dental implants application, in partial and complete edentulous patients, treated in two private centers, based on clinical and radiographic parameters.One hundred and forty patients, with 502 ITI dental implants, who were treated from 1994 to 2000 in two private centers, were investigated. For such patientsT a minimum of one year and a maximum of six years were passed since prosthesis placement over implants, so they were cooperative subjects. There was a significant relation between implant type and bone loss, so was between the presence and absence of BOP and the rate of bone loss. From totality 502 implants, 6 implants (28%) and 4 implants (1.4%) were lost, in maxilla and mandible, respectively. The total success rate was 98%. This rate, in maxilla with 212 implants was 97.2% and in mandible with 90 implants was 98.6%. The mean value of bone loss (RBL) and periodontal pocket depth (PPD) during 6 years, for the remaning 492 implants were 0.93±0.39mm and 1.99mm, respectively. The results showed that ITI dental implants, with a success rate of more than 97%, can be used as a desirable treatment choice in partial and complete edentulous patients.

---

Statement of Problem: The Prevalence of HBsAg, among patients with Down Syndrome (DS) has been reported higher than normal population. Living in institutes, comparing to home, leads to higher probability of HBsAg prevalence.

Aim: The purpose of the present study was to determine HBsAg prevalence in patients with DS and compare it with other mentally retarded patients with similar conditions, and also with healthy population in Iran.
Materials and Methods: One hundred patients, with average age of 12 years, living in five institutes inTehran, were chosen. Children with DS and other mentally retarded children were considered as the first and second groups, respectively (50 members in each group). Blood samples were taken and tested (ELLSA) to determine HBsAg and HBsAb titre. For statistical analysis, Chi- Square test was used.

Results: HBsAg was positive in 8% and 4% of DS and MR groups, respectively. HBsAb was seen in 25% of DS, comparing to 32% of MR. The prevalence of HBsAg in retarded patients living in institutes was higher than normal population of Iran (less than 3%), which was not statistically significant.
Conclusion: Consideration of sterilization principles and infection control upon dental operations, in these centers, are necessary. It is also suggested that these children, as a high- risk population, should be vaccinated against hepatitis B.

---

Statement of Problem: Rapid increases in the population of hemodialyzed patients induce the dentists to acquire a complete understanding of the special therapeutic considerations for such patients.

Purpose: The goal of this research was to study the amount of DMF in hemodialyzed patients, age ranging from 12-20 years, in the city of Tehran.
Materials and Methods: In this cross- sectional and analytic- descriptive research, 50 kidney patients (27 mail and 23 females), with the age range of 12-20 years were selected. They had referred to one of the following hospitals for hemodialysis: Imam Khomeini, Children Medical Center Fayyazbakhsh, Haft-e-Tir, Ashrafi Esfahani, Labafinejad and Hasheminejad. The data, based on clinical examination, patient's answers, patient's medical files, parents replies, were collected and analyzed by Chi- Square test.

Results: The average DMF, for. patients under study was 2.46, comparing to the normal subjects of the society, no significant difference was observed. Factors such as sex, Mother's education, oral hygiene and the number of daily brushing did not show any statistically significant difference about this index. The results also showed a 38% prevalence of severe gingivitis and 32% of moderate gingivitis.

Conclusion: This restricted study emphasizes the necessity to use proper preventive methods and to improve the patient's and parents' knowledge about oral and dental health.

---

Distraction osteogenesis (DO), firstly introduced to the medical world by Russian scientist Ilizarov for long bone lenghtening in orthopedics can be considered as an appropriate substitute in the treatment of maxillofacial deformities. Natural events occuring during the repair of a fractured bone segment not only lead to the desired bone length but also prevent from the undesired disadvantages of osteotomies and bone grafting. Recently a lot of investigations have been conducted to evaluate the efficacy of DO in the treatment of maxillofacial deformities, which in some cases have lead to successful results. In the present article a lot of issues in maxillofacial surgery and different treatment goals associated with DO are discussed.

---

Statement of Problelem: Lichen plannus is a relatively common mucotanous disorder, due to accompanying burning sensation and pain in addition to its malignant transformation, has potential importance. On the other hand, B and C hepatitis are of the five most common death causes, resulting in significant disease spread problems among dentists. As a result, the relationship between these two disorders has been recently investigated.
Purpose: The aim of the present study was to investigate the oral Lichen plannus prevalence among patients with B and C hepatitis.
Material and Methods: In this case series study, 500 patients with B, C hepatitis, 3 04 female and 369 male with the mean age of 39.09±13.13 (the youngest was 4 and the oldest was 72 years old), who referred to the hepatitis center of Shariati hospital, Transfusion organization and Hemophilia center, from August 2001 to August 2002, were evaluated. The information about all white lesions that couldn't be scraped was recorded on a questionnaire for each patient. To analyze the data, t and Fisher tests were used.
Results: Two hundred and eighty nine patients were MBS Ag" 223 were HCVAb", 12 were positive for both types of hepatitis and 23 were cyrotic. From among these patients, 3 subjects were with oral Lichen plannus (0.6%), one belonged to HBS Ag1 group (0.35%), (P=0.38) and two patients belonged to HCV Ab' (0.9%),(P=0.44). These results showed no statistically significant relationship between Lichen plannus and B, C hepatitis. Two cyrotic patients from among 23 were with LP, which statistically was significant (P<0.05).
Conclusion: All patients with LP should be tested for B, C hepatitis and liver enzymes.

---

Statement of Problem: Dental practices such as oral, periodontal and endodontic surgeries cause damages to the intraoral tissues, so having knowledge of the dental procedures that necessiciate endocarditis prophylaxis is of high importance.
Purpose: The aim of the present study was to determine the knowledge level of dental senior students in Tehran dental faculties about endocarditis
Materials and Methods: In this cross- sectional descriptive- analytic study, 253 senior students of four dentistry faculties in Tehran took part as follows: Tehran University: 71 students (M:42, F:29), Shahid Beheshti University: 74 students (M:40, F:34), Shahed University: 35 students (M:35, F:38), Azad University:73 students (M:35, F:38). The questionnaire used in this research consisted of three parts as follows: part one:
information on cardiac diseases, part two: dental procedures requiring endocarditis prophylaxis, part three:antibiotic diet in endocarditis prophylaxis. Sex and place of education of the students were also studied in detail. For statistical analysis, Chi-square test was used.
Results: On the basis of the sex, the correct answers of the female respondents of different universities wereranked as: Azad University: 72.5%, Tehran University: 71.1%, Shahid Beheshti: 57%, ShahedUniversity:55.7%. In the same way, the male respondents were reported as: Tehran Universitys: 71.6%, Azad University:66.2%, Shahed University: 57.3%, Shahid Behesti University: 52.1%, On the basis of the place of education,the following results were reported: Tehran University students managed to answer 71.3% , Azad University,Shahed University and Shahid Beheshti University students could answer 69.5%, 56.5% and 54.6%,respectively. All these differences were statistically significant, indicating that first ranked students have more information than the students of other schools.
Conclusion: It is recommended to develop more practical training programme in dental schools on cardiac
diseases, dental procedures requiring endocarditis prophylaxis and antibiotic diets.

---

Statement of Problem:The surface topography of denture base material is an important factor for the adhesion of Candida albicans and other microorganisms.

Purpose: The aim of this study was to evaluate the adherence of Candida albicans to four types of denture base materials (Acropars acrylic resin, Meliodent acrylic resin, rough and smooth surfaces of Molloplast B).
Materials and Methods: Seven blocks of two types of acrylic resins and ten blocks of silicone with one rough and one smooth surface were made and incubated in a suspension of Candida albicans. After washing,the blocks were stained with acridine orange and examined under fluorescent microscope. For statistical analysis ANOVA and Duncan tests were used.

Results: It was observed that Candida adhesion to rough surfaces of acrylic resins and silicone was significantly more than polished surfaces of acrylic resins and smooth silicone (PO.0001). However, no
statistical significant difference was found between polished acrylic resins surfaces and smooth silicone.
Conclusion: Significant differences in the adherence of Candida to the surfaces of different denture base
materials are due to differences in surface topography, chemical, physical and hydrophobic properties so it is
recommended to minimize the roughness and irregularities of denture base.