Journal of Dental Medicine

Growth factors are biological mediators that have a key roll in proliferation, chemotaxy and differentiation by acting on specific receptors on the surface of cells and regulating events in wound healing.They can be considered hormones that are not released in to the blood stream but have one a local action. Some of these factors can regulate premature change in GO to Gl phase in cell devesion cycle and even may stimulate synthesis of DNA in suitable cells, Growth substances, primarily secreted by fibroblasts, endothelia! cells, macrophages and platelet, include platelet derived growth factor (PDGF), insulin like growth factor (IGF) transforming growth factor (TGF)a and (3 and bone morphogenetic proteins BMPs that approximately are the most important of them. (BMP)s could be used to control events during periodontal, craniofacial and implant wound healing through favoring bone formation According toLynch, combination of PGDF and IGF1 would be effective in promoting growth of all the components of the periodontium.The aim of this study was to characterize growth factor and review the literature to determine the mechanism of their function, classification and application in implant and periodontal treatment.

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.

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.

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

Statement of Problem: One of the problems associated with the treatment of periodontal diseases is caused through the extension of disease toward furcation area. Several techniques in Conservative, Resective and Regenerative categories have been suggested for the treatment of furcation involvement.
Purpose: The aim of this study was to compare the results of the treatment of grade II furcation involvement in mandibular molars using an allograft material named 'Dynagraft' (a type of demineralized bone matrix) and the coronally positioned flap.

Materials and Methods: In this randomized controlled clinical trial study, twelve patients (9 females and 3 males), aged 25 to 40, suffering from bilaterally grade II furcation involvement of mandibular molars who referred to dental faculty Tehran University of medical Sciences, were investigated. The molars of one side were treated by Dynagraft whereas those of the opposite side underwent the CPF method. Measurements of the probing pocket depth (PPD), clinical attachment level (CAL), keratinized gingiva (KG) and horizontal probing depth (HPD) were recorded at baseline, 3 and 6 months after surgery. In order to investigate the bone radiographic changes, radiovisiography at the mentioned periods in addition to clinical investigation, were performed. For statistical analysis, Paired West was used.
Results: The mean PPD reduction three months and six months after the operation were 1.75 mm and 2.25mm, respectively in the Dynagraft (test) group whereas 1.26mm and 1.27mm in the CPF (control) group (P<0.005). The mean attachment gain three months and six months after the operation were 1.1 mm and 1.5mm respectively in the test group, and 0.2mm and 0.3mm in the control group (P<0.005). The mean KG reduction three months and six months after the operation were 0.5mm and 0.6mm respectively in the test group and those of the control group were 1.1mm and 1.1mm. The mean HPD reduction three months and six months after the operation were 1.55mm and 2mm respectively in the test group (P<0.005) and 0.55mm and 0.55mm in the control group (PO.01). Radiovisiography of the mentioned areas three months and six months after the operation confirmed the changes obtained from clinical measurements, showing appreciable reconstructive results (Bone filling) in the test group as compared with the control group. Moreover, root resorption was not observed.
Conclusion: Based on the results of this study, Dynagraft can be used as an appropriate material in the treatment of grade II furcation involvement in mandibular molars. However, for a through evaluation of such regenerative techniques in furcation involvement, further studies with larger population and long term follow up in addition to histologic studies are suggested.

Statement of Problem: Systemic analgesics are frequently prescribed for pain reduction following periodontal surgery. This type of treatment, however, brings about some disadvantages due to its late effect and inherent side effects. Benzydamine hydrochloride mouth wash is a non steroidal anti-inflammatory drug with local anaesthetic properties. Side effects of benzydamine are minor such as tissue numbness, burning and stinging. It brings relief to pain and inflammation rapidly.

Purpose: The goal of this study was to compare benzydamine HCL 0.15% and Acetaminophen codeine as analgesics following periodontal surgery.

Materials and Methods: This clinical study was performed on 18 patients referred to periodontics Department, Faculty of Dentistry, Tehran University of Medical Sciences. All patients were affected with chronic mild or moderate periodontitis and required surgery at least at two oral sites with similar lesions. Each patient received benzdamine HCL after first surgery and Acetaminophen codein following second operation. Pain reduction was evaluated by Visual Analog Scale (VAS). Data were analyzed with Wilcoxon-Signed and Mann-Whitney non-parametric tests. Results: Analgesic effect of Acetaminophene codeine was significantly more than that of benzydamine HCL following Reriodontal surgery (P=0.008). No significant difference was found between analgesic effects of Acetaminophene codeine and benzydamine HCL in patients with chronic mild periodontitis (P=0.9), and in cases that osteoplasty (P=0-31) or no osseous surgery (P=0.18) were performed.

Conclusion: In cases with mild post-operative pain following periodontal surgery, Benzydamine HCL and be prescribed as an analgesic. However, in other cases this mouth wash should be prescribed along with Acetaminophene codein to reduce systemic drugs consumption.

Statement of Problem: There is a controversy about the relationship between pulpal and periodontal diseases. The interrelationship between pulp and periodontium could have an important effect on the treatment plan of the tooth.

Purpose: The aim of the present research is to evaluate root canal therapy effects on periodontal healing of teeth with chronic advanced periodontitis.

Materials and Methods: In this randomized controlled clinical trial 32 single rooted teeth which had necrotic pulp or irreversible pulpitis in 7 patients with chronic advanced periodontitis were selected based on specific criteria. Using a split mouth design, teeth were randomly put in two groups of test and control. In the test group root canal therapy ,scaling & root planing were done.In the control group, only scaling & root planing were performed. Clinical parameters including Pocket Depth (PD), Clinical Attachment Level (CAL), mobility, pattern of bone destruction and plaque index (PI) were evaluated in two groups at base line, 1 and 3 months after treatment. Appropriate tests such as paired Wilcoxon and Mann-Whitney were performed.

Results: Statistically significant reductions were found in the test group when comparing baseline and one-month post treatment values for Clinical Attachment level (CAL) but not after 3-months. In the control group the CAL reductions were not statistically significant between baseline and one month post-treatment, but a increase were observed between one month and three months after treatment. There was a statstically significant difference between the test and the control groups. Other parameters didn’t show any significant differences in each group and between two groups.

Conclusion: Since clinical attachment level was the most important parameter we found it can high lighted the role of pathogene with pulpal origin in progression of periodeontal disease and it is concluded that beside periodontal treatment in some advanced periodontal cases pulp therapy maybe an effective procedure for eleminating destructive pathogens of pulp and causing periodontal healing.

Statement of Problem: Hemodialytic patients may be exposed to periodontal diseases during treatment. No information of any kind is available regarding the periodontal treatment needs of such patients.

Purpose: The aim of the present study was to determine the periodontal treatment needs of hemodialytic patients, living in Tehran, to be presented to the public health system.

Materials and Methods: In this descriptive study using CPITN index 75 patients according to multi-stage sampling method and in proportion to the number of patients in Tehran were selected. Following necessary training, qualified subjects were chosen and a special questionnaire was completed for each using personal protection, CPITN index, by WHO prob, was examined and numbered according to (0-4) codes. Results: The findings showed that 10.6% of the patients had normal periodontal status (Code-0), 12% of the patients had bleeding upon probing (code-1), 21.4% had calculus (Code-2), 21% of the patients had shallow pockets (Code-3) and 24% had deep pockets. It was also shown that 89.4% of the patients needed oral hygiene instruction, 77.4% needed scaling and 24% required advanced periodontal treatments whereas only 10.6% did not need any treatment.

Conclusion: No statistically significant relationship was found between periodontal status and factors such as age, sex, the history of hemodialysis treatment and level of patients’ education.

Background and Aim: It has been suggested that osteoporosis may be a predisposing factor for periodontitis and tissue destruction, thus periodontitis and mandibular bone density might be related. The purpose of the present study was to evaluate the clinical signs of periodontal tissue destruction in postmenopausal women.

Materials and Methods: In this cross-sectional study, 60 postmenopausal women (51 to 78 years of age) underwent radiographic examination of the right mandibular premolar. Mandibular bone density (MBD) was measured using optical densitometry. Periodontal status variables examined included: probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PLI). Data were analyzed by statistical tests using P<0.05 as the limit of significance.

Results: This study found no statistically significant association between the four indicators of periodontal disease and mandibular bone density, but there was statistically significant association between mandibular bone density and the number of remaining teeth. There was also statistically significant association between PPD and the number of remaining teeth.

Conclusion: These findings suggest that individuals with high MBD seem to retain teeth with deep periodontal pockets more easily than those with lower MBD.

Background and Aim: Low birth weight is a significant public health issue. Recent studies have suggested periodontal diseases as risk factor for preterm labor. The aim of this study was to assess the relation between gingival health and preterm labor in a sample of Iranian female population.
Materials and Methods: In this cross sectional study, 201 pregnant women without any systemic diseases or other risk factors like psychotic conditions were selected. Ninety-nine of them had term labor (infant≥37 weeks) and 102 had preterm labor (infant<37 weeks). Bleeding index, pocket depth and debris index were measured. Data were analyzed by Chi-square and Mann-Whitney tests with p<0.05 as the level of significance.
Results: Bleeding index, probing depth and debris index showed statistically significant differences between preterm and term labor mothers (P<0.001).
Conclusion: According to the findings of this study, there is a significant relationship between gingival health and duration of pregnancy. Consequently, periodontal diseases could be risk factor for preterm labor. Oral hygiene is strongly recommended to be included in pregnancy health programs.

Background and Aim: Several materials have been introduced for retrograde fillings, pulp capping and sealing root perforations, but their biological effect on vital tissues and cells is not clear. The purpose of this study was to evaluate the reaction of human periodontal ligament fibroblasts to four root canal filling materials: Pro Root MTA, Root MTA, Portland cement and amalgam.

Materials and Methods: In this experimental study, impacted or semi impacted third molar teeth were extracted in aseptic conditions and tissues around the roots were used to obtain fibroblast cell line. After proliferation, cells were cultured in chamber slides and extracts of materials were added to wells. Fibronectin, type I collagen and TGF-  expression were measured by immunocytochemistry method. Data were analyzed by SPSS 11.0 using one way ANOVA and Tukey test. P<0.05 was considered as the limit of significance.

Results: Collagen I expression was higher in Pro Root MTA group after 24 hours (p<0.05) and in Portland cement group and positive controls after 48  hours. Portland cement group showed the highest expression of collagen after 1 week. There was no significant difference in fibronectin expression after 24 hours. After 1 week the highest expression of fibronectin was seen in Portland cement, Root MTA and Pro Root MTA groups. TGF-  expression was higher in amalgam, Root MTA and Pro Root MTA specimens after 24 hours and was the highest in Pro Root MTA group after 48 hours.

Conclusion: Based on the results of this study, Portland cement and Root MTA are comparable with Pro Root MTA and better than amalgam regarding their effects on human periodontal ligament fibroblasts.

Background and Aims: There is not sufficient knowledge about the relationship between smoking and vertical bone loss in periodontal diseases. There are also important evidences which propose harmful effects of smoking on periodontal tissues including alveolar bone. The purpose of this study was to assess the relationship between smoking and prevalence and severity of vertical bone defects.
Materials and Methods: This case-control study consisted of 71 individuals with angular bone defects (case) and 69 individuals without angular bone defects (control) between 18 to 70 years old. People were selected by radiography, examining and filling up the questionnaire. Vertical bone defect was defined as interproximal bone resorption to the extent of ≥2mm with a clear angel towards the Mesial or Distal of root. Data were analyzed using SPSS software.
Result: The mean age of studied individuals was 37.14 years (±12.72). Among people with angular bone defects, 21.1% were light smokers and 25.4% were moderate-heavy smokers. There was a significant difference between smokers and nonsmokers in terms of smoking status and the chance of having angular bone defects (P=0.001). Simultaneous study of the effect of sex, age, brushing and smoking status showed that except sex, other variables have a significant effect on angular bone defects. The chance of having angular bone defects in light and heavy-moderate smokers was more than that in nonsmokers (adjusted OR=4.17 and adjusted OR=3.87, respectively).
Conclusion: These observations propose that smoking is related to increase in prevalence and severity of vertical bone defects. Smoking is considered as a potential risk factor for vertical periodontal bone loss.

Background and Aims: The precision of periodontal pocket measurements with periodontal probe is related to different factors. Some of these are related to examiner. The purpose of this study was to compare the right-handed and left-handed dental students in the measurement of periodontal pocket depth (PPD).
Materials and Methods: Eight systemically healthy adult patients (mean age of 35 years) with 0.5-6 mm periodontal pocket depth and a minimum of 20 teeth were examined by 4 right-handed and 4 left-handed students of dentistry (mean age of 25 years). These students were trained for periodontal examination probe depth measurements with Williams probe. Measurements were inserted in SPSS software and analyzed with Iintraclass correlation coefficient (ICCS) and T-test.
Results: There was statistically significant difference in the measurement of PPD between right-handed and left-handed examiners in the whole mouth (P<0.05), but this difference (0.08 mm) was not clinically significant. The most difference was found in the posterior teeth of mandible at right quadrant (mean=0.2 mm). Analyses of each pair of same handed and different handed examiners with T-test and ICCS showed that these measurements were nearly similar and reproducible.
Conclusion: There was no clinically significant difference in measurement of PPD between right-handed and left-handed examiners.

Dentistry has been a field dominated by a constant improvement of synthetic biomaterials. Tissue engineering of tooth is coming to change the panel of the dental materials such as restorative materials and implants. Certainly, it is the largest transition in history of dental materials science in terms of accepting this new and exciting technology. The objective of this article is to present various implications of tissue engineering in different fields of dentistry. To achieve this goal, a review of the literature was carried out by using Medline database to search topics including "dental stem cells", "teeth tissue engineering", "regenerative dentistry", "oral surgery", "periodontal regeneration" and "regenerative endodontics". These searches were limited to articles published after the year 2000. On the basis of our literature review, we have found that although there are significant challenges in oral tissues engineering, engineered tissues will find many applications in dentistry within the next few years.

Background and Aims: Periodontitis does not affect on all patients by the same way. There are some risk factors in some people that make them more sensitive to progress of periodontitis. Smoking, uncontrolled diabetes, and special pathogens increase the risk of periodontitis. Other factors such as stress, depression and anxiety, are not crucial risk factors for periodontitis yet. Biologic explanation of this relation is that mental conditions and exposure to stressful situations can alter immune response. The aim of this study was to review the psychological factors of anxiety and depression associated with periodontitis.

Materials and Methods: For this review article, we have searched through internet by the following keywords periodontal disease, anxiety, depression. We have tried to cover almost all dental– related sites and journals as well as Pubmed from 1990-2010.

Conclusion: Most published studies support a positive relationship between periodontitis and several psycho-social factors. Life style, stressful conditions, hormonal changes, nonchalance in oral hygiene, habits such as smoking are predisposing factors in periodontal diseases.