Journal of Dental Medicine

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Eagle's syndrome is characterized by an elongated styloid process and (or) calcification of stylohyoid ligament besides clinical symptoms. The symptoms are those related to pain when swallowing or rotating the neck, headacke, earache, dizziness, intermittent glossitis, sensation of foreign body in pharynx and transient syncope. The case which is presented can be considered a very rare form of the disease in which complete calcification of the ligament and it's thickening has occured. Also there is little relationship between the severity of calcification and severity of symptoms.A careful and thorough evaluation of each panoramic radiography is emphasized.

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Nucleolar organizer regions (NORs) are loops of rDNA, which in human, occur on the short arms of five acrocentric chromosomes, namely, 13, 14, 15, 21 and 22. NORs are usually demonstrated by binding If their associated proteins (NORAPsO to silver (Ag+) ions. The reaction is called AgNORs. It has been determined that, the number and the size of NORs is related to the proliferative activity and grade of malignancy. This has led to the application of AgNOR method to a wide range of diagnostic problem cases, including breast, salivary glands and lung malignant neoplasms.The purpose of this study was to determine the value of AgNOR method in assessment of the grade of malignancy in non- Hodgkin's lymphoma of head & neck, which often is difficult and essentially important in relation to the prognosis and treatment.41 cases of paraffin embedded specimens of NHL, which were classified by working formulation system,were selected and then AgNORs method was applied on them.AgNORs were enumerated for all 41 cases of NHL (Standard Crocker).The mean AgNORs in 11 cases of low grade 15 cases of intermediate grade and 15 cases of high grade NHL was 1.66 (SEM= 0.098), 2.25 (SEM= 0.084) and 5.19 (SEM= 0.11), respectively.In analysis of variance and multiple comparisons, a significant difference was found between the three groups of NHL (P<0.000I).It is concluded that the AgNORs, as a reliable method, could be used in differentiation of low,intermediate and high grade NHL in head and neck area.

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: One of the main aspects of orthodontic treatments is hard and soft tissue changes and their effects on patients appearance.Fixed orthodontic treatment with extraction of upper first premolars to camulfalge of ci II malocclusion is very common,however there is not sufficient studies about lip and incisors changes after this procedure. For evaluating of vertical changes of upper, lip and incisors following retraction of upper incisors, fifteen adult Iranian patients aged 15 to 24 years who sought treatment for their CI II DI malocclusion were treated. Standard edgewise technique(0.018") following extraction of four first premolars were used.A cephaiometric study was undertaken to determine the vertical change in upper incisors and upper lip. For this evaluation, thirty linear and angular measurements were utilized.Results show that: 1- The upper incisors were intruded (X=0.83mm).2- The upper lip length was increased(X~1.2mm).3- The occlusal plane, rotated upward (Anteinclination).4- The palatal plane rotated downward and backward (Retroinclination).This study shows that the standard edgwise appliance has the capacity of reduction of incisor protrusion significantly without extruding them.

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: 32 patients were entered in randomized double blind clinical research. The patients were divided into two groups. Group A(18 patients) were given a single dose of 20 mg Piroxicam one hour pre-surgery. Group B(14 patients) were received 325 mg Acetaminophen every six hours immediately after surgery. The mouth opening was measured pre-surgical treatment. Pain relief was evaluated in both groups lsl and 8th hour after surgery. The mouth opening was measured lsl and 7,b day after surgery. The results showed that the analgesic effects of Piroxicam were higher than acetaminophen, however, the comparison of trismus means revealed no significant difference.

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Peripheral giant cell granuloma (P.G.C.G) is an exophytic lesion with an approximate size of 0.5-1.5 mm. It usually occurs on gingival and alveolar ridge of mandible particularly in molar and premolar region. The relation of serum calcium (Ca), Phosphor (P), and alkaline phosphatase (Alk) levels to P.G.C.G is yet controversial. In this descriptive study, 33 patients with P.G.C.G were chosen and serum Ca, P, and Alk levels compared with the normal range. In all patients the level of Ca was in the normal range. Phosphor (P) was in the normal range in all patients over 17 years old and 80% under 17 years. The level of ALK in 75.8 percent of the patients over 17 years and 90% under 17 years was in the normal range. In conclusion, no relationship was found between serum changes and P.G.C.G. It means P.G.C.G can be compeletly independent lesions from serum changes.

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Recurrent aphtus stomatitis (RAS) is an oral mucous lesion in patients with no other signs of disease. Investigators have always notified the role of immune system especially humoral immunity in aphtus immunopathogenesis. The aim of this case-controlled study was to measure amount of serum immonogiobulins (A,G,M) and complement component (C₃ C₄) in patients with RAS and to evaluate any relation between differences in these factors and pathogenesis of RAS. Immonogiobulins (A,G,M) and complement components (C₃ C₄) of 50 patients with RAS was measured using single radial immuno diffusion technique. The results were compared with immonogiobulins (A,G,M) and complement components (C₃ C₄) of 50 healthy people whom were similar in age and sex with the patients group. Results showed that the patients group had higher level of IgA and IgM while serum IgG was similar in both groups. The C₃ was lower in aphtus patients while no significant difference was found in amount of C₄. The sex had no significant effect on serum level of measured factors. From the results it can be concluded that the humoral immunity reaction has an important role in immunopathogenesis of RAS. This humoral response might accurse as a result of cellular immunity reaction.

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Sialoprotein is a phosphorylated skeletal glycoprotein. The function of sialoprotein is still not fully understood. It is possible that this component participate in cell differentiation and the conversion of unmineralized matrix into mineralized structures. The purpose of the present study was to determine the serum sialoprotein concentration in-patient and normal subjects to investigate the relationship between serum sialoprotein and dentin, enamel structural differentiation. The study group consisted of 50 patients, 32 males and 18 females, aged 17-54 (with an average of 32.5 years). The control group consisted of 50 normal volunteers, 26 males and 24 females, age 22-51 (with an average of 39.60 years).The laboratory data of this group were used as a reference. Human blood was obtained from control and patient group. The blood sample was centrifuged at 3000* g for 20 min, the supernatant was discarded.Then each sample was centrifuged for 20 min at 10000 g applied to a sepharose column and eluted with 4 moll Guanidine - HCL at 50 moll tris, pH 7.4 at a flow rate of 0.5 ml/min. The fractions obtained by chromatograply was monitored by electrophoresis. Our results showed that sialoprotein control increased in patients serum (18.45+/-3.2I micro gr/L) compared to normal subjects (11.37+/-2.45 micro gr/L).

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Carious lesions are usually found by dentists, using bitewing radiographs, and according to the depth of the lesions, the treatment plan is designed. At the present, this technique is the most accepted one and is used generally. But it is not a perfect technique and there are some errors in determining of depth of proximal carious lesions. These errors are mainly related to the use of new high-speed films with broad density and lower voltages. In this study, dentin thickness under proximal caries in bitewing radiography was compared with its real thickness, in tooth structure. Twenty-four teeth samples with proximal caries were used. Before and after removal of carious lesions bitewing radiographs were taken and then each tooth was sectioned occlusogingivally and the thickness of dentine under proximal caries and on bitewing radiographs were measured under microscope with 0.01 mm accuracy. Mean value of dentine thickness in tooth structure was 41% of its mean thickness in bitewing radiographs, showing 59% difference (reduction). Therefore, more care should be taken in using standard technique and interpreting of bitewing radiographs by clinicians. Clinical examinations also should be performed in ideal conditions, and patients should be clinically and radiographically examined every six months.

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Osteodystrophy is one of the most common complications at the last stage of renal disease,which cause low bone mineral density (BMD) and skeletal deformities in patients. In this study evaluation of renal osteodystrophy was evaluated through BMD measurement of 45 under dialysis and 78 healthy persons by intra-oral digital radiography (RVG). Results Showed that:1- The average of BMD in hemodialysis patients was indeed lower than normal population (P^O.OOO).2- The mean of BMD of females was lower than males (P=0.021).3- There was no correlation between and BMD (P=0.560).4- Age and BMD had no significant relationship (P=0.648).5- There was negative correlation between alkaline and BMD therefore ALP is a useful predictive factor forBMD(P=0.002).

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Concern for adverse effects must accompany any use of ionizing radiation. Such concern for the expanded use of CT scanning, conventional tomography and panoramic in dental implant radiology can be expressed by the establishment of absorbed radiation dose for critical tissues (resulting from these radiographic procedures). Potential patient benefit should be weighted against the risk and other disadvantages and/or advantages of a particular radiographic imaging technique. Measurement of dose values can act as a guidline for such risk determinations. The purpose of this study was to measure and compare the absorbed doses of various anatomic sites during these radiographic techniques. The absorbed radiation doses in bone marrow, thyroid gland, salivary gland, eye, brain and skin entrance were determined by placement of lithium fluoride thermoluminescent dosimetres (TLD, S) at selected anatomic sites within and on a humanlike x-ray phantom. The phantom was exposed to radiation from panoramic, linear tomographic and computer- assisted tomographic (CT) stimulated dental implant radiographic examinations. The mean dose was determined for each anatomic site. CT examination showed disruption dose, while panoramic radiography was generally the lowest. The mean absorption value by paratid gland was higher than of other salivary glands.

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One of the major factors in a successful root canal therapy is the determination of root length before canal preparation. Radiography has been proved to be useful in this case, but nowadays for reducing radiation, radiovisiography has been recommended. The aim of this study was comparing conventional radiography (CR) with radiovisiography (RVG) in determination of canal length. 101 anterior and posterior extracted human teeth were selected. After mounting in unolit block, K- file (Num. 15) was placed in canal with tactile sense. Working length was measured by C.R and RVG. The results were analyzed by complete, randomized block design. RVG and CR showed shorter length than actual length. But, the measured lengths did not show significant statistical differences. As a result, considering the advantages of RVG, it is recommended in determining canal length.

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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.

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Nowadays, bone mass estimation, through imaging methods, is widely used in metabolic diseases diagnosis and treatment. One of these methods is called "optical densitometry" which estimates bone density by measuring the intensity of the transmitted light on different parts of a radiographic image. Digital radiography systems act similarly by determining grey levels of the image. The aim of this study is comparing two different methods of optical densitometry and a digital system densitometry known as radiovisiography. 45 samples, containing urografin with three different concentrations, were imaged, by both radiovisiogrphy (RVG) and conventional film systems. To determine the densitometry of films and radiovisiography images, optical densitometry and bone densitometry option of the RVG software, were applied respectively. Data were analyzed and compared for their reliability (repeatability) and correlations with concentration. In RVG densitometry system, the correlation with concentration is moderate (r=0.42) and intra samples and intra group reliability are 97.68% and 88.19%. Moreover, in conventional optical film densitometry, correlation with concentration (r=0.987) is high, intra samples and intra group reliability is high, intra samples and intra group reliability are 99.97% and 99.84%, respectively. According to the results, it is suggested that conventional film optical densitometry is more precise and reliable than RVG densitometry.

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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.

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The differential diagnosis between pleomorphic adenoma, the most common salivary gland neoplasm, microscopically, and two other common salivary gland neoplasms, meaning adenoid cystic carcinoma and mucoepidermoid carcinoma, is difficut.The purpose of this study was to determine the differences between pleomorphic adenoma, adenoid cystic carcinoma and mucoepidermoid carcinoma regarding the staining intensity with PTAH and H&E and also to investigate the relationship between staining intensity with PTAH and malignancy grade in mucoepidermoid carcinoma. 72 paraffin embeded samples including 24 pleomorphic adenoma, 24 adenoid cystic carcinoma and 24 mucoepidermoid carcinoma were selected and stained with PTAH. The staining intensity in total, in nucleus and cytoplasm of tumoral cells were evaluated and compared with H&E staining, statistically. The results were analyzed by Kruskal-Wallis, and Wilcoxon signed ranks tests (P<0.05).The logistic model was presented to predict the degree of malignancies through the assessment of nucleus and cytoplasm staining intensity in tumoral cells, and the patient's age. In this study, a statistically significant relationship was observed between staining intensity by PTAH and H& E in nucleus of tumoral cells in pleomorphic adenoma. Moreover, statistically significant relation between staining intensity by PTAH and H & E in cytoplasm of tumoral cells in adenoid cystic carcinoma was found. But there was no relation in other cases. On the other hand, a statistically significant relation between intensity of staining in total, in nucleus and cytoplasm of tumoral cells and the type of tumor was found. No relation was obtained between malignancy grade of mucoepidermoid carcinoma and staining intensity in total, in nucleus and cytoplasm of tumoral cells. The presented logistic model indicated a direct relation between tumor malignancy with patient's age and staining intensity in nucleus of tumoral cells, but a reverse relation was found between cytoplasm staining intensity in tumoral cells and tumor malignancy.Our findings show that PTAH and H & E staining methods, lead to similar results, however, PTAH staining is a reliable method in differential diagnosis of such salivary gland tumors.

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Statement of Problem: The main objective of endodontic therapy is chemomechanical cleansing of entire pulp cavity and its complete obturation with an inert material. During this procedure, the failure of detection and inadequate cleaning of a canal will result in failed endodontic therapy. Therefore, the dentist must have enough knowledge of root canal morphology to treat a tooth successfully.
Aim: The aim of this study was to determine the number and type of root canals of mandibular incisor teeth.
Materials and Methods: In order to do this in-vitro, descriptive study, 68 non-carious mandibular incisor teethj collected from different clinics in Yazd, were immersed in indian ink, decalcified and cleared.

Results: It was found that 55.9% of the teeth had two separate canals that in 5.5% of them, the canals merged before' apical foramen. In 4.4% of these samples, two separate canals existed along the whole root.
Conclusion: Considering high percentage of two canals in lower mandibular incisors, during access preparation, more attempts in detection of the second canal, is emphasized.

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Statement of Problem: Cephalometric findings are of high importance in making decision about orthodontic treatment plans and orthognathic surgeries. Natural head position (NHP) is considered as a useful and exact radiographic technique.

Aim: The aim of the present study was to compare two techniques, namely Standard and NHP, in lateral cephalometry.
Materials and Methods: In this cross- sectional study, performed in Shiraz. 138 randomly selected students {70 males .and 68 females), age ranging from (13-15). were evaluated clinically and radiographically. None of them had a history of orthodontic treatment, head and face fracture or surgical operations. Lateral cephalograms were taken in both standard and natural head position techniques, for each student. For statistical analysis, l-lest for paired samples, was done.
Results: This study showed that in anterior-posterior dimension, among angles with significant differences in two techniques, those of standard one were more reliable, whereas in vertical dimension.statistical differences showed natural technique as more useful one.
Conclusion: Due to the fact that natural cephalometry requires more patient cooperation, more time and a higher complex technique, it is not suggested, except when different clinical and cepholomeiric findings are observed.

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Statement of Problem: The goal of bone regenerative therapy is to reconstruct the damaged tissues to initial condition, which seems so important in periodontoiogy and implantology. In such therapies, different biomaterials, with some advantages and disadvantages, may by use.
Purpose: The aim of this research was to evaluate the quality, bone trabecular density and thickness of newly forming bone as well as foreign body reaction against Biostite®, in comparison with the control group.
Material and Methods: In this experimental study the total number of 5 sheep was operated with general anesthesia. At first 10 standard defects were created in 5x5x5mm on the left and right edentulous mandibular ridge. Five defects were randomly treated by Biostite®, the remaining five were considered as controls. After six months, the sheep were sacrificed and the separated defect areas with intact margin
were placed in 10% formaline and prepared for histologic and histomorphometric study. To analyze the data, Mann-Whitney U test was used.
Results: The mean percentage of new bone formation in Biostite® group was statistically more than the control group (PO.05). Newly formed bone was vital in both groups which was a combination of lamellar and woven types, however, the thickness and density of new bone in biostite® group was more than the controls. Foreign body reaction was observed in Biostite® group.
Conclusion: It is suggested that Biostite® synthetic material can be useful in bone regenerative
therapies.

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Statement of Problem: Computer Sciences, in radiology, like other fields, is of high importance. It should also be noted that the accuracy of the technique and work conditions affects the radiographs information considerably. There for, in order to get more accurate diagnostic information, it seems necessary to investigate different digitized radiographic techniques and to compare them with the conventional technique.
Purpose: The aim of this study was to compare the accuracy of conventional and digitized radiographic images by three digitization techniques in proximal caries detection.
Material and Methods: In this research study, sixty extracted human canines, premolars and molars were mounted in blocks and imaged on E-Kodak film, similar to bitewing radiographs. Ten bitewing radiographs were then scanned at 600 d.p.i with flat bed scanner and a digital camera, then digitized at 300 d.p.i with another digital camera. The digitized images were displayed randomly on a high-resolution monitor. Six
observers assessed the caries status of 120 proximal surfaces by conventional and digitized images. The observer's scores were compared with the results of the macroscopic examination. Reliability of each technique was calculated. Data were analyzed using chi-square and ANOVA tests.
Results: No significant differences were detected between different techniques in intact proximal surfaces and enamel caries diagnosis. However, digital techniques were more sensitive in dentin caries detection (P<0.05).
Conclusions: When conventional film images are digitized, medium resolution (300 d.p.i) seems to be sufficient. At this resolution the file size is decreased and there is no significant loss of the information necessary for caries diagnosis.

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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.