مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال بیست و سوم شماره 6 (پیاپی 107، شهریور 1394)

Odontogenic infections are one of the common cause of maxillary sinusitis. This study aimed to evaluate the relationship between the teeth with periapical lesions or periodontal disease and sinus mucosal thickening using cone-beam computed tomography (CBCT). This was a retrospective and cross-sectional study. CBCT scans of 97 patients (188 sinuses) were evaluated retrospectively for the presence of periapical lesions and/or periodontal disease in posterior maxillary teeth and associated sinus mucosal thickening. Thickening >2 mm was considered pathological and was categorized by degree (normal، 0-2mm، 2–4 mm، 4–10 mm، and >10 mm). Periodontal bone loss was categorized in 25%، 25-50%، >50%. And for data analysis، Chi squre and Spearman correlation were performed. Mucosal thickening>2 mm was observed in 109 sinuses (58%). Data analysis revealed significant associations between the mucosal thickening>2 mm and sex (males، p=0. 001)، and age (p<0. 001). There was a close relationship between mucosal thickening and periodontal bone loss (p=0. 057)، also there was a significant association between mucosal thickening and periapical lesions (p=0. 001). Sinus mucosal thickening was a common radiographic finding، which was more likely to be observed in males with older age and periapical lesions significantly increased the thickness of the maxillary sinus.

The application of herbal plants instead of synthetic drugs is increasing in recent years because of their lower side-effects and high varieties of efficient components. The study of antiinflammatory and antinociceptive effects of hydroalcoholic Althea officinalis root extract. seems to be necessary due to the existence of its anti-inflammatory and antinociceptive components. In this study the effect of injection of Althea's root extract on experimental inflammation and pain was investigated. For evaluation of the analgesis effect of Althea plant, 30 male rats with an average weight of 180-220 g were selected. It was used Xylene-induced ear edema and Formalin tests for investigating anti-inflammatory and antinociceptive effects of Althea plant. In each of these two tests, the animals were divided into 6 groups(each group consisting of 6 mice)interventionaland, positive control groups(receiving dexamethasone at in inflammatory test, and receiving morphine in formalin test), and experimental groups receiving hydroalchoholic extract at doses of 50, 100and 200 mg/kg. Hydro-alcoholic Althea officinalis root extract reduced inflammation produced xylene, especially in high doses 200 mg/kg, compored to the intervention and positive control groups(p<0.05). Also, hydroalcoholic extract of Althea root in all doses, especially, in dose of 200 mg/k decreased the formalin-induced pain. The hydroalcoholic of Althea officinalis root extract had antinociceptive and antiinflammatory effect in both phases(especially inflammatory phase), which was caused by formalin, and this effect may be beacause of flavonoid and tannin components in plants, which had anti-inflammation and antinociceptive properties.

Echinops ilicifolius, Echinops jesdianus, Echinops ceratophorus and Echinops lasiolepis are defined as native plants of Yazd that their immunomedulatory effects have not been studied yet. The aim of this study was to determine the effect of different concentrations of these plants on peripheral blood mononuclear cells(PBMCs) proliferation and interleukin(IL)-4 secretions. Root extracts of Echinops ilicifolius, Echinops jesdianus, Echinops ceratophorus and Echinops lasiolepis were prepared by Maceration method. PBMCs were obtained from three healthy volunteer individuals and cultured with the presence of 0.1,1,10,100 and 200 µg/ml with concentrations of 10 µg/ml of phytohemagglutinin. The rate of cell proliferation was determined by BrdU kit. The IL-4 levels in PBMCs. supernatant were measured by enzyme-linked immunosorbent assay(ELISA). P value<0.05 was considered significant. The different concentrations of root extracts of all plants showed inhibitory effect on PBMCs. There was a significant difference among Echinops lasiolepis extracts in different concentrations(p=0.045). The levels of IL-4 were similar in super natant in control group and different concentrations and the control groups. The results showed that root extracts of Echinops species had inhibitory effect on PBMCs proliferation and in some species with decrease in IL-4 secretion might have immunomedulatory effects. The effect of Echinops extract fractions on PBMC is suggested.

Nowadays, the use of panoramic radiographs for evaluation of uprighting and root parallelism, after the closure of spaces and before the debanding of fixed appliances, often been accepted, and the use of radiography to evaluate the results at the end of orthodontic treatment is discussed.It is not clear whether panoramic radiography reflects the exact mesiodistal position of the maxilla and mandible tooth roots. We had 10 patients with class I molar relationships, and took an alginate impression from both jaws then poured that with moldano plaster.To determine the long axis of the teeth, orthodontic wires (0.7) Parallel to the long axis of the teeth, (on diagnostic casts) was used. To take a panoramic radiography from casts, Panoramic imaging device “Planmeca 2002 CC” with 4mA and 60kvp was used.Photo was taken from Casts and Panoramic radiographs, then the angles between the wires and the reference line, were measured by the Autocad 2005 software, and the values related to casts and panoramic radiographs, were compared. Significant percentage of achieved angles of the panoramic images (71.2%), statistically,were not in the acceptable range(±2 degree). Generally, the lowest accuracy of panoramic radiography in assessment of mesiodistal angulation of the teeth was in the lower lateral incisor region. (ICC=-0.237). Also, the differences between the actual angles and radiographic angles in maxilla, was considerably less than in mandible. This study aimed to determine the accuracy of panoramic radiography in the assessment of mesiodistal angulations of the teeth. Dentists should act cautiously in making clinical decisions for requirements of angle adjustments, according to panoramic radiograph findings, with the knowledge of permanent distortion panaoramic image.

One of the orthodontic treatment problems, which causes marginal gaps and microleakage between tooth and composite is microleakage of composite bonding of orthodontic brackets. The microleakage formation permitting the passage of bacteria and oral fluids, which may cause white spot lesions under the brackets surface area.This is a clinical problem during orthodontic treatment. Few studies have been conducted in this area. The aim of this study was comparison of microleakage of composite silorane base and methacrylate base composite in orthodontic brackets. Thirty human premolar were collected and divided into 2 groups. In group 1, 15 orthodontic brackets were bonded using silorane base composite, in group 2, 15 orthodontic brackets were bonded using methacrylate base composite. Then the teeth were kept in water and thermo cycled(500×, 5-55°C). Specimens were further sealed with nail varnish, stained with 5% basic fuchsin for 24 hours. Then, all teeth sectioned and dye penetration rate were examined by an esteriomicroscope, and scored 0 to 3 for marginal microleakage for the bracket- adhesive and adhesive-enamel interfaces. The data collected analyzed with SPSS16 software, and fisher exact and Mann Whitney tests. Microleakage values were lower in silorane composite than in the methacrylate group, and this difference was found to be statistically significant(P-value =0.03). Also, the rate of microleakage between adhesive-bracket than adhesive-enamel interface was meaningful(P-value=0.025). The results of the current relealed that silorane-bass silorane-base composite provided low microleakage for orthodontic brackets, for this reason, it could be used it for bonding brackets.

Understanding the anatomical and pathological relationship between posterior teeth or edentulous area with maxillary sinus is essential for diagnosis and treatment planning. This study aimed to assess the correlation between maxillary sinus floor topography and related root position of posterior teeth. 55 panoramic images were selected through census. These images were chosen from sajad oral and maxillofacial radiology and Navab Azam oral and maxillofacial surgery clinic in yazd from 2001-2015. Totally, 440 first and second premolars, maxillary, first, and second molars(from each 110) were investigated. The interpretation of CBCT scans were performed by oral radiologist specialist and also panoramic radiography and the results were carried out by a trained senior dental student. The results were repeated two weeks later to investigate intra-observer. The collected data were analyzed using SPSS version 17 and, Anova, Chi square, Fisher, Exautts and t-test. The agreement between the CBCT and panoramic radiographs in determining root form was measured with Kappa test and it was kappa=0.549, which was meaningful with P-value=0.0001. This meaned that CBCT and panoramic radiographs showed an agreement in determining the position of maxillary sinus floor and posterior teeth roots. According to the results of this study, it was recommended to establish the exact correlation between maxillary sinus floor and posterior teeth roots especially in classification 3(projected in panoramic radiographs)CBCT images were prepared for minimal damage and infection transmission.

One of the most important steps in root canal therapy is removal of microorganisms presented in the root canal by means of cleaning and shaping with a variety of manual and rotary instruments. The aim of this study was to compare the amount of dentinal debris remained in canal after application of two nickel titanium rotary files(Flexmaster, Twisted) with stereomicroscope. In this lab-trial study, 60 extracted human premolars were used. After dividing the teeth in two groups,cleaning and shaping of each group was done with one of the twisted files and Flexmaster. After preparation of root canals, the roots were sectioned at 2, 4, and 6 mm from the apex. Stereomicroscopic pictures were prepared. In image J program, the amount of remained debries was calculated by dividing the level of debri presented in each section on the area of canal in each section. The data were analyzed statistically by using SPSS software version 16 by using, paired t test and ANOVA. There was no statistically significant difference in the mean percentage of remained debris between two groups(p>0/05). There was a significant difference in the mean percentage of remained debris in each section of each group(p<0/05). According to the obtained results, there was no significant difference in mean percentage of debris within two groups after preparation of the canal, which indicated that both instrument have the same effect on cleaning of the straight canals.

Currently, dental implant is one of the most modern approaches to teeth replacement. Panoramic radiography is considered as the prerequisite for implant therapy. The purpose of the present study was to investigate the vertical magnification of digital panoramic images in various anatomic parts of the mandible. A total of 30 patients referred to Sajjad Radiography Center for implant therapy with high quality images of both panoramic radiography and CBCT were selected. The panoramic images were acquired with Prolin EX set and the CBCT images were recorded via Planmeca ROMEXIC2.9.2.R. Specific areas of panoramic images with certain anatomic structures were considered. The vertical distance between two desired points A and B were measured in the panoramic radiography and compared to CBCT images. In this way, the magnification index of panoramic radiography was obtained. Measurements were calculated in four areas including posterior maxilla, posterior mandible, anterior maxilla, and anterior mandible. Based on the statistical findings of the study, the rate of panoramic radiography magnification compared to CBCT was 21% in the anterior and 13% in the posterior regions, that showed a statistical significant difference(P<0.001). Also, the proportion of mean magnification of panoramic radiography to CBCT was 1.18 in maxilla and 1.16 in mandible, and there was a statistical significant difference(P<0.001). Based on the results of statistical testes, there was interaction between anterior-posterior and inferior-superior. In the case of application of panoramic images in implant placement, the site factor of the implant, being in the maxilla or mandible and in the posterior or anterior, should be considered.

The oral cavity has been proposed as a reservoir for Helicobacter, pylori(H. pylori) that could be responsible for the refractoriness of gastric infection to triple therapy. The data on the role of dental plaque in the transmission of Helicobacter pylori have varied. Furthermore, there has been few reports on the relationship between dental plaque control and H. pylori infection of gastric mucosa. This study evaluated the efficiency of periodontal treatment as a supplement of triple therapy vs. triple therapy alone, in gastric H. pylori eradication. In this single blind, randomized clinical trial, fifty patients were selected randomly into two intervention and control groups, each group contained 25 patients. The Urea Breath Test(UBT) was conducted on total subjects in a period of 8-12 months after triple therapy for both groups and periodontal treatment for intervention group. Poisson regression model and IRR was used in order to find a significant relationship between the two groups. Our results indicated that 80 % of those treated with the combined therapy exhibited successful eradication of gastric H. pylori, compared with 56 % who underwent only triple therapy; however; there was not a significant difference between the two groups(P value=0.167). The adjunction of periodontal treatment to eradication therapy appeared not to reduce gastric H. pylori recurrence compared with eradication therapy alone among patients with gastric diseases associated with H. pylori. It seemed, there was not enough evidence in this field, Therefore, there is a need for to further clinical trials.

Determining the effect of stress on strock in benficial. If there is a relationship between them, using public education can lead to decrease the risk of stroke. This study investigate the effect of stress on cerebrovascular accident. This study was a prospective case-control, which was performed on the patients with stroke referred to nerve clinical Ghaem Hospital, and the control group were selected among the staff of the university with no history of stroke during winter 2015. The persian translation of questionnaire of Holmes and Rahe stress scale related to the last month was completed among all of the participants in both groups. Diagnosis of stroke and determination of its etiology was made by neurologist. By considering the frequency of serve stress, 361 patients with stroke were investigated and from these 190 patients were in the control group. The relative frequency of stress and stroke and intracerebral homorrhage and subarachnoid hemorrhage were meaningful(p<0.001, p<0.001, p=0.006). There was no significant relationship between the relative frequency of serve stress among the patients with ischemic stroke, cryptogenic infraction, and cardioembolic with atherosclerotic and the control group (p=0.637, p=0.311, p=0.439, p=0.109,). There were a significant relationship between serve stress and atherosclerotic stroke(p=0.026). While, high stress score was significantly more frequent in atherothrombotic subtype of brain infarction than controls, p=0.046. There was a meaningful relationship between stress as an important risk factor in the patients with hemorrhagic stroke and atherothrombotic brain infarction. Based on this research stress could be considered as a risk factor of stroke.