مجله دانشکده دندان پزشکی اصفهان
سال دهم شماره 4 (پیاپی 45، مهر 1393)

The unpleasant feeling of pain prevents patients from visiting the dental office. This pain also occurs during scaling، leading to aggravation of periodontal diseases. The aim of this research was to campare the effect of oral ibuprofen and local lidocaine gel on pain relief during scaling and root planing. In this single-blind clinical trial، 80 patients with mild-to-moderate periodontitis، who needed scaling، were selected from the Department of Periodontology، Faculty of Dentistry and divided into four groups. Iboprofen، placebo tablet، lidocain gel and placebo gel were used in groups 1-4، respectively، during scaling. Patients marked the severity of pain after the treatment by VAS index. Data were analyzed with SPSS 11. 5 using ANOVA، and Kolmogorov-Smionov and Tukey tests (α = 0. 05). The mean pain score in the lidicaine gel group (1. 80) was significantly lower than those in other groups (p value = 0. 023). The mean pain score in the placebo gel group (3. 90) was higher than the other groups (p value = 0. 023). Under the limitations of this study، use of lidocain gel to reduce the pain during scaling was more effective than systemic administrarion of Iboprofen tablet.

Pain and hemodynamic changes are common complications of surgeries on impacted third molars. In this study، the effect of premedication with a 75-mg dose of Pregabalin on hemodynamic changes and postoperative pain was evaluated. In this double-blind randomized clinical trial، 210 patients who needed surgical removal of impacted wisdom teeth were selected. The subjects were randomly assigned to two groups. The experimental group (n = 105) received 75 mg of Pregabalin orally one hour before the operation. Placebo was prescribed for patients in the control group (n=98). Hemodynamic changes were assessed in four stages: stage 1: one hour before surgery and before premedication; stage 2: immediately before surgery and after injection of anesthetic agent; stage 3: after surgery; and stage 4:6 hours after surgery. Pain intensity was measured with visual analog scale (VAS). Data were analyzed with SPSS 15، using ANCOVA and Mann-Whitney U test (α=0. 05) Mean heart rates at stages 2، 3 and 4 revealed significant differences after adjusting for age (p value < 0. 001). Mean systolic pressure changes at stages 2، 3 and 4 in the case group were more unfavorable compared to the control group (p value < 0. 001). Mean diastolic pressure changes at stages 2، 3 and 4 were significantly different between the two groups (p value < 0. 05). Mean diastolic pressure decreased in the test group، with no changes in the control group. Postoperative pain in the control group was significantly more severe in the control group compared to the case group (p value < 0. 001). Considering the limitations of this study، premedication with oral Pregabalin with a dose of 75 mg in impacted third molar surgery has a significant effect on reducing systolic and diastolic pressures and is effective in reducing postoperative pain scores.

The efficacy of masticatory system depends on maximum produced by elevating muscles between the mandible and maxilla. The purpose of this study was to determine mean maximum bite force in complete denture and mandibular distal extension partial denture wearers by considering the face and ridge form. Sixty-four patients، including 32 complete denture and 32 partial denture patients aged 40‒65 years were selected by simple sampling technique for this interventional/analytical study. The patients were divided into 4 groups based on face form (square، square-tapering، tapering and oval) and into 3 groups based on ridge form (square، tapering and oval). Three measurements were made on each side in the first molar region with a digital measuring tool for maximum bite force and mean of these values was used for statistical analysis. Data were analyzed with ANOVA، Spearman’s correlation coefficient، independent t-test and chi-squared test (α = 0. 05). Mean maximum bite force in partial denture wearers was 18. 4 ± 5. 18 kg (20. 7 ± 4. 63 in men and 16 ± 4. 7 in women) (p value < 0. 001). Mean maximum bite force in complete denture wearers was 8. 5 ± 3. 21 kg (9. 9 ± 0. 53 in men and 7. 1 ± 2. 17 in women) (p value < 0. 001). In different face forms، square face form had maximum bite force compared to others (p value < 0. 001). In different ridge forms، square ridge had maximum bite force compared to others (p value < 0. 001). Maximum bite force in partial denture patients was significantly greater than that in complete denture patients. In addition، maximum bite forces in square face form، square ridge form and men were higher than others.

Application of fissure sealants is one of the techniques to prevent occlusal decays. The most recent pit and fissure sealant produced is the self-etching fissure sealant which does not require etching and bonding steps and is easy and fast to use. The aim of this in vitro study was to compare microleakage of Prevent Seal self-etching fissure sealant، Clinpro conventional fissure sealant and Filtek Flow flowable composite resin.

This experimental/interventional study was carried out in the laboratory. Forty-five extracted maxillary premolars، with no carious lesions، were selected and divided into 3 groups. The teeth in group 1 were sealed with Prevent Seal self-etching fissure sealant، the teeth in group 2 with Clinpro conventional fissure sealant، and the teeth in group 3 with Filek Flow flowable composite resin. After thermocycling and using dye penetration by floating in 0. 5% fuchsin، the teeth were sectioned and microleakage was evaluated under a stereomicroscope. Data were analyzed by Kruskal-Wallis test (α = 0. 05).

Based on the results، the highest amount of microleakage was related to Filtek Flow flowable composite resin and the least amount of microleakage was related to Clinpro fissure sealant. However، there were no significant differences between the microleakage of all the three groups (p value = 0. 128).

Based on the results of this research study، self-etching fissure sealant، conventional fissure sealant and flowable composite resin were not significantly different from each other in relation to microleakage.

One of the important characteristics of endodontic sealers is their antifungal activity. The purpose of this study was to compare the antifungal activity of following sealers: MTA Fillapex، tg-sealer، Multi-Cal، AH-Plus، RoekoSeal against Candida albicans، by two different direct and indirect methods.

In this experimental study، the agar diffusion test (ADT) (the indirect method) was used to compare the antifungal activity of freshly mixed sealers against a standard strain of C. albicans. Each sealer was placed in a well prepared in the middle of agar plates، in contact with C. albicans. After incubation، the diameter of the zone of inhibition of fungal growth was measured by caliper. In direct contact test (DCT)، to evaluate the antifungal activity of sealers after setting، suspensions containing the powdered sealer and C. albicans were cultivated on agar plates after 6، 15 and 60 minutes and incubated. Colony-forming units (CFU/mL) were calculated after incubation. Data were analyzed with SPSS 20 using one-way ANOVA، repeated-measures ANOVA and t-test (α = 0. 05).

ADT method for freshly mixed sealers showed that the antibacterial activity of Multi-Cal against C. albicans was significantly higher than the other sealers (p value < 0. 001). However، in DCT method for set sealers، MTA Fillapex exhibited the maximum antifungal effect against C. albicans (p value < 0. 05). The silicone sealer RoekoSeal had the least antifungal activity in both techniques (p value < 0. 05).

The sealers Multi-Cal and MTA Fillapex exhibited the highest with ADT and DCT techniques، respectively. RoekoSeal exhibited the least antifungal activity with both techniques.

Systemic anaphylactic shock due to injection of local anesthetic agents is one of the most urgent clinical conditions during dental procedures، although it has a very low incidence rate. The aim of this study was to assess the dentists’ knowledge about anaphylactic shock caused by local anesthetic agents and its clinical symptoms and signs. Sixty-five dentists working in their private offices or dental clinics of Ahwaz in 2012-2013 were included in this cross-sectional descriptive and analytic study. The dentists were asked to answer a questionnaire with 16 questions related to anaphylactic shock. The results were analyzed with descriptive tests and chi-squared test using SPSS 16 (α = 0. 05). The mean age of dentists was 40±5 years. More than half of the subjects (63. 1%) had selected epinephrine as the first drug in the treatment of anaphylaxis، but only 28% of the dentists preferred intramuscular route as the most effective route for epinephrine injection. There were no significant correlations between gender (p value = 0. 843)، work experience (p value = 0. 955) and academic rank of dentists and their awareness (p value = 0. 895) about anaphylactic shock. The results of the present study showed that most dentists do not have sufficient knowledge about anaphylaxis، the necessary measures and latest developments in recent years، indicating the necessity of changing attitudes toward this vital issue. It is suggested that targeted training programs be provided on the subject.

Dentists use panoramic radiographs to assess the relationship between impacted wisdom teeth and inferior alveolar canal before their surgical removal to avoid injuries to inferior alveolar nerve. The aim of this study was to evaluate inferior alveolar canal configuration and position adjacent to the impacted mandibular third molar by panoramic radiography. In this descriptive study، standard panoramic radiographs with 384 impacted lower third molars were selected. The relationship between inferior alveolar canal and the roots of impacted mandibular third molars was evaluated by two experienced experts. Data were analyzed by SPSS 11. 5 using descriptive statistics. Evaluation of panoramic radiographs showed superimposition of the canal on third molar roots (85. 4%)، periapical radiolucency (28. 4%)، a decrease in the density of tooth roots (19. 8%)، deviation of mandibular canal (11. 5%)، narrowing of mandibular canal (3. 4%)، interruption of radiopaque border of mandibular canal (2. 9%)، and external root resorption (2. 1%). In some cases more than one abnormality were observed in tooth roots. In the present study، superimposition of the roots of third molars on the superior border of the inferior alveolar nerve canal and external root resorption of third molars were the most and least common anomalies on radiographs، respectively. In addition، mesial angulation، class I and type B were the most common types of impaction of mandibular third molars.

Dental caries is the most common infectious and transmissible disease of the teeth. Significant Caries Index is one of the indices defined by WHO to identify individuals who have the highest DMFT (Decayed، Missing، Filled teeth). The aim of this study was to evaluate DMFT index and Significant Caries Index in 12-year-old male students in Sirjan. In this cross-sectional descriptive-analytical study seven hundred 12-year-old students from Sirjan، selected by systematic cluster-randomized sampling، were evaluated. Data were collected by examination and a questionnaire. The teeth were examined with a blunt-tip dental explorer، a dental mirror and illumination by torchlight. The questionnaire consisted of questions on parents’ educational level، birth rank of the student، number of children in family، toothbrushing frequency، fluoride use and dental visit status. Data were analyzed with SPSS 16 using t-test and one-way ANOVA (α = 0. 05). The mean of DMFT and SiC indices were 3. 56 ± 2. 34 and 6. 04 ± 1. 32، respectively. There were significant relationships between DMFT index and the number of children in the family (p value = 0. 016)، birth rank (p value = 0. 042)، toothbrushing frequency (p value = 0. 000) and fluoride use (p value = 0. 042). However، there were no significant relationships between DMFT index and parent’s educational level (p value = 0. 047) and dental visits (p value = 0. 198). The means of DMFT and SiC indices in 12-year-old students in Sirjan were higher than standards defined by WHO. Furthermore، the number of children in the family، birth rank، toothbrushing frequency and fluoride use had significant effects on dental caries in students.

Computers and the Internet are considered useful tools to develop and improve health care services. The aim of this study was to evaluate knowledge، attitudes and skills of general dentists in Isfahan about the use of computers and the Internet for professional purposes in 2013. In this cross-sectional study 294 general dentists were recruited. Simple random sampling was used and data collection tool was a questionnaire. The questionnaire’s validity and reliability were confirmed. It included four sections: demographic data، knowledge، attitude، and skills. The questionnaire was completed by the participants. Data was analyzed with descriptive tests، t-test، chi-squared test and Pearson’s correlation using SPSS 16 (α = 0. 05). Of the participants 63. 3% had a computer and 61. 6% had access to the Internet in their office. The mean scores of the participants for knowledge، attitude and performance were 23. 4 ± 8. 9، 40. 1 ± 5. 5 and 4. 7 ± 2. 6، respectively. Age and sex had no significant relationship with the participants’ knowledge، attitude and performance (p value > 0. 05). The results showed a significant، but weak، correlation between attitude and job experience (p value = 0. 043، r = -0. 012). In addition، 80. 4% of the participants were interested in taking part in computer courses. Considering the results of this study، the knowledge and skill of using computer and the Internet of Isfahan dentists was at a moderate level and their attitude was at a high level in Isfahan and a large number of them were interested in participating in educational courses. Therefore، considering the importance of this issue and a high attitude level of dentists and their interest in gaining skill، additional training in this area is recommended.

Foreign bodies in maxillary sinuses are classified as either traumatic or iatrogenic. The routes of entry of metal foreign bodies، such as dental amalgam، are usually oroantral fistulas or traumas. The present report explains a rare case of a procedural accident that during a dental procedure. Case Report: A 30-year-old man presented to the dental office for a restorative procedure on his upper right second molar. During the dental procedure، furcation area and the inferior wall of maxillary sinus were penetrated. After packing of amalgam and suspected bleeding in the area، radiography revealed amalgam beyond the furcation area within the right maxillary sinus. The tooth was extracted and the patient was referred to a maxillofacial surgeon for treatment. Foreign bodies in paranasal sinuses، especially metal objects such as amalgam، must be removed to prevent chronic mucosal irritation or malignant mucosal alterations even if they are asymptomatic. Thus، it is recommended that dentists pay attention to the creation of oroantral fistulas during dental procedures and existence of foreign bodies in sinuses and refer the patient to a specialist، if necessary، to prevent potential complications.