fatemeh ayatollahi

Identification and completely cleaning the extra root canals are crucial for the success of endodontic treatment. Prevalence of the middle mesial canal (MMC) in mandibular molars is still a topic of debate due to the complex and diverse anatomy and morphology of these teeth. This study aimed to investigate the prevalence of MMC in mandibular molars using CBCT radiography.

In this descriptive cross-sectional study, 300 CBCT images obtained between 1995 and 2019 in a private oral and maxillofacial radiology center in Yazd, Iran, were evaluated. The first and second mandibular molars were examined for the presence of MMC based on the patients' age, gender, tooth location, and type. Data were analyzed using SPSS 17 and the Chi-square.

Out of 300 mandibular molars (122 first molars and 178 second molars), MMC was found in only 18 teeth (6%). The prevalence of MMC was significantly higher in the first molars (18 cases) than in the second molars (0 cases). Twelve MMCs were observed in females and 6 in males. 12 MMCs were located in the left side and the rest in the right side. The mean age of individuals with MMC was 37.33±15.27. There was no statistically significant association between the presence of MMC and age, gender, or tooth location (P > 0.05), but the prevalence of MMC was higher in the first molars than in the second molars (P = 0.0001).

The prevalence of MMC in mandibular first molars was low in the studied population and was not detected in mandibular second molars. Nevertheless, the possibility of MMC should be considered during the treatment of teeth.

Vital pulp therapy includes is differnt methods that are used to preserve pulp vitality and root development in immature permanent teeth with thin dentin wall and open apical foramen which have been damaged or inflamed due to dental caries, trauma, or during the restoration. This study was conducted to assess the knowledge of Yazd general dentists toward Vital pulp therapy in immature permanent teeth in 2022.

In this descriptive-cross-sectional study, a valid and reliable questionnaire, including demographic information and 15 questions related to the knowledge of vital pulp therapy was distributed among 150 general dentists in Yazd City, Iran. Data were analyzed using SPSS-22 software, T-test and ANOVA.

The participants in this study, included 55.3% men and 44.7% women with an average age of 34.25 (±7.32) years old and an average years of job experience of 8.32 (±7.04). Among them, 35.3% had participated in dentistry retraining courses. The average knowledge score of the participants in this study was 9.2 out of 15. The average score in different groups did not show any significant difference in terms of age, sex, job experience, work place and participation in retraining courses. (P-value >0.05)

Yazd general dentists had intermediate level of knowledge about the vital pulp therapy of immature permanent teeth. It seems that the need for retraining courses to improve the level of knowledge about vital pulp therapy to help choosing the best treatment plan for young permanent teeth is evident.

Dentistry is not only an evolving science but also an art with good eye-hand coordination. A variety of magnification devices are used in dentistry to increase the clarity and accuracy of examinations and surgeries. The purpose of this study is to evaluate knowledge, attitude and practice toward using dental magnification among dental residents and dental professors.

In this cross-sectional descriptive study, all professors and residents were studied by census. A questionnaire was administered to the clinical faculty to assess three parameters: knowledge, attitudes and practice of magnification devices among dental residents and masters. The questionnaire consisted of 4 parts: demographic information, knowledge (11 questions), attitude (7 questions), and practice (4 questions). Data were analyzed by SPSS 23 statistical software and analyzed by T-tests and one-way analysis of variance (ANOVA) and Chi- Square.

A total of 81 dentists completed the research questionnaire, of which 50 (61.7%) were male and 31 (38.3%) were female. Most dentists answered knowledge questions about depth and field of view changes with increasing magnification and the ability to adjust eye convergence under a microscope (74.1%). Also, the results of ANOVA statistical test did not show a significant difference between the scores of dentists’ attitudes according to the field of specialization.

Although the skill of dentists was acceptable at using magnifying devices, they had little knowledge about the importance of this issue. The most important reasons were mentioned lack of access and high cost of using these devices.

Microleakage is one of the most important factors in the failure of root canal treatment. Microhardness is one of the physical properties of bioceramics that can be affected by various environmental factors such as enviromental humidity. The aim of this study was to evaluation the effect of adding water to semi-setting cement on the microhardness and microleakage of CEM cement.

50 single-rooted teeth were selected. Teeth were cut from the CEJ region and the apical 3 mm of the root were trimmed and dentinal blocks with 5 mm height were prepared Peeso reamer size 2 was used to prepare the canal. The teeth were divided into two groups of 23 cases and two groups of 2 positive and negative controls. In the first group, CEM-cement prepared according to the manufacturer's instructions was placed in the canal. In the second group, after adding water to the semi-setting CEM cement mixture, the canal was filled with this cement. The samples were placed in 1% methylene blue for 3 days and then cut. Microleakage was recorded under a stereomicroscope. The microhardness of the samples was measured with Vickers device after mounting in acrylic resin. Statistical analysis was performed using SPSS19 software and Mann-Whitney Kruskal-Wallis and one-way ANOVA tests.

There was a statistically significant difference between the two groups in microleakage (P-Value <0.008) and microhardness (P-Value <0.001).

According to the results of the present study, adding water to the semi-setting CEM cement not only does have a very bad clinical effect, but also may even increase sealling ability.

The third root of mandibular molar teeth is the most important normal anatomical variation in these teeth. Failure to recognize the presence of this root is one of the most common reasons for treatment failure in these teeth. Therefore, the aim of this study was to investigate the prevalence of Radix Entomolaris in the mandibular first and second molars in the population of Yazd City using CBCT imaging.

In this study, 217 CBCT images prepared in an oral and maxillofacial radiology clinic were examined. The presence of the third root in the first and second molar teeth of the mandible was investigated according to the gender of the patients and the side of the tooth placement. Data were analyzed using SPSS16 software and Chi-Square statistical test. 

The prevalence of Radix Entomolaris in the present study in first molar and second molar teeth was recorded 5.1% and 1.8%, respectively. It was reported that its bilateral prevalence was 1.4%. In unilateral cases it was observed more on the right side. The occurrence of Radix Entomolaris had no statistically significant relationship with gender (P>0.05).

The overall frequency of Radix Entomolaris in the population of Yazd City is 6.9%. Its frequency is more likely to be unilateral, mostly in the first molar and without the influence of gender.

Nowadays, in the treatment of necrotic teeth with open apex, based on the availability of bioceramic biomaterials with the ability of calcified tissue induction on cement and bone and periodontal ligament repairment stimulation using these materials has become more acceptable than the traditional calcium hydroxide apexification method. Cold ceramic is one of these bioceramics that in previous studies has shown successful results in the treatment of apexification.

Case Report:

 This article was a report of a successful case of apexification with cold ceramic and 10-months follow up of second mandibular molar tooth of a 14-year-old girl. In 10-month-old follow up, the tooth was asymptomatic and the periapical lesion healed after 10 months.

: It seems that cold ceramic could be used as a desirable material in the treatment of apexification and to strengthen the regeneration of periapical tissue.

Oral cavity is the entrance gate of respiratory and gastrointestinal tract. Therefore, oral health could be as mirror of global health. Timely diagnosis & early treatment of oral lesions, especially in susceptible admitted patients in infectious disease department have a vital role in health policy. Therefore, this study was designed to assess the frequency of oral soft tissue lesions in patients admitted to the Infectious department of Yazd Shahid Sadoughi of Medical Sciences.

This cross-sectional study was carried from January 2018 to March 2018. Eighty-nine who were admitted to the department of infectious diseases were eligible to participate. Clinical data regarding age, sex, type & site of lesions, oral hygiene status, smoking, and dental prostheses were documented. Data were analyzed by SPSS 19 using Chi-square and Fisher exact tests. The significance level was set at 0.05 with a 95% confidence interval.

49 men and 40 women with the age of 53.4± 14.3 years were examined. The frequency of oral lesions in hospitalized patients in the department of infectious diseases reported 30%. Red-white lesions (57.78%) and vesiculo-bullose lesions (40%) were the most frequent lesions, respectively. Among studied variables, frequency of oral soft tissue lesions based on age (P=0.001), smoking (P=0.034) and oral health status ((P=0.042) had a meaningful difference.

This rate of frequency due to known side effects is a matter of concern and it is considered by experts

Oral cavity, as the main source of complications such as infection, is unfortunately ignored in cancer patients. In this study, the frequency, type, and location of oral mucosal lesions were determined among patients admitted in the hematology and oncology department.
In this cross-sectional study, 88 admitted patients were examined between November 20, 2017 to August 21, 2018. Demographic data, history of smoking, and denture use were documented. Oral examinations were further conducted to evaluate oral soft tissue lesions according to the checklist.
88 hospitalized patients were screened, out of whom 57(64.7%) had at least one lesion. A total of 79 oral mucosal lesions were identified and ulcerative lesions, found in 51 (57.9%) patients, were among the most frequently encountered problems. Pigmented lesions were more prevalent in smokers (P<0.001). Red and white lesions were significantly more than other lesions among complete denture wearing patients.
In light of the high prevalence of oral complications in our patients, this study indicates the need for consultation with oral medicine specialist for a timely diagnosis and better management during the treatment process.

Dental anxiety is one of the important reasons for avoiding dental treatment and, in the long time it can result in decrease in oral and dental health as well as decrease in quality of life of patients. Furthermore, the presence of anxiety in the patients and its repetition in the examination of patients can also affect the efficiency of dentists. The aim of this study was to investigate the effect of verbal education on the anxiety of patients with irreversible pulpitis

In this clinical trial, 96 patients with irreversible pulpitis of maxillary premolars referred to Khatam-ol-Anbia Specialty Clinic in Yazd, Iran were randomly studied into case and control groups. Before the start of the treatment, a verbal description of the therapeutic measures and type of devices was given to the case group patients for 15 minutes, but no verbal education was given to the control group. Patients completed the Standard Dental Anxiety Scale (DAS). The data were statistically analyzed using SPSS17 software and T-test and paired T-test.

Before the intervention, the anxiety score in the control group was 10.46 and in the intervention group was 11.71 (p > 0.05), and after the intervention, it was 8.65 and 8.21 respectively (p > 0.05). The rate of anxiety reduction in the intervention group was significantly more than the control group (p =0.017).

The reduction in anxiety score in the intervention group was significantly more than the control group, which was the result of intervention and it can be said that the verbal explanation was effective in reducing the anxiety of the patients.

The present study aimed to investigate the different levels of Galacto oligosaccharide prebiotic on growth performance and intestinal morphology of Carassius auratus gibelio. A number of 240 baby fish with the mean weight of 4.88 ±0.28 g were divided into four groups. The first group as the control was fed with basic diet (having no Galacto oligosaccharide) while the second, third, and fourth groups were fed with the diets containing 0, 0.5, 1 and 2 % Galacto oligosaccharide for six weeks. At the end of the test, the growth markers were calculated (including final weight, specific growth rate, and food conversion ratio). Then, intestinal biopsy was conducted and the mean length, width, and absorption surface of intestinal villus were measured in each treatment. The results indicated a significant effect of treatment with 2% Galacto oligosaccharide on villus length, width and absorption surface in Carassius auratus gibelio (P<0.05). However, no significant difference was found between treatments in terms of growth parameters. Due to the significant effect of Galactooligosaccharide prebiotic on the increase of absorption surface in Carassius auratus gibelio as well as the relative increase of growth parameters int he fish fed with Galacto oligosaccharide than the control treatment, it seems that this substance can be used as a suitable stimulating factor of growth and feeding in the diets of red ornamental fish.

Proper seal is needed for successful endodontic treatments such as apical plug treatment. Some of studies have been shown that tissue fluid can affect the sealing ability adversely. The purpose of this study was to evaluate the sealing ability of CEM cement apical plug in dry, blood contaminated and saliva contaminated canals. 70 single root and single canal extracted human teeth were decornated from CEJ. preparation of apical area were done up to #40 K-file using step back method and coronal area was enlarged up to #80 k-File. After open apex condition reconstruction and creation of dry, blood contaminated and saliva contaminated canal condition, CEM cement apical plug was inserted into the canal. After full setting of CEM cement, the remnant of canal space was obturated using gutta percha and AH26 sealer. Microleaksge value was evaluated with fluid filtration method and data were analyzed using and kruskalwalis and Mann-whitney tests. Based on our data, the microleakage value was 26.96, 44.36 and 27.00 in dry, blood contaminated and saliva contaminated canal, respectively. The micro leakage value in blood contaminated condition was significant lesser than dry and saliva contaminated condition ( P-value= 0.000) It seems that however, sealing ability of CEM cement reduce in blood contaminated condition; but dose not affected by saliva contamination. Of course, more invitro and animal study are recommended to confirm these results.

 Sealing ability is one of the most important factors for successful endodontic treatment. Some studies have shown that the powder to liquid ratio can influence the properties of dental materials. Subsequently, this may happen for those used for sealing in endodontics. The purpose of this research was to assess the microleakage of calcium-enriched mixture cement (CEM cement) apical plug in different powder to liquid ratio. Ninety-six extracted human single root and single canal teeth were decoronated. Working length was determined using ≠15 k-file. Canal preparation was performed using step back method. Samples were divided into 3 groups randomly. CEM cement was placed into the canal with 1.13, 2.27 and 3.40 powder to liquid ratio in the group 1, 2 and 3, respectively. After complete setting of CEM cement, the micro leakage value was evaluated using fluid filtration method. Data were analyzed using ANOVA and Scheffe tests. The bubble movement in three groups showed a statistically significant difference (p< 0.001). Minimum and maximum bubble movements were observed in the group with powder to liquid ratios of 3.40 and 1.13 respectively. Increased CEM Cement powder to liquid ratio will increase the sealing ability of this material as apical plug. Considering the conditions of this study, the powder to liquid ratio of 3:40 provided the best sealing ability.

File Fracture is one of the most common problems during root canal treatment which can affect treatment procedure and prognosis, so it is important to diagnose and prevent it. The aim of this study was to evaluate and compare the diagnostic value of cone-beam computed tomography (CBCT) and digital periapical radiography for detection of separated instrument retained inside the canal. Methods and Materials: Ninety single-rooted extracted human teeth were selected and randomly divided into 3 groups (n=30). Group 1, separated file #10 at the 2-mm apical third of the root canal; group 2, separated file #35 at the 2-mm apical third of the root canal; and group 3, without a broken file (control group). The teeth were instrumented to size #30 and were shaped to size #55 and then the canals were obturated up to separated instrument, or the working length for the teeth without a separated instrument, with lateral condensation technique. After that all teeth were placed in dry skull, digital radiography and CBCT was taken. After data collection, data was analyzed using SPSS software by means of sensitivity, specificity, positive and negative predictive values, and frequency tables. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography in detection of a fractured file #10 in the canal was 96.7% and 63.3%, 76.7%, 73.1%, 67.6%, 70%, for CBCT, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography in detection of a fracture file #35 in the canal was 93.3%, 96.7%, 96.6%, 93.5% and 95%, and 36.7%, 76.7%, 61.1%, 54.8%, 56.66%, for CBCT, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography was better than the CBCT technique in both sizes of broken files.

Multiple methods for evaluating microleakage have been introduced over the years, but there has been no agreement as to which technique will give more accurate results. The aim of this study was to compare the accuracy and results of fluid filtration and marginal adaptation methods for mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement apical plugs.
Methods and Materials: A total of 250 single-rooted human teeth were collected. The teeth were decoronated, the root canals were prepared and open apex condition was stimulated by passing #1 to 4 Peeso Reamer drills from apical foramen. Five teeth were selected as the positive and negative controls and the rest of the samples were randomly allocated to two groups of MTA and CEM cement plugs. In each group, apical plug was placed into the canal. After the apical plugs were completely set, microleakage and marginal adaptation of the samples were evaluated using fluid filtration method and scanning electron microscopy (SEM), respectively. The obtained results were analyzed by independent-samples t test.
Gap between plug and dentin walls and air bubbles displacement was higher in MTA group compared to the CEM cement group, though this difference between MTA group and CEM cement group was not statistically significant.
According to the obtained results, it seems that there is a direct relationship between the two methods of microleakage assessment.

Leishmaniasis is a protozoal disease transmitted by sand-fly. The term leishmaniasis encompasses multiple clinical syndromes.
A 24-year-old male native of Yazd, Iran, was referred from the dental and subsequently to the infectious clinic with complaints of ulcer and swelling over his lower lip for three months. The lesion progressively increased in size over a few weeks and there was no history of fever or other complaints. The lesion had response to treatment with multiple antibiotics by various medical practitioners.
The case was interesting according to the rare location of the lesion since it can be confused with other infectious diseases.

Calcium hydroxide (CH) is one of the most common intracanal medications. Corticosteroids (CS) are used in endodontics because of their anti-inflammatory activity. This study aimed to evaluate the antimicrobial effect of CH+betamethasone and CH+saline against Enterococcus faecalis (E. faecalis) using agar diffusion test and measuring the microbial zone of inhibition (ZOI). Methods and Materials: Four plates containing Mueller-Hinton broth and E. faecalis culture media, were prepared. In each plate, 5 holes (5×3 mm) were created and a creamy mixture of CH+betamethasone was inserted into the holes (10 holes for each material). Two holes with ampicillin disks and two empty holes were used as negative and positive controls, respectively. Plates were incubated for 24 h and then the diameter of microbial ZOI was measured. The pH of each mixture was measured by pH meter. Data were analyzed using the Mann-Whitney U test. The mean diameter of ZOI for CH+betamethasone and CH+saline was 3.4 and 3 mm, respectively. The difference was not significant (P=0.143). The pH was 12.5 for CH+saline and 12.3 CH+betamethasone, respectively. The mixture of CH+betamethasone had good antimicrobial effects against E. faecalis. Further studies are needed to confirm the value of this mixture in clinical settings.

The treatment of pulpal necrosis in an immature tooth with an open apex presents a unique challenge to the dentist. Revascularization is a new treatment procedure for the management of these cases. This study examined the ability of demineralized bone matrix as a scaffold to aid pulp revascularizaion of immature cat teeth. Sixteen immature teeth from 4 cats after preparation of access cavity and cleaning of canals, were placed into two groups; control group containing blood in canal and experimental group containing blood + demineralized bone matrix. Teeth were treated with revascularization technique and cats were followed up for four months. Then periapical radiographs were taken and analyzed for presence of apical radiolucencies, apical closure and thickening of root canal walls. The data were statistically analyzed using Fisher's exact test. 0.05 was established as a level of significance. The two groups showed no statistical difference regarding presence of apical radiolucencies, apical closure and thickening of root canal walls. In control group, none of the teeth showed any apical radiolucencies and 75% of teeth showed apical closure and thickening of root canal walls. In experimental group, none of the teeth showed any apical radiolucencies, 90.9% of teeth showed apical closure and 81.8% showed thickening of root canal walls. Based on the results of this study, the demineralized bone matrixes do not have adverse effect on revascularization procedure and can be used as a scaffold in this technique.

Background and aims. Inferior alveolar nerve block injection is one of the common intra oral anesthetic techniques, with a failure rate of 15-20%. The aim of this study was to evaluate the position of the lingula as an index for this injection.Materials and methods. Thirty eight panoramic radiographs of 7–11 year old patients were analyzed and the distance between the lingula index and occlusal plane was measured. Then, lower alveolar nerve block injection was performed on 88 children. Finally, a visual analogue scale was used to measure the rate of pain in the patients.Results. This distance increased with age and in children younger than nine years is −0.45 mm on the right side and −0.95 mm on the left side. This distance in children older than 9 years is −0.23 mm on the right side and 0.47 mm on the left side.The success rates of inferior alveolar nerve block injection based on lingual index were 49% on the right side and 53.8% on the left side. Conclusion. As the lingual index has various positions and its distance from the occlusal plane increases with age, it is not an appropriate landmark for inferior alveolar nerve block injection.

Background and aims. The exposure and processing of dental radiographs are not routinely associated with the spatter of blood or saliva; however, infection control is still an issue resulting from contaminated equipment, supplies, film packets or cassettes. This study aimed at comparing the efficacy of four commercially available disinfectants on microorganisms present on the equipment of radiology department.Materials and methods. Samples from twelve sites of the radiology department were collected using a sterile swab smeared with normal saline, which was then dipped in a test tube. Experimental surfaces were then disinfected by the spray-wipe-spray method using one of Micro 10, Deconex, Alprocid or Microzid AF disinfectants, followed by resampling. The samples were subsequently cultured on blood agar and EMB plates and the colonies were counted. Isolates were identified by biochemical tests. For statistical analysis, Wilcoxon signed ranks test, Kruskal-Wallis, Chi-square and Fisher exact tests were used.Results. Staphylococcus aureus and coagulase-negative staphylococci had the highest and Lactobacillus spp. had the lowest prevalence before disinfection. There were significant differences between the cfu/mL of bacteria before and after disinfection with any of the four disinfectant solutions. There was a significant difference between efficacy of Deconex and Alprocid (P = 0.014), Deconex and Microzid AF (P = 0.001), and Deconex and Micro 10 (P = 0.001). Conclusion. According to the results, Deconex has the highest disinfectant efficacy compared to other solutions.

Physicians are at risk for exposure to infectious agents from a variety of sources throughout their workday. Their impact cannot be underestimated, but it remains clear that with simple infection control procedures and universal precautions such as the use of gloves, masks, and frequent hand washing, dermatologists can protect themselves from most of these risks. The use of thoughtful surgical technique, and practice of laser safety techniques such as the use of an evacuator, are simple to apply and are high yield in terms of peace of mind and decreasing infectious risks. Preventive strategies provide dermatologists with the safest working environment to care effectively and efficiently for all of their patients.