Journal of Dentistry, Shiraz University of Medical Sciences
Volume:23 Issue: 2, Jun 2022

Statement of the Problem:

As a stimulant drug of the central nervous system, methamphetamine reduces salivary secretion by stimulating inhibitory α2-receptors in the sympathetic system. The acidity of this substance reduces the salivary pH and causes severe dental caries and erosion in the cervical region of teeth, appearing as "meth mouth".

This study aimed to determine the effects of methamphetamine withdrawal on the volume and pH of stimulated saliva in patients under treatment at rehabilitation centers.

This descriptive cross-sectional study was conducted on a total of 20 individuals at the rehabilitation centers of Gorgan, Iran. The volume and pH of stimulated saliva were measured at three intervals: before withdrawal, four days after withdrawal, and 30 days after withdrawal. Data analysis was performed using ANOVA test in SPSS.

The results showed a significant difference in the mean volume of saliva before and after withdrawal (p< 0.05). Thirty days after withdrawal, the mean volume of saliva was significantly different from the mean volume after four days (p< 0.05). Moreover, the mean pH of saliva after withdrawal was significantly different from the mean pH before withdrawal (p< 0.001). On the other hand, the mean salivary pH at 30 days after withdrawal was not significantly different from the mean pH on the fourth day after withdrawal (p> 0.05).

It seems that methamphetamine withdrawal influences the volume and pH of stimulated saliva in patients under treatment at rehabilitation centers.

Statement of the Problem:

 Molar teeth with furcation involvement are one of the most common problems in patients with periodontal disease. Regeneration methods are of the most controversial treatment strategies for these lesions.

The purpose of this study was to determine the effect of plasma rich in growth factors (PRGF) with 1.2% Atorvastatin (ATV) in the treatment of furcation involvement of mandibular molars.

The present randomized clinical trial was conducted on 15 patients with moderate periodontitis and class II furcation involvements; 24 defects were located in four groups of six, including debridement, ATV1.2%, PRGF, PRGF with ATV1.2%. The parameters of vertical probing depth (VPD), vertical clinical attachment level (VCAL), gingival index (GI), horizontal probing depth (HPD) and gingival recession (GR) were measured at baseline (T0), immediately before surgery (T1), 3 (T2), and 6 (T3) months after surgery. Moreover, the bone conditions were evaluated by digital subtraction radiography before and six months after surgery. Data were analyzed using SPSS23 software.

No significant difference in radiographic parameters was observed among the groups (p= 0.08). There was no significant difference in the mean levels of VPD, VCAL and HPD among the groups at different times (p<0.05). Comparison of clinical parameters of VPD, VCAL and GI in the treatment groups compared to the baseline showed a significant improvement in each group (p< 0.05) but there was no significant difference among different groups (p< 0.05).

The use ofPRGF with ATV 1.2% in grade II furcation involvement in mandi-bular molars was effective in the improvement of clinical and radiographic parameters six months after treatment, but this effect revealed no difference in comparison with the other groups.

Statement of the Problem:

Growth assessment has become an important issue in many medical and dental fields. Determining the stages of dental development and skeletal maturation are essential methods in evaluation of growth phases.

This study aimed to assess the relationship between developmental stages of maxillary and mandibular canines and second molars by Nolla’s methodand skeletal maturation stages by cervical vertebral maturation. In addition, diagnostic performances of dental developmental stages were evaluated to identify growth phases.

In this descriptive-analytical study, 201 digital panoramic and lateral cephalometry of children referred to the Orthodontic Department of Babol Dental School (8 to 15 years) were examined. The stages of dental development were determined by Nolla’s method, and the stages of skeletal development were determined by cervical vertebral maturation stages (CVMs). Positive likelihood ratio (LHR+) was used to determine the diagnostic performances to identify growth phases. The Kendall's Tau-b correlation coefficient was used to measure the association between the CVM stages and dental calcification stages. In this study, p ≤ 0.05 was considered significant.

The relationship between dental development and skeletal maturation in different teeth was significant (p ≤ 0.05). Kendall's Tau-b correlation coefficient between the stages of dental development and skeletal maturity in girls ranged from 0.578 - 0.634 and in boys ranged from 0.588 - 0.655. The right second molar in maxilla presented the highest correlation coefficient. The right and left second molars in maxilla and left second molar in mandible in stage 5 had the highest LHR+ to identify the pre-pubertal growth phase.

Despite the high correlation coefficient between dental development and skeletal maturity, the LHR+ for determining growth stages in only a small number of teeth was more than 10.

Statement of the Problem:

 Caffeine intake affects bone metabolism through inhibition of osteoblast proliferation.

This study aims to assess the effect of caffeine consumption on implant stability in the healing period of patients.

A prospective cohort study is designed to assess implant stability in the posterior of the maxilla. Patients were divided into two groups based on daily caffeine intake as group 1 with consumption of 400 mg/daily caffeine or more, and group 2 with consumption of 100 mg/daily caffeine or less. The implant stability was measured by resonance frequency analysis (RFA). The mean implant stability quotients (ISQs) were calculated. RFA measurements were made at 4, 6 and 8 weeks after implant placement.

A total of 102 patients were studied (51 in each group). The mean of ISQ was 43.49± 2.32 in the group 1 and 42.78±2.34 in the group 2 at four weeks after insertion. The mean of ISQ was 50.86±3.06 in group 1 and 51.37±2.44 in the group at six weeks after implant placement. At eight weeks after implant surgery, the mean of ISQ was 56.78±3.77 in the group 1 and 57.84±1.82 in the group 2. The mean of ISQ between the two groups at 4, 6 and 8 weeks after implant placement was not statistically different. (p = 0.13, p = 0.36 and p = 0.08 respectively) The repeated measure test indicated a similar increase in ISQ in various study times in the two studied groups (p =0.47, df=1, F=0.52).

Acquired data suggest that caffeine intake may not have a negative effect on implant stability in the healing period at the posterior of the maxilla.

Statement of the Problem:

 In recent years, regeneration of periodontal soft tissues in the reconstruction of periodontal defects and the finding of suitable membranes and graft materials for the placement of autogenous grafts have been of great interest in various studies. In this regard, the proliferation and adhesion of regenerative cells are two linchpins of the complete regenerative process.

This study aimed to evaluate the effects of low-level laser beams on the attachment and the proliferation of human gingival fibroblasts in the presence of acellular dermal matrix (ADM).

All the experiments were conducted compared to tissue culture plate in four groups as follows: (1) Fibroblast+ADM+laser, (2) Fibroblast+ADM+ no laser, (3) Fibroblast + laser radiation, and (4) Fibroblast+ no laser. In this experimental study, the primary attachment was evaluated by passing 8h from seeding of 5×105 gingival fibroblasts with or without a single dose (15.6 J/cm2) of laser radiation. Cell proliferation rate was also examined at 24, 48, and 72 hours after cell culture, following exposure to 5.2 J/cm2 of laser at each day of examination. Thereafter, fibroblasts were incubated under the normal culture condition (at 37°C, 5% CO2) in high glucose Dulbecco's Modified Eagle's medium (DMEM) medium supplemented with 10% fetal bovine serum, 1% glutamax, and 1% penicillin/streptomycin. Subsequently, the cellular viability was assessed on each time point using MTS calorimetric assay. The obtained data were statistically analyzed by applying ANOVA and Tukey tests.

There was a significant difference among the means of these four groups in terms of the proliferation of fibroblasts at 24, 48 and 72 hours (p < 0.001). Moreover, there was no significant difference among the means of two groups in terms of fibroblastic attachment in 8 hours (p < 0.2). The fibroblast group has shown the highest proliferation rate among all groups after laser radiation.

It was indicated that the laser radiation increases the fibroblast cell proliferation. Accordingly, although this increase was higher in the fibroblast group alone compared to the fibroblasts cultured on acellular dermal matrix, the laser radiation did not significantly increase the attachment of fibroblast cells to acellular dermal matrix.

Statement of the Problem: 

There are global efforts for introducing a new herbal antimicrobial agent with minimal side effects. There are some reports about the antimicrobial properties of Pimpinella anisum and Oregano Vulgare.

In this study, the antimicrobial properties of Pimpinella anisum and Oregano Vulgare have been assessed.

In this experimental in vitro study, the dental plaque samples were collected from children aged 3 to 5 years old who were referred to a private dental office with diagnosis of dental caries. After determination of the bacterial colonies of Streptococcus sanguinis, Streptococcus mutans and Streptococcus salivarius, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of ethanolic and methanolic extracts of Pimpinella anisum and Oregano vulgare were measured by macrodilution and microdilution methods.

The mean MIC and MBC of Pimpinella anisum extract and Oregano vulgare extract and their combination against Streptococcus mutans, Streptococcus sanguinis, and Streptococcus salivarius were statistically different (p< 0.001). The combination of these extracts showed the lowest MIC and MBC.

Hydroalcoholic extracts of the Pimpinella anisum and Oregano Vulgare were effective antibacterial agent against Streptococcus mutans, Streptococcus salivarius, and Streptococcus sanguinis so the combination of these two extracts showed the highest antibacterial properties on all the bacteria evaluated.

Statement of the Problem:

Healing complications after the conventional surgical biopsy procedure along with bacterial colonization indicates scope for sophisticated techniques. Amalgamation of photo-disinfection along with healing properties of diode laser with practiced biopsy technique can help in dealing with post biopsy complications.

The present study will analyze the possibility of conjugation of conventional surgical biopsy technique with diode laser regarding its superior properties for achieving better healing and analgesia along with sterilization of the biopsy site.

A randomized control trial was done where punch biopsy procedure was performed for homogenous leukoplakia. Patients were randomly divided into laser group (Test group) and control group. Test group received laser ablation and low level laser therapy (LLLT) on surgical site along with warm saline rinses whereas control group was prescribed with systemic analgesic and antibiotics. Pain on visual analogue scale (VAS), erythema along with the size of defect was evaluated on day 0, 2 and 4. Swabs were collected from the biopsy site and culture was done for evaluation of bacterial load.

Highly statistical significant values indicating laser induced analgesia were obtained after analysis for 2nd and 4th day (p= 0.00). Erythema and biopsy defect size evaluation showed significant results for 2nd day (p value 0.023 and 0.004 respectively), which showed absence of erythema and enhancement of healing in test group compared to controls. Statistical significant results were obtained for estimation of bacterial colonization with p value as 0.00, 0.00 for 2nd and 4th day claiming laser supported bacterial disinfection. There was a significant percentage increase on 2nd (p= 0.013) and decrease on 4th post-operative day (p= 0.022).

The results encourage the conjugation of conventional incisional punch biopsy with low level lasers to avoid systemic intervention for post biopsy complications.

Statement of the Problem: 

Pharmacologic management of uncooperative behavior is a growing trend in dentistry. Determining the most appropriate drug, route of administration, and proper candidate for sedation have been the goal of several investigations.

The aim of this study was to compare the sedative effect of intranasal (IN) sedation of midazolam (MDZ) in compare to dexmedetomidine (DEX) while taking into consideration the effect of dental fear, and psychological status on sedation success.

This double-blind randomized clinical trial included 92 uncooperative dental patients aged 4-6. Study participants were randomly assigned to receive either 0.2mg/kg IN MDZ or 1µg/kg DEX. Sedation was evaluated using the Houpt sedation rating scale. Vital signs were recorded before and during sedation. Prior to sedation, the level of dental fear was determined through children's fear survey schedule-dental subscale (CFSS-DS). Psychological characteristics were screened using the strengths and difficulties questionnaire (SDQ). Data were analyzed using T-test, Mann-Whitney, Chi-square, and repeated-measures analysis of variance (ANOVA).

Overall ratings of sedation and subscales of sleep, crying, and movement were comparable between groups (p> 0.05); however, more acceptable behavior (overall scores (4+5+6) was observed in MDZ group compared to DEX group (64% vs. 47.7%) (p= 0.007). All participants were found to have abnormal levels of dental fear (CFSS-DS≥38). However, according to SDQ, the study participants have mainly shown normal behavioral status. A significant association was found between dental fear and sedation success (MDZ, p= 0.001, DEX, p= 0.03), while similar findings were not observed for psychological characteristics (MDZ, p= 0.09 and p= 0.41; DEX, p= 0.71 and p= 0.53). Physiological parameters remained within normal limits in both groups.

Sedation with IN MDZ resulted in overall behaviors, which were more satisfactory in highly fearful pediatric dental patients. Despite baseline uncooperative behaviors, the psychological status of study participants were close to average and were not associated with sedation failure.

Statement of the Problem: 

Regular dental checkups to diagnose early childhood caries (ECC) are critical for maintaining and improving children's oral health and well-being. The prevalence of ECC is important for planning proper oral health programs. 

This study aimed to investigate the prevalence of ECC and its related factors in children aged 3 to 5 years at Babol, Iran.

This cross-sectional study was conducted on 280 children aged 3-5 years in the kindergartens of Babol. Children were examined for dental caries according to World Health Organization criteria. The variables such as age, gender, health, nutritional habits, parents' educational level, parents' job status, and level of dental care were recorded in the questionnaire. Data were analyzed using t-test, chi-square and ANOVA and p< 0.05 was considered significant.

Average decayed-missing-filled teeth (dmft) were 4.03±3.6 and 73.2% in children with ECC, while 26.8% were caries-free. A significant association was found between age, snack consumption, father’s education, mother’s job, nocturnal drinking milk, tooth-brushing, and a history of dentalcheck up before age 2 with ECC.

The results of this analysis showed a high prevalence of ECC in Babol. Therefore, educational and interventional programs in prevention and dental health care, especially for mothers, nurses, and teachers of these age groups, should be considered.

Statement of the Problem: 

Oral squamous cell carcinoma (OSCC) constitutes more than 90% of oral malignancies. The main risk factors of OSCC include cigarette smoking and alcohol. However, since not all smokers or alcohol drinkers develop this disease, other factors have also been suggested including genetic characteristics of every person to be implicated in the probability of developing OSCC.

Our aim in this study is to investigate the possible relationship between fingerprint patterns and the probability of developing OSCC.

In a cross sectional study, we had 140 patients in 2 groups as OSCC and cancer free. Fingerprints were recorded by fingerprint scanner device. The fingerprint patterns were categorized into three major groups and four subgroups. Groups were tested by chi-square.

The relationship between the main fingerprint patterns and incidence of OSCC became significant (p= 0.037). The frequency of the main pattern of Arch was significantly higher in the experimental group than in the control group (p< 0.05). Considering the main patterns of Loop and Whorl, no significant difference existed between the two groups. Furthermore, the frequency of subtype patterns of Double Whorl and Central Pocket Whorl was significantly higher in the control group than in the experimental group (p< 0.05).

Since dermatoglyphics is contingent upon genetic variations, fingerprint can be used for investigating the susceptibility of people in developing different diseases, though further studies are required in this regard. This method is in no way a substitute for gold standard methods for diagnosis.

Focal cemento osseous dysplasia (FCOD) is a subgroup of benign fibro osseous lesions, which occur in a single site of tooth-bearing areas of jaws. It is usually asymptomatic and noticed accidentally through routine radiological exams. There is often no need for treatment of such lesions. This case was a 28-year-old male patient with a mixed radiolucent-radiopaque lesion in posterior part of his mandible. Based on radiographic examination, cemento ossifying fibroma (COF) was the first differential diagnosis. After the surgical removal of the lesion, histopathologic evaluation was made and the case was diagnosed as FCOD. Fortunately, after a few months of operation, there was no complication and complete bone formation was occurred.

This report describes a regenerative endodontic procedure of an immature permanent incisor with internal root resorption (IRR) and 4-years follow-up. A healthy 8-year-old man was referred for treatment of tooth #9 after a traumatic intrusion. The periapical radiograph showed an IRR and an open apex with periradicular lesion. A diagnosis of pulp necrosis and chronic apical abscess was achieved. In the first appointment, under local anesthesia and rubber dam isolation, an access cavity was designed and the root canal was chemically cleaned under irrigation with 10 mL 1.5% sodium hypochlorite (NaOCl). The root canal was then dried and calcium hydroxide paste was placed. During the second appointment, the root canal was irrigated with 5 mL of 17% ethylenediaminetetraacetic acid (EDTA) for 5 minutes and dried. The blood clot was established in a time of 3 minutes after the bleeding from the periapical tissue was trigged. White mineral trioxide aggregate (MTA) was placed up to the amelocemental junction and the final restoration of the access cavity was carried out. During periodic clinical and radiographic follow-up, the patient remained symptom free, the periapical region was completely healed, inhibition of the root resorption process achieved, and formation of the new periodontal ligament as well as tooth widening development observed, meeting functional expectations after 48 months. The regenerative endodontic procedures are an available option to treat IRR in severely immature teeth. The available literature on the regenerative endodontic procedures applied to IRR treatment is limited, and more research is needed in this field.