مجله دانشکده دندان پزشکی اصفهان
پیاپی 2 (تابستان 1384)

Introduction. P53 has been known as a tumor suppressor gene and also Ki-67 is a cell cycle regulator. The aim of present study was to investigate P53 and Ki-67 protein expression in the epithelial lining of odontogenic cysts and its correlation with their biologic behavior and the degree of inflammation within the cyst wall.Methods. P53 and Ki-67 immunoreactivity in 58 odontogenic cystic lesions including 19 Keratocysts, 20 dentigerous cysts and 19 radicular cysts were studied, using a biotin-streptavidin peroxidase method.Results. Frequency of P53+ Lesions in three groups was not statistically significant and there was no correlation between intensity of staining for P53 and Ki-67 proteins. But we found positive relationship between inflammation and intensity of P53 staining in odontogenic keratocyst. Ki-67 expression in odontogenic keratocyst was higher than dentigerous cyst and radicular cyst, but in this study we could not find any correlation between Ki-67 expression and degree of inflammation.Discussion. Since we couldnt show any Discrepancies in distribution of P53, so the existence of greater proliferative potential and recurring of the odontogenic keratocyst may not be due to higher immortality and continual persistant, compared to other types of examined cysts, but it may be associated with increased potential of cell division. Mean while, expression of Ki-67 in OKC was higher than other cysts. Finally inflammation may disturbe the natural trend of opotosis (P53) and facilate proliferetive ability of epithelial lining (Ki-67) in odontogenic keratocyst.

Introduction. Temporo-mandibular disorders (TMDs) are a group of chronic and common disease that a lot of skeletal, Dental and psychologic factors can have an effect on it. Proposed treatment to control this disorder consists of wide variety of drugs and non-drugs methods beside dental treatment. Some investigations have reffered to relation between TMDs and some psychologic factors such as depression. The aim of this study was to investigate affects of relaxation therapy on TMDs.Methods. This was a clinical trial study. The case group consisted of 25 patients with TMDs and an average mark of depression Beck index of 4/4. After Beck test, patients were taught relaxation therapy methods. These methods were done until-two weeks. After completion of methods, Beck test was done again and TMD patients were re-enaluated.Results. The average incidence of pain in TMJ (in function and Rest) the maximum opening, maximum protrusive and Lateral movement, deviation of mandible in maximum mouth opening, and Beck test mark before and after relaxation therapy were meaningful and changes showed decrease in TMDs signs.Discussion. Findings show the effect of psychologic factors as an independent etiologic factor or dependent precursor of TMDs. These effects shouldn’t be ignored, therefore the relaxation therapy without any side effects can be a combined method with other methods to increase patients cooperation because of foovering the pain.

Introduction. In order to obtain good radiographs having optimum processing solution is important. Generally after a period of time the solutions will be oxidized and loose their efficacy. The goal of present research is comparison of the quality stability of four processing solutions available in market "Champion, Teifsaz, Cronex and Novin".Methods and Materials. One hundred and twenty eight intraoral radiographic films of one type with specific speed were exposed under identical exposure factors. A metal step wedge was used for the image. Each 4 days two periapical films were exposed and processed this was continued for two months. Finally optical density of radiographs processed in each solution were measured and compared according to the day of investigation.Results. All of the four solutions created acceptable density on the radiographs on the first day but there was a decrease in optical density after a period of time. Generally the Champion solution made the best density and after that were Cronex, Teifsaz and Novin. There was a decrease in the quality of Teifsaz, Cronex, Champion and Novin in order.Discussion. As the composition and percentage of these four solutions are different, the stability of them are also different. Champion was found to have the best quality among three other processing solutions.

Introduction. End stage renal disease (ESRD) is the last stage of the decending process of structural and functional distruction of kidneys. This process is often combined with acute diseases like glumerulonephritis and pyelonephritis. Uremic smell of mouth, enamel hypoplasia and defects, increase in dental debries, periodontal diseases, considerable delay in bone and dental age and fair decrease in oral hygiene are of this general oral symptoms. Despite these unfavorable factors, the recent researches indicated relatively lower DMFT index in these patients. Regarding these results, this study is trying to identify the DMFT index in the above mentioned patients.Methods. In this descriptive- analytic research, 22 patients with end-stage renal disease being treated with hemodialysis were examined. This was the total number of the patients ranging from 17 to 33 years old who were referred to Ali Asghar Medical center in Isfahan. After examining and indicating the DMFT index in these patients, they were compared with a healthy control group which were identical to the study group regarding their sex, age.Results. Comparison between the patients with ESRD being treated by hemodialysis and healthy control group showed that DMFT was lower in ESRD than in control group. In this study however, no statistically meaningful relation was seen between sex, the age of the patients at the beginning of hemodialysis treatment, duration of hemodialysis treatment and the DMFT index of patients with ESRD being treated by hemodialysis.Discussion. Patients with End-stage renal disease being treated by hemodialysis had noticeably, lower DMFT index compared to the normal people and this difference is more distinct in posterior teeth. Further, more despite the fact that no statistically meaningful relation was found between the age at the beginning of hemodialysis treatment, the duration of hemodialysis treatment and the DMFT index of patients with ESRD, it is probable that meaningful statistical relation will be found in larger sample size.

Introduction. Cardiovascular disease is the most common cause of death in developed counteries and it’s morbidity and mortality is also increasing in Asia. Hypertension, hyperlipidemia and smoking are majore risk factors of atherosclerosis. In recent years infectious agents such as clamidia pneumoniae, Helicobacter pylori and dental flora infections seems to be effective in development of atherosclerosis. This study was designed for finding possible relation between dental flora and coronary artery disease.Methods. This was a case-control study (40 case and 40 control patients). Case group were the patients with 75%-one vessel coronary stenosis in angiography and control had normal angiography, oral samples were povided for microbial culture in 2 groups, and data were analyzed.Results. Frequency of streptococcus viridance, streptococcus -hemoliticus, pneumococcus, gram-negative staphylococcus, gram-positive staphylococcus, Nisseria and diphteriod was 82.5, 15, 2.5, 12.5, 7/5, 17.5 and 5 percent in case group and 37.5, 27.5, 7.5, 5 and 7.5 percent for control group, respectively Statistical test showed significant difference between frequency of streptococcus viridance in case and control group.Discussion. This study suggests a probable relation between streptococcus viridance and coronary artherosclerosis disease, so prophylaxis can be recommended for this purpose.

Introduction. Diabetes mellitus is a syndrome in which energy metabolism equilibrium is disturbed due to loss of secreted insulin or fault in it's function. The result is abnormal metabolim of carbohydrate protein and fat. Numerous oral soft tissue lesions were reported in diabetic patient. The goal of this study was to compare the relative frequency of oral manifestation in diabetic patients (type I) in diabetic research center with normal community of Isfahan.Methods. This experimental study was of case-control type. Popualation in which the study was conducted consisted of 96 diabetic patients and 96 healthy individuals who were relatives of diabetic patients accompanying them. Simple sampling method was used as the method of sampling Data were collected from research center by examining diabetic and control group. Data were then registeried in preformed check lists and statistically analyzed.Results. Data showed that relative frequency of irritation fibroma, fissure tongue, traumatic ulcers, xerostomia, glossodynia and candida related ulcer was 6.2, 21.9, 8.4, 57.3, 9.4 and 6.2 percent respectively. Their frequency in control group was 21, 9.4, 3.1, 16.6, 3.1 and 2.1 percent respectively.Discussion. There was statistically significant differences between frequency of these lesions and case control group. Comparing results of this study with the study of Guggenheim indicates that prevalence of these lesions in our case group was higher than his study group finally further study is suggested to determine the etiology of this high prevalence in our study group.

Introduction. Nowadays dental implants are accepted as a successful replacement of conventional fixed and removable prosthesis which can restore esthetics in an ideal way. Because of visibility of anterior teeth while smiling and speaking, the importance of esthetics in these areas is very important. In this research, the provision rate of esthetic indexes of crowns supported with swiss- plus implants is assessed, also overall patient satisfaction is evaluated.Methods. The study was done on 21 patients who were treated with 30 implant supported crowns and the variables: clinical crown length, crown width, faciolingual dimention of crown, contact point position, soft tissue margin level and papilla index, crown color, abutment visibility and patient satisfaction range were assessed. Differences in variables between two groups were analyzed using the paired t- test. A wilcoxon signed rank test was used in analysis of differences in papilla index score.Results. The average amount indexes in implant-supported crowns and natural teeth in arrangement were: clinical crown length 10.05mm and 9.35mm, crown width 7.36mm and 7.33mm, faciolingual dimension 6.67mm and 7.72mm, mesial contact point position 36.20 and 32.86 percent, distal contact point position 50.86 and 41.76 percent, soft tissue margin level -0.64mm and -0.15mm, papilla index in mesial 2.17mm and 2.60mm, papilla index in distal 2.10mm and 2.63mm. color of 24 crowns were similar to natural teeth and in one case abutment was visible. 95.2 percent of patients expressed satisfaction from esthetics of the crowns (60 percent complete satisfaction and 40 percent partial satisfaction).Discussion. In comparison to the natural teeth, The crowns 1 were longer 2 had smaller faciolingual width 3 had more apically soft tissue margin level 4 had lower scores of papilla index. No significant statistically differences were observed in mesiodistal width and contact point position between two groups.

Introduction. Recently, the Ariadent Zinc phosphate cement has been introduced to market with low cost. Some dentists purchase this product because of low cost and others avoid buying it because of unreliable quality. The two important properties of ideal dental cement are to have the minimum film thickness (less than 25 micron) and to have favorable compressive strength. The purpose of this study was to determine the mean and to compare the film thickness and compressive strength of Ariadent and Harvard Zinc phosphate cement.Materials and Methods. In this experimental study evaluation was made based on Iranian standard number 2725. To measure film thickness of each cement, the first step was to prepare two glass slabs and their thickness was measured with micrometer, then each cement was prepared according to standard procedure and was put between the glass slabs. The difference between glass slabs with and without cement was measured. This procedure was repeated 3 times and average of three measurements were obtained and determined as mean of cement film thickness. To determine the compressive strength of each cement at first a mold was fabricated according to standard procedures. Then each prepared cement was poured in to the mold. After 24 hours each of five prepared specimens was Put under load and the average compressive strength was calculated.Results. The mean film thickness for Arident Zinc phosphate was 42.334.50 micron and for Harvard cement was 24.335.70. The mean compressive strength of Ariadent Zinc phosphate cement was 44.904.11 MPa and for Harvard cement was 62.855.19 MPa. The statistical analysis (t-student) revealed significant difference between two phosphate cement.Discussion. In this study mean film thickness of Iranian Ariadent Zinc phosphate cement was more than standard level (25 micron) and the mean compressive strength was less than standard level (70 MPa). These results indicated that Ariadent cement was of low quality and below standard. But Harvard Zinc phosphate cement had a standard film thickness and its compressive strength was close to standard and this is a reason for acceptable quality of Harvard Zinc phosphate cement.

Introduction. Some children show aggressive uncontrollable behavior during dental procedures, the only way to control this behavior is pharmacological methods such as conscious sedation. Recently intranasal administration of midazolam has been considered. The main goal of our study is to determine the effectiveness of intranasal administration of midazolam (in a does of 0.5 mg/kg) in behavioral management of uncooperative children.Methods and Materials. In this study 30 healthy, uncooperative children of 3 to 5 years old were evaluated. At the beginning of each session, we tried to use ordinary techniques of behavioral management in treatment of patients. In the case of unsatisfactory response intranasal midazolam was immediately used. To determine the affectivity of the drug, evaluation of child behavior before and after administration of midazolam was undertaken, using Houpt rating scale of general behavior.Results. A statistically significant difference was demonstrated in patients behavior before and after administration of intranasal midazolam (based on Houpt rating scale of general behavior). Thus we concluded that this drug is effective in sedation and reducing the anxiety of children under treatment.Discussion. Although the results are indicative of a positive effect of drug in sedating patients, this is not indicating that a child with a behavioral score of 1 or 2 of Houpt scale will be changed to a child with scores of 5 or 6 after administration of the drug. In fact this drug makes children more controllable in comparison to their previous condition and reduces their range of movement and crying so that dentist will be able to work in a relatively more suitable condition. Midazolam has the most effect in children who have a greater potential to cooperate and have a mild to moderate degree of anxiety.

Introduction. Prophy-jet is a device which is used for removal of extrinsic stains and cleaning of implant surfaces. However, some reports showed that sodium bicarbonate used in prophyjet has abrasive effects. The aim of this research was to compare the abrasive effects of 3 different powders namely, Air flow (standard sodium-bicarbonate), Soda (not purified sodium bicarbonate- which is cheap and is used for polishing porcelain crowns) and (Jet fresh) aluminum trihydroxide.Materials and Methods. Sixty extracted teeth were divided in 3 equal groups. In first, second and third group, Air flow, Soda and Jet fresh were used as powder in prophy jet. Then slurry of prophyjet (EMS-piezone) was sprayed from 2 millimeters on each tooth surface for 60 seconds. Defects formed on tooth surfaces were measured under electron microscope.Results. Soda was less abrasive than standard Air flow and Jet fresh. Average cavity depths were 0.25, 1.33 and 1.75mm accordingly.Conclusion. Powders used in prophyjet could have abrasive effects. Soda may be safer to be used in prophyjet. However, due to its crystal sizes, it often causes blockage of prophyjet tubes.

Introduction. The study for beauty can be traced back to the earliest civilizations. Many factors influence the perception of beauty, and esthetic dentistry continues to grow as a major part of overall dentistry. One of the most important factors in beauty of the teeth is the proportion of them to one another, and golden proportion is determined to be 1.618. The purpose of this study was to determine the average dimensions of the six maxillary anterior teeth in specific population and to evaluate relationship between these dimensions.Methods. Casts and photographs were obtained from 100 students of Isfahan Dental School with normal occlusion. Measurements of length and width were made on the casts and photographs using an electronic digital caliper. Average dimensions and ratios were calculated.Results and Discussion. Dimensions in men were larger than dimensions in women but most ratios in men and women were not different. All values in left and right were approximately equal. In addition the golden proportion was not found in ratios.

Introduction. The periodontal inflammation is one of the most common oral and dental diseases. Periodontitis is advanced periodontal bacterial infection. At present treatment of this disease is oral hygiene instructions, scaling and root planning, plaque control with different mouth washes and in some cases, periodontal surgery. In this investigation, Benzydamin was used as mouth wash which has anti pain and anesthetic properties. The purpose of this research was to study anti-inflammatory effects of using Benzydamin mouth wash 0.15 percent on moderate periodontitis.Material and Methods. This was a clinical test study, which has been done in Isfahan University (School of Dentistry). Sample included 80 patients, (52 female and 28 male) with an average age of 27 years. Patients who had moderate periodontitis were tested and divided into 40 person group (case and control). In both groups before performing the firt phase of treatment, index of gingival inflammation and bleeding index was determined. In case group, patients were given both oral hygience instructions and oral Bensydamin month wash. In control group only oral hygiene instructions were given to them. After one week, both case and control groups were recalled and once more indexes determined and then average was made. Acording to statistical formulas descriptive statistic and t-tests, curves and tables were made.Results. The mean for bleeding index before clinical test were 2.01 and 1.7 and after clinical test were 1.22 and 1.27 for both case and control groups. These differences between two groups were significant. But the mean for gingival inflamation index before and after clinical test were 2.18, 2.01 and 1.87, 2.03 which in both stages. Their differences were not significant.Discussion. Rsults indicate Benayamin month wash will decrease gingival bleeding and to lesser extend gingival inflamation. In control group, bleeding index was decreased slightly which can be due to oral hygiene instructions.

Introductiion. There are a lot of edentulous patients who need complete dentures in any society. One of the most important problems of edentulous patients is remaining dental lesions. Atrophy of maxillary or mandibular bone, infections abcesses, tumors and so on are among some other problems. In this study we tried to evaluate the panoramic radiography in order to detect these problems.Methods. This study was a descriptive research. We studied 192 panoramic radiography from edentulous patients in Isfahan city. We evaluate five criteria in these Radiography: Impacted teeth, root fragments, Migration of Maxillary sinus, displacement of mental foramen to height of Residual ridge and condensing osteitis.Results. From these 192 panoramic radiographics, twelve radiography (6.3 percent) had impacted teeth, 49 radiography (25.5 percent) had root fragment, 122 radiography (63.3 percent) had condensing osteitis, 140 radiography (72.9 percent) had migration of maxillary sinus (Atrophy form maxillary bone) and 96 radiography (50 percent) had displacement of mental foramen residual ridge (atrophy form mandibular bone).Discussion. In this study Impacted teeth, root fragments and maxillary and mandibular bone atrophy in radiography of edentulous patients were observed therefore, it is necessary for dentists to have panoramic radiography for edentulous patients perior to treating their complete denture patients.

Today, the laser is used in a wide range of dental procedures. Some of the advantages of some lasers in treatment of oral soft tissue lesions are: elimination of need for local anesthesia, minimal bleeding, fast healing, absence of postoperative complications and reduction of recurrence rate. For these reasons is was used for treatment of oral fibroma.To our knowledge this is the first time both Nd: YAG and Er: YAG lasers was used for biopsy of oral fibroma in Iran. Oral fibroma was removed by these two lasers and examined by pathologist. The patient had no pain without using any local anesthesia. While using Nd: YAG laser, bleeding was not seen but cutting of tissue was slower than using blade. When using Er: YAG, cutting of tissue was faster than previous laser but bleeding could be seen.

Adequate processing of tissues before histologic slices is necessary for preparation of proper histologic sections in animal studies. Fixation is one of the most important and early laboratory stages of tissue processing. Amount of penetration time of fixator material, into deep layers and central portions of hard tissues, is important factor for prevention of cell lysis. The purpose of vital perfusion technique is immediate and rapid fixation of tissue, before tissue lysis and necrosis.After general anesthesia, the common carotid artery and jugular vein were isolated through a vertical incision and dissection of muscles, in both sides of the neck. The carotid arteries, were clamped, then normal saline and 10 percent formalin were injected respectively, through one branole. While heart rate and respiration slowed down, the content of jaw vessels were normal saline and formalin. Oral mucosa became completely pale and muscles got stiff. Formalin was observed in vessels and between tissues.The histologic sections had favorable quality. Signs of tissue lysis were not observed and small vessels were also empty from blood. The vital perfusion fixation technique from carotid arteries can make rapid fixation of the periodontal tissue and jaw bone of dog and prevent tissue changes. This method can facilitate other laboratory stages for preparation of histologic sections.

Dry socket is undoubtedly on tne most distressing post operative sequel of teeth extraction. It occurs in spite of the most careful aseptic procedures and regardless of the ability and skills of the surgeon. The purpose of this study was to determin the relative frequency of dry socket after mandibular wisdom teeth extraction and defining the risk factors corresponding to this complication. This descriptive-analytic study was performed on 386 patients who were candidate for wisdom teeth extraction. A medical history was taken. Some of these patients were found to have a history of smoking and were taking birth control pill. Operation time and trauma during extraction, and the oral hygiene status of patients were recorded. Three days after extraction the patients were recalled and examined for dry socket.The findings revealed the relative frequency of the dry socket was 7.5% (29 patient). Its occurrence was more in females than males, and maximum incidence was in the age between 20-40. The incidence were related to trauma and duration of extraction, history of smoking and oral contraceptive pills and pericoronitis, and had no specific relation with periapical lesions and oral hygiene.In this study, Similar to other studies, specific relation was found between dry socket and other factors like, smoking and age. But something which was obvious was the close relation of dry socket with the intensity of trauma during extraction.

As uses of X-ray increases for diagnostic purposes, the necessity for dentists to have adequate knowledge about prescribing radiographs also increases. This will cause correct diagnosis and reduces the radiation to the patient. The aim of this cross sectional study was to evaluate the knowledge of dentists from Isfahan about prescribing radiographs.For this research a question form was designed and filled by 230 dentists, which were chosen randomly.T-test analysis was used. The results showed that the dentist's knowledge about prescribing panoramic and periapical and bitewing radiographs was good, about occlusal and about growth and development assessment was moderate and about in highrisk and normal patients and periodontal caries patient and CT and MRI was poor.There was no difference between knowledge of female and male dentists.There was no difference between knowledge of general dentists, residents and specialists about prescription panoramic, periapical, bitewing, growth and development assessment and caries, but the knowledge of residents was better than general dentists about prescription occlusal radiographs. About CT andMRI the knowledge of specialists and residents were higher than general dentists. About prescription radiography for periodontal patient knowledge of specialists were higher than general dentists and residents.