Journal of Dental Research, Dental Clinics, Dental Prospects
Volume:2 Issue: 1, Winter 2008

Background and aims. Complete and predictable regeneration of tissue lost as a result of infection or trauma is the ultimate goal of periodontal therapy. Various graft materials have been successfully used in the treatment of intrabony defects. The purpose of this study was to evaluate the use of a decalcified freeze-dried bone allograft (Cerabone) with the autogenous bone graft as a gold standard in the treatment of human two- or three-wall intrabony periodontal defects.Materials and methods. This split-mouth study was done on 10 pairs of matched two- or three-wall intrabony periodontal defects with 5 mm or more probing depth and 3 mm or more depth of intrabony component following phase I therapy. In the control sites autogenous bone graft and in the test sites decalcified freeze-dried bone allograft were used.Results. At baseline, no significant differences were found in terms of oral hygiene and defect characteristics. At six months, analysis showed a significant improvement in soft and hard tissue parameters for both treatment groups as compared to preoperative measurements. There were no statistical differences in clinically-measured parameters between treatment groups after 6 months except for crestal resorption that increased significantly in control group (P = 0.25). Defect resolution and bone fill in the test and control groups were 2.5 ± 0.46 mm versus 2.7 ± 0.73 mm and 2 ± 0.62 mm versus 2.20 ± 0.52 mm, respectively.Conclusion. The results of this study demonstrated that both graft materials improved clinical parameters. The comparison of the two treatment groups did not show any significant differences in clinical parameters after six months. However, because of the limited amount of intra-oral donor bone, it is preferable to use decalcified freeze-dried bone allograft.

Background and aims. C-reactive protein (CRP) is a well-known acute-phase reactant produced by the liver in response to inflammation caused by various stimuli. Periodontal disease is a chronic infection of tooth-supporting structures characterized by attachment loss and alveolar bone loss. The aim of this study was to assess the relationship between serum C-reactive protein levels and periodontal diseases.Materials and methods. The study was conducted on 166 patients referring to Tabriz Faculty of Dentistry. The age range was between 35 and 59 years. 83 subjects with periodontitis according to NHANES III index as test group and 83 healthy individuals as controls participated in this study. Body mass index (BMI), waist circumference (WC), probing depth, attachment loss and CRP levels were measured in both test and control groups. Data was analyzed with Student's t-test, odds ratio (OR), Chi-square test and Spearman's correlation coefficient, using SPSS 13.0 software.Results. The results revealed a statistically significant difference between all of the analyzed variables in test and control groups (P < 0.05). Classifying the test subjects into two subgroups (subjects with CRP ≥ 3 mg/l and subjects with CRP < 3 mg/l), the highest OR in females belonged to WC (OR = 6.4; 95% CI: 1.18-35.2, P = 0.02) and in males to obesity (OR = 4.8; 95% CI: 0.65-35.19, P = 0.05). Considering the correlation between obesity, overweight, WC and CRP with probing depth and attachment loss denoted that obesity presented the highest (r = 1, P = 0.00) and overweight the lowest (r = 0.4, P = 0.07) association. In females, CRP was related to the severity of periodontitis and attachment loss (r = 0.662, P = 0.00). Excluding overweight, the association between all the variables was statistically significant (P < 0.05). Conclusion. Our findings indicate that periodontal disease is correlated with CRP elevation and diseases associated with obesity.

Background and aims. Dental procedures injuring oral tissues may induce bacterial release to blood stream that can cause infective endocarditis in susceptible patients. The aim of this study was to determine the level of knowledge of general dental practitioners (GDPs) in Tabriz, Northwest of Iran, regarding endocarditis prophylaxis in cardiac patients receiving dental treatments.Materials and methods. This was a cross-sectional, descriptive, analytical study that included 150 GDPs. All practitioners were given a self-administered questionnaire which consisted of three parts assessing their knowledge of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis. Statistical analysis of data was carried out using independent t-test, one-way ANOVA and chi-square test.Results. The level of knowledge among GDPs in three areas of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis were 63.7%, 66.8% and 47.7%, respectively. Their overall level of knowledge regarding endocarditis prophylaxis was 59%. Association of the level of knowledge with age and practice period was statistically significant (P < 0.05). However, the level of knowledge was not significantly associated with gender or university of graduation in either of three areas evaluated (P > 0.05).Conclusion. According to our results, the knowledge of endocarditis prophylaxis among GDPs in Tabriz was in a moderate level. Regarding the importance of endocarditis prophylaxis in susceptible patients, it should be more emphasized in the curriculum of dental schools and continuing dental education programs.

Background and aims. The knowledge of variations in root canal morphology is critical for a successful endodontic treatment. The purpose of this study was to investigate variations in the root canal system of human mandibular first permanent molars in an Iranian population.Materials and methods. In this study, 209 mandibular first molar teeth were decalcified, dye-injected, and cleared in order to determine the number and configuration of the root canals. Results. The results demonstrated that 65.56% of the mandibular first molars under study had three, 31.57% had four and 2.87% had two canals.Conclusion. According to the results of this study and considering variations in the root canal systems of the mandibular first molars, it seems that great care should be taken in the root canal treatment of these teeth.

Background and aims. Determining the proper length of the root canals is essential for successful endodontic treatment. The purpose of this in vitro study was to evaluate the effect of file size on the accuracy of the Raypex 5 electronic apex locator for working length determination of uninstrumented canals.Materials and methods. Twenty maxillary central incisors with single straight canals were used. Following access cavity preparation, electronic working length by means of Raypex 5 apex locator and actual working length were determined. Data were analyzed using ANOVA with repeated measurements and LSD test.Results. There was no significant difference between electronic and actual working lengths when a size 15 K-file was used.Conclusion. Under the conditions of the present study, a size 15 K-file is a more suitable size for determining working length.

Background and aims. A perfect endodontic treatment necessitates proper understanding of the morphology of canal and pulpal variations. This in vitro study was conducted to demonstrate the internal anatomy of mandibular canine teeth in an Iranian population. Materials and methods. The samples consisted of 100 extracted mandibular permanent canines. The roots of the teeth were molded in acrylic boxes. The crowns of the teeth were cut and 2 mm cross sections were made from CEJ to the apex. Sections were examined using stereomicroscope to reveal the number and location of root canals.Results. From 100 evaluated teeth, 12 (12%) had 2 canals from which 5 had type II canal configuration and 7 (7%) had type III. 88% of the specimens had one canal and none were seen to be of type IV.Conclusion. The findings of this study emphasize the importance of dentist's knowledge of variations in root canal morphology, since leaving a canal untreated is one of the main reasons of endodontic failures. When treating mandibular canines, the existence of a second canal should be taken into consideration.

Background and aims. Oral pemphigus vulgaris is a chronic autoimmune mucocutaneous intraepithelial disease that primarily affects patients over the age of fifty, resulting in mucosal ulceration and is a potentially life-threatening disease. The purpose of this study was to investigate the efficacy of dapsone in combination with systemic corticosteroids to treat the oral lesions of oral pemphigusMaterials and methods. Twenty patients diagnosed with oral pemphigus were selected. Oral manifestations were graded according to the severity of disease from 1 to 3. All patients were treated initially with systemic corticosteroids. Each was assigned to one of 4 groups according to their response to therapy. Patients who responded less than 50% healing of lesions began a trial of dapsone. After 4 weeks, signs and symptoms were recorded, and if a patient was lesion-free, the dapsone dosage was gradually tapered. Results. Five patients with mild to moderate disease were treated with systemic corticosteroids alone. 15 patients with moderate to severe disease were treated with systemic corticosteroid and dapsone therapy. Of these, 10 patients had significant benefits, while 5 patients did not respond to dapsone adjuvant. Conclusions. The use of dapsone in combination with systemic corticosteroids is a useful method for treatment of oral pemphigus.

Background and aims. Dentists administer thousands of local anesthetic injections every day. Injection to a highly vascular area such as pterygomandibular space during an inferior alveolar nerve block has a high risk of intravascular needle entrance. Accidental intravascular injection of local anesthetic agent with vasoconstrictor may result in cardiovascular and central nervous system toxicity, as well as tachycardia and hypertension. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections.Materials and methods. Three experienced oral and maxillofacial surgeons performed 359 inferior alveolar nerve block injections using direct or indirect techniques, and reported the results of aspiration. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases. Data were analyzed using t-test.Results. 15.3% of inferior alveolar nerve block injections were aspiration positive. Intravascular needle entrance was seen in 14.2% of cases using direct and 23.3% of cases using indirect block injection techniques. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between direct or indirect block injection techniques (P = 0.127) and between right and left injection sites (P = 0.778).Conclusion. According to our findings, the incidence of intravascular needle entrance during inferior alveolar nerve block injection was relatively high. It seems that technique and maneuver of injection have no considerable effect in incidence of intravascular needle entrance.