Journal of Dental Research, Dental Clinics, Dental Prospects
Volume:3 Issue: 3, Summer 2009

Background and aims. There is no consensus about the effect of tongue thrusting on incisor position. The purpose of this study was to evaluate the position of anterior teeth in growing children with tongue thrust swallowing.Materials and methods. In the present study 193 subjects with an age range of 9 to 13 years participated. All the patients were examined by a trained investigator and those having tongue thrust swallowing were selected and the position of their anterior teeth was compared with a control group consisting of 36 subjects with normal occlusion. Data was analyzed by independent sample t-test. Results. Among the 193 students who were examined in this study, 10 cases (5%) were diagnosed to be tongue thrusters. Overjet was significantly increased in tongue thrust individuals (P < 0.05), while the other variables were not statistically different from the controls (P > 0.05).Conclusion. The results indicated that tongue thrust may have an environmental effect on dentofacial structures. Considering the high incidence of tongue thrust in orthodontic patients, it is suggested that dental practitioners observe patients of all ages and those in all stages of orthodontic treatment for evidence of tongue thrust swallowing.

Background and aims. Candidiasis is a common opportunistic infection in immunocompromised patients. Radiation to the head and neck affects the oral mucous membrane and produces xerostomia. Xerostomia alters the oral mucosa and predisposes them to colonization by Candida species. The aim of this study was evaluation of Candida species before and after radiotherapy. Materials and Methods. Twenty patients undergoing radiation therapy were selected. None of the patients had taken any antibiotics and antifungals during the 3-month period prior to the study and did not take any during the study; in addition, they did not have any systemic conditions predisposing them to Candida infections. Swabs were collected from all the patients for Candida species culturing procedures 3±1 days before treatment and 2 and 4 weeks after radiotherapy. Swabs were inoculated on 2% Sabouraud’s dextrose agar. Different types of Candida species are specified by colony color. Analysis of variance was used to assess the difference between the periods before and after treatment. Results. Mean age of the patients were 59.4 years. Ten patients were Candida-positive before the initiation of radiotherapy. Eighteen and 20 patients were Candida-positive after two and four weeks of radiotherapy, respectively. The most frequent type of Candida in this study was Candida albicans both before and after radiotherapy. Conclusion. The present study suggests that patients undergoing head and neck radiotherapy should take antifungal agents, especially sugar-free agents, topical fluoride and salivary substitutes. The most commonly found Candida in this study was Candida albicans, which might be attributed to its high pathogenecity.

Background and aims. Descending necrotizing mediastinitis (DNM) is a rare and life-threatening infection. Management of this condition is very difficult and before 1990s, DNM had a mortality rate of 40% despite the use of antibiotics. One of the etiologies of this condition is rapid downward spread of oropharyngeal infection along the cervical fascia planes into the mediastinum. Materials and methods. Patients with DNM from odontogenic, peritonsillar and retropharyngeal origins, who underwent surgical treatment from 1990 to 2007, were reviewed. Data extracted from medical records of the patients included age, gender, origin of the infection, surgical approaches, and the cause of mortality. Descriptive data were expressed as a Mean ± SE.Results. Thirteen patients aged 15 to 56 (mean, 34.5 years old; 8 males and 5 females) were studied. The origins of infection included odontogenic abscess in 10 cases and peritonsillar and retropharyngeal abscess in 3 patients. The mean duration from onset of symptoms to the surgery was 12.18 ± 0.98 days (range 3 to 24 days) and the mean duration from initial surgery to discharges was 28.51 ± 3.25 days (range 5 to 92 days). Post-operative mortality was seen in three patients. Conclusion. Descending necrotizing mediastinitis can arise from odontogenic abscesses and must be detected as early as possible, as it is a life-threatening infection.

Background and aims. Histpathologic diagnosis of exophytic lesions is occasionally influenced by clinical and radiographic diagnosis and even the surgeon’s observation during biopsy. The aim of this study was to evaluate the cases with failure in clinical diagnosis. Materials and methods. A total of 73 patients with peripheral exophytic lesions were evaluated in Zahedan Faculty of Dentistry in 2006. Specialists gave their differential diagnoses based on the criteria of oral medicine texts. Then a biopsy was taken and the histopathologic diagnosis was determined. Finally, consistency rates of clinical and histopathologic diagnoses were determined. Statistical analysis was carried out with SPSS software using Chi-Square and Fisher’s exact tests.Results. In the present study 73 subjects with oral soft tissue (peripheral) exophytic lesions were orally examined and biopsies were taken. Forty-four subjects (60.35%) were females and 29 (39.7%) were males. A total of 81.7% (62 subjects) of clinical diagnoses were consistent with histopathologic reports. In 18.3% (11 subjects) of the cases clinical diagnoses were not confirmed by histopathologic reports. Conclusion. In order to reach a diagnostic agreement, conformity of clinical and histopathologic diagnoses is necessary.

Background and aims. Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran.Materials and methods. In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis.Results. Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000). Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P < 0.05). The type of occlusion, axial inclination of teeth, existence of prosthesis, frenal attachment, and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05).Conclusions. Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR.

Background and aims. Panoramic radiographs are used for surgical planning of unerupted third molars. The major problems associated with panoramic radiography include unequal magnification and geometric distortion of the image. The purpose of this study was the clinical evaluation of the effect of radiographic distortion on the position and classification of unerpted mandibular third molars.Materials and methods. Panoramic radiographs of 20 patients with indication for extraction of lower third molars were included in this study. On the day of surgery, a silicon impression was taken from the second and third molar region and poured with type IV gypsum to provide a study cast. The inclination of the lower third molar to the second molar on panoramic radiography was compared with this angulation on the study casts.Results. There was a mean difference of 5.75° ± 1.65 between the position of the lower third molar on panoramic radiographs and on study casts. Student’s t-test indicated a statistically significant difference (P < 0.05).Conclusion. Panoramic radiography tends to exhibit a more mesial position of the third molars; however, panoramic radiography can still be used as the main tool for surgical planning of lower third molars.

Dentigerous cysts, commonly encountered in the practice of dentistry, are benign odontogenic cysts associated with crowns of unerupted and/or impacted permanent teeth. They frequently occur during the second and third decades of life. Treatment modalities range from enucleation to marsupialization, which may be influenced by the age of the patient, severity of impaction, and root form of associated tooth/teeth. The purpose of this report is to describe the successful outcome of conservative surgical management of a large dentigerous cyst associated with an impacted mandibular second premolar in a young patient.

Odontogenic fibromyxoma is a rare and locally-invasive benign neoplasm found exclusively in the jaws. It has the potential for extensive bony destruction and extension into the surrounding structures. In the presented case, radiographic and histological features as well as the treatment and follow-up of odontogenic fibromyxoma accompanying odontogenic cyst of mandible in an 8-year-old boy are discussed.