Journal of Dental Research, Dental Clinics, Dental Prospects
Volume:4 Issue: 2, Spring 2010

Background and aims. Burning mouth syndrome (BMS) is a chronic pain disorder characterized by a chief complaint of oral burning/pain with no clinically observable oral mucosal lesions. The prevalence of BMS has been reported to be 2.5-5.1% in the general population and several psychological disorders have been reported as associated or predisposing factors for BMS. The aim of this study was to determine the correlation between BMS and anxiety in the elderly residents of sanitaria in Tehran, Iran. Materials and methods. In a cross-sectional analytical study, 50 patients with BMS were included along with 50 healthy individuals as controls. Inclusion criteria were: age over 60 years, burning sensation in the mouth, normal oral mucosa, absence of diabetes, satisfactory prosthesis, absence of iron deficiency and other nutrients, and no heavy smoking habits. Similar inclusion criteria were considered for the control group without any oral complaints. Burning/pain severity was assessed by a 100-mm visual analog scale and the severity of anxiety (state, trait, and total) was determined by Cattell's Anxiety Scale. Data was analyzed by t-test and Pearson's correlation coefficient.Results. Individuals with BMS assessed their burning/pain severity to be 27.4 mm (95% CI=25.2 - 29.6 mm). Standardized total anxiety scale in individuals with and without BMS (±SE for mean) was 5.9±0.2 and 4.6±0.3 with significant differences (p=0.001). Similar significant differences were observed in state and trait anxiety between the two groups.Conclusion. It seems that both state and trait anxiety are associated with burning mouth syndrome.

Background and aims. Orofacial pain is one of the most common reasons for attendance at the dental clinic. The prevalence and the sources of orofacial pain vary from place to place and patients’ response to pain also differs. The aim of this study was to determine the prevalence and pattern of orofacial pain as well as the factors influencing patients’ response to orofacial pain among patients presenting for dental treatment in our center. Materials and methods. Consecutive patients presenting with orofacial pain at the Dental Center, University of Port Harcourt Teaching Hospital during the one-year period of the study were recruited into the study. Patients’ demographic data were collected and recorded in special forms. Patients were later examined to confirm the specific cause of pain. This was also recorded. Data generated were analyzed using SPSS for Windows.Results. Four hundred and forty-eight patients out of the 2,426 patients seen during the study period had orofacial pain, yielding a prevalence rate of 18.5%. There were 255 females and 193 males with most patients in the 17-27-year age group (49.1%). Lower jaw was commonly affected. Most patients presented after a period of at least one month, with severe and spontaneous pain. Most patients had drug therapy before presentation. Caries was the most common source of orofacial pain.Conclusion. Orofacial pain was not uncommon in our center and it accounted for about 20% of patients’ attendance in the center. Dental caries and periodontal diseases were the most common sources of orofacial pain while temporomandibular joint pain and atypical facial pain were not common in our center. Young adults and females were most commonly affected.

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. In spite of their enormous importance, permanent first molars might be affected by caries in children in developing countries. The aim of this study was to evaluate the treatment needs of first permanent molars in a group of schoolchildren in Mashhad.Materials and methods. This cross-sectional descriptive study was carried out on 700, 7-9 year-old students in primary schools in Mashhad. The schools were randomly selected from each district. Treatment needs and DMFT of first permanent molars were calculated. Data was analyzed using ANOVA, Chi-Square and t-test.Results. A total of 95.3% of the children required dental treatment. Fissure sealant application and filling were the treatments most required in all age groups. The mean DMFT of first permanent molars was 1.31±1.4. It was significantly higher in girls than boys (P=0.040).Conclusion. Great treatment needs and caries prevalence in permanent first molars in Mashhad schoolchildren show that dental caries is still a serious problem in the children of our society; therefore, education of parents and teachers is necessary for promoting children's oral health.

Background and aims. The present study evaluated the most common reasons for replacing amalgam restorations in a university clinic. Materials and methods. A total of 217 restorations which needed to be replaced were clinically and radiographically evaluated in a period of 4 months. The frequencies of reasons for replacing amalgam restorations were calculated: The assessed items included recurrent caries, tooth structure fracture (functional or non-functional cusps), amalgam bulk fracture, amalgam marginal fracture, proximal overhangs, and esthetics. Data were analyzed using Fischer’s exact test.Results. Both in vital teeth and teeth which had undergone root canal therapy, the most common reason for amalgam replacement was cusp fracture, with the fracture of non-functional cusps being statistically significant. Recurrent caries was the second most common reason for amalgam replacement. In Class I restorations, the most common reasons were recurrent caries and esthetics, with no statistical significance. The most frequent problem in Class II restorations was fracture of non-functional cusps, with a statistical significance in three-surface restorations.Conclusion. According to the results, failing to reduce undermined cusps and neglectful caries removal are the reasons for majority of amalgam restoration replacements. These issues should be emphasized in the curriculum for dental students and continuing education courses.

Talon cusp is an accessory cusp similar to a projection, extending from the cingulum or cemento-enamel junction to the incisal edge. It occurs on labial or palatal surfaces of primary or permanent anterior teeth in both arches. This accessory cusp can occur as an isolated entity or in association with other dental anomalies. Occurrence of a talon cusp on supernumerary teeth is rare and uncommon. This paper reports an unusual case of a talon cusp on a supernumerary tooth in association with mesiodens.

Alveolar ridge resorption has long been considered an unavoidable consequence of tooth extraction. While the extent and pattern of resorption is variable among individuals, there is a progressive loss of ridge contour as a result of physiologic bone remodeling. Even today, with best modalities of tooth preservation, there is a group of elderly individuals who do not benefit from modern preventive practices and who now present a dilemma in terms of maintaining the masticatory apparatus necessary for nutrition. Even with excellent dental care, such patients experience abrasion of the natural tooth crowns with age, and embedded roots are left within the alveolar bone. According to old concepts of dental care, extraction of these roots would have been recommended, but today’s goal of excellence in endodontics dictates otherwise. We report a case in which vital and non-vital root submergence was carried out to prevent alveolar ridge reduction.

Rehabilitation of facial defects is a complex task, requiring an individualized design of the technique for each patient. The disfigurement associated with the loss of an eye may result in significant physical and emotional problems. Various treatment modalities are available, one of which is the use of implants. Although implant-supported orbital prosthesis has a superior outcome, it may not be advisable in all the patients due to economic factors. The present article describes a simplified technique for the fabrication of a silicone orbital prosthesis by constructing a custom ocular prosthesis to achieve ideal fit and aesthetics. Multidisciplinary management and team approach are essential in providing accurate and effective rehabilitation.