مجله دانشکده دندان پزشکی اصفهان
سال هفتم شماره 1 (پیاپی 25، بهار 1390)

Nowadays, various antibiotics and antiseptics are used as locally delivered adjuncts to scaling and root planing (SRP) in the treatment of periodontitis. The aim of this study was to evaluate the clinical efficacy of xanthan-based CHLO-SITE gel (xan-CHX) as a local adjunctive therapy to SRP in the treatment of moderate-to-severe periodontitis.

In this controlled clinical trial, 6 patients with moderate-to-severe chronic periodontitis were selected. Each subject had at least three pockets 4-7 mm deep. Twenty-eight randomly selected pockets were assigned to the control group and 44 pockets were assigned to the test group. Scaling and root planing (SRP) procedures were carried out in all the pockets. In the test group, in addition to SRP, xan-CHL gel was injected into the pockets. Clinical indices (PPD, CAL, BOP, PI) before and three months after treatment were measured and evaluated by paired t-test, chi-squared and Kruskal-Wallis testes using SPSS software.

At baseline, there were no significant differences between the control and experimental sites in relation to the indices measured. After 3 mouths, means of PPD and BOP in the experimental sites were significantly lower compared to control sites (p value ≤ 0.05). Mean of CAL in the experimental sites was significantly higher than that in control sites (p value ≤ 0.05).

The results of this study revealed that injection of xan-CHL gel with SRP has better clinical efficacy than SRP alone in the treatment of periodontitis.

Regular application of mouthwashes has been recommended for the prevention and control of caries and periodontal diseases. Use of mouthwashes can affect restorative dental materials. The purpose of this in vitro study was to investigate the effect of three commercially available mouthwashes (Irsha, Chlorhexidine, Oral-B) in Iran on the microhardness of Z100 composite resin. In this in vitro experimental study 30 cylinders of composite resin were fabricated and stored in distilled water for 24 hours. Vickers hardness (VH) values of the samples were measured using Vickers hardness tester. The samples were stored in the mouthwashes for 12 hours, which was equivalent to two minutes of daily mouthwash application for a year. Microhardness values were measured again after immersion in the mouthwashes. Data was analyzed with of ANOVA and Tukey test (α = 0.05). Means of microhardness values for composite resin samples stored in Irsha, chlorhexidine and Oral-B mouthwashes were -1.94 ± 0.23, -16.14 ± 0.7 and -7.37 ± 1.4, respectively. Differences in microhardness values in the Irsha group were higher than the two other groups, with statistically significant differences (p value < 0.05). Under the limits of the present study it was concluded that various mouthwashes do not exert the same influences on the microhardness of composite resins. Chlorhexidine exerted the least influence on microhardness among the three mouthwashes under study.

Radiographic evaluation of mineralization stages of third molars is a valuable and important criterion for age estimation in legal medicine. The pattern of dental development is hereditary and differs from race to race. Therefore, the aim of this study was radiographic evaluation of developmental stages of third molars based on chronological age in Gilani children and young people. In this descriptive, analytical cross-sectional study, 400 panoramic radiographs from Gilani patients with an age range of 6-22 years were evaluated and developmental stages of third molars were recorded by Demirjian method. The mean age of the subjects in every developmental stage was determined. The correlation between age and developmental stage was analyzed by Spearman's correlation coefficient. The differences between right and left sides, and upper and lower jaws were analyzed by Wilcoxon test and sex differences were analyzed by Independent t-test (p value < 0.05). Regression equations was obtained for age estimation (α = 0.05). The youngest age for observation of third molar bud was 6 and the oldest age was 11 in both jaws. There was a strong correlation between age and third molar developmental stage. There were no significant differences between right and left sides, but there were significant differences between upper and lower jaws. Comparison between males and females revealed significant differences in only the C stage of left mandibular third molars and A and E stages of left maxillary third molars. Within limitations of the present study, radiographic evaluation of third molar development in Gilani children and adolescents might provide a reference for age estimation.

Leukoedema is a chronic condition of the oral mucosa with an unknown etiology; its prevalence has been reported differently in different studies. The aim of this study was to determine the relative frequency of leukoedema and the associated risk factors in patients referring to the Department of Oral Medicine in Isfahan Faculty of Dentistry. In this prospective-descriptive study, the oral mucosa of 404 patients referring to the Department of Oral Medicine was examined. Data on smoking, unusual habits (cheek biting and use of hot drinks) and systemic diseases were recorded based on a checklist. Data was analyzed by chi-squared test and Fisher’s test using SPSS program (α = 0.05). The relative frequency of leukoedema was 23%. Mean age of the subjects was 31.56%. There was a significant relationship between the relative frequency of leukoedema and smoking, cheek chewing and habitual drinking of hot liquids (p value < 0.001). In addition, a significant relationship was observed between leukoedema frequency and anemia (p value = 0.022). Leukoedema was more prevalent in male, in 20-39 age group, and anemic patients. Habitual cheek chewing and hot drinks were risk factors for leukoedema. Smoking seems to have the greatest role in leukoedema, intensifying the effect of other factors.

Shape and size of upper anterior teeth are important in dental and facial beauty. The aim of this study was to determine the correlation between dental and facial indexes and to evaluate whether there is a golden ratio and its relationship with the proportions measured. In this cross-sectional study, digital images of 34 female and 30 male dental students were taken at maximum smile in a similar manner. Then the images were assessed with Photoshop CS5 and ACDSee computer programs and measurements were made with AutoCAD 2011 software. Data was analyzed with independent t-test and means were compared with a constant. The entire variable means did not demonstrate any significant differences between males and females (p value > 0.05). The inter-pupillary to inter-canine distance ratio did not reveal any significant differences with the golden proportion of 1.618 between males and females (p value > 0.05). Only the ratios of inter-pupillary, inter-canthus and inter-zygomatic distances to maxillary central widths in females, and the ratios of inter-zygomatic and inter-alar distances to maxillary central widths in males were not significant. Under the limitations of the present study, it was concluded that dento-facial proportions are not significantly different between males and females and the golden ratio applies in the inter-pupillary to apparent width of anterior maxillary teeth proportion. Facial indices are appropriate measures to measure the apparent width of anterior maxillary teeth and can be used as a standard for Iranian dentists and surgeons.

Selection of appropriately-sized central teeth has an important role in esthetics of dentures. The aim of this study was to compare proportion of mesiodistal width of central incisors in the maxilla to those in the mandible in students and products of Idealmako Company. In this descriptive-analytical study, 93 students of Isfahan Faculty of Dentistry in the age range of 20-30 were selected randomly. Mesiodistal widths of left and right upper and lower centrals were recorded by two directly, using an intraoral caliper, and indirectly, using subjects’ casts and a caliper with an accuracy of 0.01 mm at height of counter of the teeth three times. The sizes of Idealmako products were measured by the same caliper. Data was analyzed by one-way ANOVA, t-test and post hoc Scheffé’s test using SPSS software (α = 0.05). Proportion of upper-to-lower mesiodistal width of centrals was 1.55 ± 0.13 in students and 1.68 ± 0.17 in Idealmako products. Mean proportion of mesiodistal width of upper centrals to lower centrals in natural teeth is less than that in artificial teeth. A similarity between the width of upper centrals in the natural and artificial teeth (the numerator of the fraction) accounts for this significant difference between the proportion of the two groups, leading to the very small size of lower centrals (denominator of the fraction) in Idealmako artificial teeth.

14-18 year-old female students of Isfahan public schools in 2009-2010 based on Index of Orthodontic Treatment Need (IOTN). In this descriptive study, 370 14-18 year-old female students were selected by random clustering method. The subjects were examined clinically based on two components of IOTN: Dental Health Component (DHC) and Aesthetic Component (AC). Data was analyzed with descriptive statistical methods, including Spearman’s correlation coefficient (α = 0.05). Regarding DHC, 10.8% of samples showed grade 5, 13.5% showed grade 4, 23.8% had grade 3, and 51.8% demonstrated grades 1 and 2. In those showing grade 5, the most common malocclusion was unerupted (i) teeth. The most common malocclusion in grade 4 was contact displasments (d) for more than 4 mm and in grade 3, contact displasment was less than 4 mm and more than 2 mm. The most common malocclusion in grade 2 was contact displasment (d) less than 2 and more than 1 mm. In addition, regarding AC, 98.8% of the subjects were classified as “no need”, 1% as “borderline need” and 0.0% as “definite need” for treatment. No statistically significant differences were noted between AC and DHC (p value = 0.294). It was concluded that 24.3% of 14-18 year-old female students in Isfahan need orthodontic treatment (IOTN grades 4 and 5) and common malocclusions are contact point displacements, unerupted teeth and increased overjet.

Knowledge of the possible internal anatomy and morphology of the root canal system of the teeth is a key factor in successful root canal treatment. The aim of this investigation was to determine the prevalence of C-shaped canals in mandibular second molars of a Kermani population. In this in vitro cross-sectional study, 200 extracted mandibular second molars were collected from several health service centers in Kerman city. Access cavities were prepared on occlusal surfaces of the teeth and the pulp tissue was removed by immersing the samples in 2.5% sodium hypochlorite for 12-24 hours. Then the teeth with C-shaped canals were separated and cross-sections were prepared at CEJ, mid-root and apical portions of the canals using a diamond disk. The C-shaped canals were classified according to the method introduced by Haddad in 1999. Data were analyzed using descriptive analysis (α = 0.05). Of the total of the samples ten teeth showed C-shaped canals (5%). Two teeth (1%) belonged to category I (true C-shaped); five teeth (2.5%) were from category II; one tooth (0.5%) was from category III and one tooth (0.5%) was C-shaped at CEJ, with the canals separating at mid-root and ending in three separate apical foramina. According to the results of this study, the prevalence of C-shaped canals was 5% in the Kermani population under study, which is consistent with reports from all other parts of the world.

Recurrent intraoral herpes is a common oral disease that causes painful ulcers and viral shedding, resulting in various complications for patients. The antiviral efficacy of oral mouthwashes has not been adequately studied, although they are a readily available and rapid treatment modality for oral ulcers. In this experimental study, viricidal effects of chlorhexidine and Persica mouthwashes on Vero cell lines were examined, before and after HSV-1 infection of the cells, in the presence of various concentrations of mouthwashes at different time intervals by using quantal assays. Then the results were compared with those of acyclovir. The 50% cytotoxic concentrations (CC50) of the two mouthwashes were determined. Data was analyzed by one-way and two-way ANOVA (α = 0.05). CC50 of Persica at 5- and 30-minute intervals were 0.2% and 0.14%, respectively. Chlorhexidine was toxic at durations more that 5 minutes. Before inoculation, both mouthwashes showed viricidal effects and Persica showed more viricidal effect than chlorhexidine and acyclovir (p values of 0.0001 and 0.04, respectively). After virus inoculation antiviral effects of these mouthwashes were only limited to concentrations above 1/4. Acyclovir demonstrated the highest antiviral effect (p value = 0.0001). Considering the better direct anti-HSV effect of the herbal mouthwash, Persica, and its less side effects compared to chlorhexidine, it can be used to reduce oral fluid contamination caused by viral shedding and reduce infectivity of intra-oral ulcers.

Despite significant advances in dentistry, pain after root canal therapy is still of concern for both patients and dentists. Although the pain does not necessarily indicate endodontic failure, relief of this pain is very important for the patient. In addition, the ability to prevent or control this pain is an important factor for a dentist's professional success. Pain in endodontics is usually due to a periapical inflammatory reaction, which occurs before, during, or following various endodontic procedures. The severity of the inflammatory response is variable, depending on local and systemic factors. The cause of pain and/or swelling in endodontic therapy is not always clear. There are numerous factors accounting for endodontic pain, suggested by researchers. These factors may be classified into three main groups: Iatrogenic factors, patient factors, and intracanal factors. The most important factor in controlling post-endodontic pain is to have sufficient knowledge about the causes of the problem and to prevent them. The aim of this review article is to discuss factors involved in post-endodontic pain and offer techniques, including the use of analgesics, to prevent or relieve the pain.

The term biopsy indicates the removal of tissue from a living body for diagnostic microscopic examinations. Biopsy is the most accurate and appropriate of all diagnostic histologic procedures. Without biopsy, accurate diagnosis of lesions is impossible. Biopsy procedures should be performed whenever a definitive diagnosis cannot be established by common clinical examinations. The purpose of taking a biopsy is to distinguish different lesions with similar clinical or radiographic features or diagnosis of malignancies. This article presents different types of biopsies, indications, contraindications and common problems in biopsy procedures.

The final outcome of dental caries and periodontal diseases is edentulism. Edentulism makes functional and esthetic demands on patients. The aim of this study was to determine the prevalence of edentulism and associated factors among adults over 35 years of age to use the results in public health promotion and disease prevention programs. In this descriptive analytical cross-sectional study, 400 subjects (200 females and 200 males) aged 35 years and older were selected in Yasooj by random cluster sampling method. Each subject’s name, age, sex, job and income, history of smoking, xerostomia, history of systemic diseases, oral hygiene, nutritional status, history of dental examinations and reasons for edentulism were recorded in a questionnaire. Descriptive statistics and Pearson’s correlation coefficient were used for analysis of data (α = 0.05). The prevalence of edentulism in cases classified into three groups was: 9.5% of 35-44 year-old subjects, 40.7% of 45-64 year-old subjects, and 71.1% of subjects over 65 years of age. The prevalence of edentulism was the same in males and females. The prevalence of edentulism increases with age. There is no significant relation between edentulism and gender. The relation between edentulism and other associated factors is significant.