Journal of Dentistry, Shiraz University of Medical Sciences
Volume:12 Issue: 4, 2012

Statement of Problems: Sufficient knowledge, experience and careful examination usually lead to appropriate clinical diagnosis. However, lesions with similar clinical features present a diagnostic challenge. Therefore, a confirmatory histopathological examination can be helpful to reach the final diagnosis.

The present study was conducted to evaluate the agreement between clinical and histopathological diagnoses of oral epithelial and mesenchymal lesions in a period of 30-years (1976-2006) at Mashhad Dental School.

The percentage of concurrence and discrepancy between clinical and histopathological diagnoses of 625 epithelial and 2480 mesenchymal lesions was compared. Clinical data including the patient’s gender and age and the lesion’s location were also evaluated in cases with discrepancy. Data were analyzed using Mann-Whitney, T-Test, Chi-Square, Likehood Ratio, Fisher’s Exact and Kappa tests.

An overall agreement between clinical and histopathological diagnoses was seen in 71/4% of epithelial lesion cases, with maximum parity in squamous cell carcinoma and papilloma. In 57/1% of the mesenchymal cases, the diagnosis was in total agreement. Denture hyperplasia, epulis fissuratum, and pregnancy tumor showed the highest concurrence, respectively.

Although histopathological examination leads to final diagnosis, in some cases proper strategies and more attention to clinical features of the lesion are necessary to minimize the discrepancy, especially for those with non-specific clinical presentation.

Statement of Problem: Periodontists use different criteria to assess the success of periodontal treatments so that there is no consistent approach regarding the important parameters to be used for successful treatment.

The aim of this study was to determine success criteria of periodontal treatment using Delphi method based on the experience of expert panel of periodontists.

In this cross-sectional study using Delphi method, 15 periodontitists in Iran determined the level of importance of attachment level, probing depth, furcation involvement, mobility, plaque, inflammation and patient satisfaction following periodontal treatment of the posterior teeth in a patient with moderate to severe chronic periodontitis. The periodontists were questioned concerning the relative importance of each outcome measure, a minimally acceptable level for success for each criterion and the length of time for these parameters to remain stable.

Following two rounds of Delphi surveys, the periodontists considered the attachment level, bone loss and plaque to be a ''very important'' parameter for successful periodontal treatment. Probing depth, furcation involvement, inflammation, function, esthetics, mobility and patient satisfaction were considered to be" important" factors for successful periodontal treatment. The panelists agreed that a minimal of 1mm attachment gain, 1mm reduction in probing depth, Glickman grade I furcation involvement, Miller degree I mobility, and no change in the bone level are acceptable outcomes following 1 year of treatment. Finally, the periodontists considered that 1 year results of treatment should remain stable for a minimum of 5 years.

These studies suggest that Delphi method is a practical approach which can establish minimal standards for successful therapy of the posterior teeth based on the opinions of expert periodontists.

Statement of Problems: Enamel preconditioning using phosphoric acid has been recommended prior to applying self-etch adhesives. Meanwhile, there is the possibility for etching of the dentin.

The aim of this study was to evaluate the shear bond strength (SBS) of two self-etch adhesives to the dentin of the primary and permanent teeth in case of phosphoric acid preconditioning. Methods and Materials: In this experimental study, the buccal surfaces of 48 permanent molars and 48 primary molar teeth were prepared for bonding of two self-etch adhesives including Clearfil SE Bond (CSEB) and ACE All Bond SE (ABSE), to the dentin. Each of the permanent and primary teeth was randomly divided into 4 groups (n=12). According to the manufacturers’ instructions, CSEB and ABSE were applied on the dentin or etched dentin of both permanent and primary teeth, then, they were bonded with composite resin. The specimens were stored in water at 37oc for 24 hours and then were thermocycled for 500 cycles. SBS was performed at a crosshead speed of 1.0 mm/min using DARTEC universal machine. The results were statistically analyzed in SPSS 11.5 using Kruskal-Wallis and T-Test.

The bond strength of CSEB was significantly higher than ABSE adhesive in both primary and permanent teeth (p =0.001). Acid preconditioning significantly increased the dentin bond strengths of ABSE adhesive in the primary and permanent dentin (p =0.001), and CSEB adhesive in primary dentin.

Bond strength of the studied adhesives was significantly different. While acid phosphoric preconditioning improved the bond strength of the both adhesives in primary teeth, it did not influence the bond strength of the studied two-step self-etch adhesive in the permanent dentin.