مجله دانشکده دندان پزشکی اصفهان
سال هشتم شماره 5 (پیاپی 33، آذر 1391)

Impacted third molar surgery can be associated with a number of complications. Different medications and mouthwashes are used to reduce the incidence of such complications. In this study the effect of a herbal drug, Nabiddaru®, on reducing some complications of impacted mandibular third molar surgery was evaluated. In this clinical trial, 30 adult patients were randomly selected. Impacted mandibular third molar was extracted by surgery on one side and the effect of Nabiddaru® on decreasing the incidence of postoperative complications was investigated. The impacted third molar on the contralateral side was extracted in the same way after a month; however, no medications were used to relieve postoperative complications. Data was analyzed by SPSS using chi-squared test, paired t-test and Fisher’s test. The pain reported by patients at 6-, 12-, 24- and 48-hour postoperative intervals in the Nabiddaru® group was significantly lower than that in the control group (p value = 0.007), (p value = 0.006), (p value = 0.05) and (p value = 0.05), respectively. Bleeding at 2-day postoperative interval in patients treated with Nabiddaru® was lower than that in the control group (p value = 0.05). Trismus at 24-hour postoperative interval in the Nabiddaru® group was significantly lower than that in the control group (p value = 0.04). Considering the results of the present study Nabiddaru® is effective in reducing pain, bleeding and trismus after impacted third molar surgery.

Calcium aluminate α-aluminate (CAA) and wollastonite calcium α-aluminate (WOLCA) are new cements with sufficient biocompatibility and sealing ability. Radiopacity of these cements have not been evaluated. The aim of the present study was to determine the minimum amounts of two types of radiopacifiers necessary to incorporate into these two cements in order to achieve the necessary radiopacity in comparison with Pro-root MTA and Portland cement. In this experimental study, bismuth oxide and barium sulfate, with concentrations of 10% and 20%, were added to CAA and WOLCA as radiopacifiers and the radiopacity results were compared with that of Pro-root MTA as gold standard. Sixty Teflon ring specimens, measuring 10 mm in diameter and 1 mm in thickness, were prepared according to ISO standard of 6876, 2001. The specimens were divided into 12 groups of 5 and placed onto PSP cassette plates. The specimens were radiographed under exposure conditions of 63 kVp, 8 mA and 0.6 seconds. Data were analyzed by one-way ANOVA at a significance level of 0.95. The materials exhibited radiopacity (in mm of aluminum) in the following descending order: Pro-root MTA, 0.8 gr of CAA + 0.2 gr of bismuth oxide, 0.8 gr of WOLCA + 0.2 gr of bismuth oxide, 0.9 gr of WOLCA + 0.1 gr of bismuth oxide (p value < 0.001). For appropriate radiopacity based on international standards, combination of 0.8 gr of CAA + 0.2 gr of bismuth oxide, 0.8 gr of WOLCA + 0.2 gr of bismuth oxide and 0.9 gr of WOLCA + 0.1 gr of bismuth oxide are recommended.

Dental environment is always a stressful place for most patients because of factors such as fear of anesthetic injection and a history of past painful dental treatments. The aim of this study was to evaluate the effect of music on pain perception, anxiety and blood pressure in patients referring to a private dental clinic for root canal treatment.

In this clinical trial 60 patients referring to a dental clinic for endodontic treatment were evaluated. The subjects were randomly and equally assigned to the music intervention and the control groups. Subjects in the music group listened to their favorite music throughout the root canal treatment but the control group subjects did not. The subjects’ pain, heart rates and blood pressures, and anxiety levels were measured before the study, after anesthesia, during and at the end of the root canal treatment procedure by linear VAS, a digital blood pressure monitor, and Spielberger’s State-Trait Anxiety Inventory, respectively. Data was analyzed by t-test (α = 0.05).

The results revealed no significant differences between the two groups in systolic and diastolic blood pressures after the procedure; however, there were significant differences between the two groups during the procedure (systolic, p value = 0.013; diastolic, p value = 0.002). There were no significant differences in anxiety levels, heart rates and pain perception between the two groups (p value > 0.05).

In this study music had no effect on reducing patients’ anxiety levels; however, it had a significant effect on systolic and diastolic blood pressures during treatment. In addition, music had no effect on pain resulting from root canal treatment and also on heart rate. It appears music is effective in preventing blood pressure changes during root canal treatment.

In both medicine and dentistry, generalists should serve as primary care providers in the health care system in many countries, diagnose complex disorders and refer them to specialists. The aim of this study was to investigate cases and referral patterns of patients to dental specialists by general dentists in Kerman, Iran in 2011. In this descriptive cross-sectional study 248 dentists in Kerman were selected based on census. A valid and reliable questionnaire was designed based on previous studies on the case and patterns of referral to dental specialists. The questionnaire was submitted to the subjects in their offices or workplaces to complete. After data collection, data were coded. Spearman’s rank correlation was used to evaluate correlation. Data were analyzed with chi-squared test using SPSS 13 (α = 0.05). Differences were noted in the referral patterns of cases in relation to age, gender, and years of practice of the GP. A higher referral rate to the specialist was observed in patients with remarkable medical conditions. Most general dentists referred complex dentoalveolar surgery cases. Female dentists referred more patients compared to males. Referrals were most often made because of inadequate experience or instruments. This study showed that a relatively large number of dentists are in favor of referring patients in Kerman. However, in some cases these systems are not well managed and dentists require instructions in the correct referral patterns.

Antibiotics are widely prescribed in dentistry. However, the indications of antibiotic therapy are limited, especially in endodontics. There is little information available concerning the pattern of antibiotic prescription among dentists. The aim of this study was to evaluate and determine pattern of antibiotic prescription among general dental practitioners in Isfahan, Iran. In this cross-sectional, descriptive study, 280 general dental practitioners of Isfahan were included. A questionnaire containing 15 questions was prepared. Before the study was initiated the reliability and reproducibility of the questionnaire were determined. Data was analyzed by descriptive statistical tests using SPSS software. For non-allergic patients, amoxicillin 500 mg, 3 times daily (63.3%) and penicillin VK 500 mg, 4 times daily (11.4%), were the most commonly prescribed antibiotics, respectively. For patients allergic to penicillins, clindamycin 300 mg, 4 times daily (39.3%) and erythromycin 400 mg, 4 times daily (28.2%), were the first and second antibiotic choices. An initial double dose was prescribed by 39.3% of the subjects. Painful irreversible pulpitis without apical periodontitis (5.7%) and necrotic pulp with acute apical abscess (85%) were the least and the most common cases in which antibiotics were prescribed, respectively. Most of the participants prescribed antibiotics for a proper duration. However, most dentists were not aware of how to prescribe antibiotics. It seems that it is necessary to improve the knowledge of dental practitioners concerning the patterns of antibiotic prescription through continuous education programs.

It is useful to determine facial proportions in different communities to find an index for assessment of esthetics. The aim of this study was to determine several facial indices in females and males and compare them with the golden ratio and finally to compare anthropometry and digital photography techniques. In this cross-sectional analytical study, 20 female and 20 male subjects with no history of orthodontic treatment and facial esthetic surgery were selected. The subjects all had Cl I occlusion. Digital photographs were taken from all the subjects in the natural head position. Independent t-test, one-sample t-test and paired t-test were used for statistical analysis (α = 0.05). There were no significant differences between the two anthropometry and digital photography techniques in relation to measurements (p value < 0.05). The average ratios of oral width to nasal width, the distance between the nasal base and the chin to the distance between underneath the nose to the chin, the inter-zygomatic width to the nasal width in females, and the distance between the underneath of the nose and the chin to the distance between the nasal base and the chin in males were higher. Other ratios were not statistically significant in females and males. The majority of variables in males and females were different from the golden ratio (p value < 0.05), except for the ratios of oral width to the distance between the inner canthi of the eyes in females and males and the distance between the nasal base and the chin to the distance between the underneath of the nose to the chin in males (p value < 0.05). Based on the results of this study both methods can be used for facial ratio analysis but computed technique is reproducible and can be carried out in less time with greater accuracy. Due to differences of most of ratios of the present study from the golden ratio, it can be concluded that this ratio cannot always be used as a standard for treatment planning for dentists and surgeons in Iran.

Occasionally, due to overexposure or over-development, radiographs become dark. If this darkness can be decreased, there will be no need to repeat the radiographs. The aim of this study was to compare the effects of indirect digital technique and lightening solutions on improvement of diagnostic quality of darkened radiographs. In this experimental study, 50 periapical radiographs were taken from different areas of the maxilla and mandible of a head phantom with standard diagnostic quality using the bisecting technique. Subsequently, the exposure time was increased 1.5 times to produce darkened radiographs. The darkened radiographs were corrected by the use of a lightening solution and an indirect digital technique. Three well-trained post-graduate oral radiology students separately assessed the radiographs and graded the radiographs from 1 to 4 using a questionnaire based on their quality. Data were analyzed using Friedman’s and Wilcoxson’s tests (α = 0.05). There were statistically significant differences between diagnostic qualities of darkened radiograph and other groups (p value < 0.001). The qualities of radiographs lightened with lightening solution and indirect digital technique were better than those of the control group (p value < 0.001). The qualities of radiographs lightened with lightening solution were better than those lightened by indirect digital technique (p value < 0.001). Under the limitations of this study in the enhancement of diagnostic quality of dark radiographs, the lightening solution was better than indirect digital technique. Further evaluations are recommended.

People’s facial appearance can play an important role in their social success. On the other hand, facial appearance-related problems have an important effect on an individual’s quality of life. The aim of this research was to determine the relationship between dentofacial malformations and self-esteem and self-concept among male and female students of Isfahan Universities.

In this cross-sectional research, 159 students, 18-25 years of age, were randomly selected from Isfahan Universities. The subjects consisted of 84 male and 75 female students, selected using easy sampling method. The subjects filled two Rosenberg self-esteem and Rogers self-concept questionnaires (A: the real self; B: the ideal self) and were examined in relation to dentofacial deformities. Data was recorded in two groups of dentofacial deformity and free of dentofacial deformity. T-test, ANOVA and Pearson’s correlation coefficient were used for data analysis (α = 0.05).

The results did not show any relationship between self-esteem (p value = 0.342), self-concept A (p value = 0.581) and self-concept B (p value = 0.720) in the two groups. There was no relationship between deformity type and self-esteem (p value = 0.71), self-concept A (p value = 0.49) and self-concept B (p value = 0.337). In addition, there was no relationship between sex and self-esteem (p value = 0.237), self-concept A (p value = 0.416) and self-concept B (p value = 0.081). However, there was a direct relationship between self-esteem and self-concept A (r = -0.31).

Under the limitations of this research, there was no relationship between dentofacial deformities and self-esteem and self-concept.

Development of implant dentistry is one of the major advances in the dental science. With the development of implants in this field, implantologists face the inevitable challenge of how to deal with problems associated with implants. Studies so far have focused on surgical and prosthetic techniques, although information on how to treat the disease is still deficient. The aim of this review study was to provide a general view of conditions around implants and therapeutic suggestions in this regard. Review Report: Following an electronic search in Medline and Embase, papers were collected up to the end of 2011 and since controlled clinical trials in this field were limited, no restrictions were imposed on paper type. The previous review articles and Meta-analyzes were also used. In relation to implants with bone loss involving less than 50% of the implant length, accurate assessment of bone resorption is recommended. If bone loss is less than 2 mm, nonsurgical approaches similar to those of periimplant mucositis are used. If bone loss is greater than 2 mm but less than half the implant length, surgery is recommended and if there is more than 50% bone loss around the implant, implant removal is often recommended. With an increasing number of implants placed every year, periimplant conditions have become a challenge. The decision-making tree presented here represents guidance for clinicians on how to deal with implant complications. Future studies in this area are needed to confirm the protocols presented here.

Propolis is a beehive product which contains antioxidants. It also has anti-bacterial, anti-viral, anti-fungal, anti-carcinogenic and anti-inflammatory properties. The aim of the present article was to review literature and collect data on various applications of propolis to promote oral health. Review Report: Twenty-two different studies were selected, based on inclusion criteria, by running a search for the key word “propolis”, alone and/or combined with “oral health” and “dental treatment” in national and international electronic databases including medlib.ir, SID, Iranmedex, Magiran, PubMed and ISI Web of Knowledge from 1997 to 2009. The twenty-two selected articles were published from 1997 to 2009.

Efficacy of propolis in wound healing, as an intracanal irrigation agent, in caries prevention, in the treatment of periodontitis and dentinal hypersensitivity, and as an anti-fungal and anti-bacterial agent has been evaluated and demonstrated in different dental studies.

Considering the useful characteristics of this material including anti-inflammatory activity, antibacterial and anti-fungal effects and particularly provoking the immune system, which might be useful in preventing many diseases, it seems that this material has the potential to be used in dental sciences; however, further evaluations are necessary.