مجله دانشکده دندان پزشکی اصفهان
سال نهم شماره 2 (پیاپی 37، خرداد 1392)

Salivary calcium and phosphate levels might have a relationship with dental caries severity. Evaluation of different indexes such as alkaline phosphatase, which increases salivary phosphate levels, and hydroxyapatite ion activity, which reflects salivary calcium and phosphate levels, might help determine the risk of dental caries. The aim of the present study was to compare salivary alkaline phosphatase activity and hydroxyapatite ion activity index in 6‒12-year-old children with different rates of dental caries. In this descriptive-analytical study the teeth were examined in 152 children, aged 6‒12, by a dentist and were placed into three experimental groups according to the dental caries severity as follows: group 1: severe dental caries (DMFT ≥ 6); group 2: moderate dental caries rate (1 < DMFT < 6); and group 3: mild dental caries rate (DMFT ≤ 1). After collection of saliva, salivary alkaline phosphatase levels and hydroxyapatite ion activity were measured for each sample. Data was analyzed using one-way ANOVA and a post hoc Tukey test (α = 0.05). The means and standard deviations of alkaline phosphatase levels in groups 1 to 3 were 5.39 ± 2.96, 5.71 ± 3.68 and 5.83 ± 4.53 unit/dL, respectively. Hydroxyapatite ion activity rates were 25.80 ± 0.70, 28.28 ± 0.76 and 28.50 ± 0.56 in groups 1 to 3, respectively. The results of one-way ANOVA showed no significant differences between the experimental groups in alkaline phosphatase levels (p value = 0.830) and hydroxyapatite ion activity (p value = 0.065). According to the finding of the present study, alkaline phosphatase level and hydroxyapatite ion activity have no effect on tooth caries severity in 6‒12-year-old children. Future studies are recommended.

Given the strong association between smoking and periodontal disease, it is necessary that dentists place emphasis on smoking cessation in patients. Effectiveness of motivational interviewing in reducing plaque and improving self-care behaviors has been documented in previous studies. The aim of this study was to evaluate the effect of motivational interviewing on improving oral self-care behaviors in patients referring to dental clinics in Tonekabon, Iran. In the quasi-experimental study, 80 smoking patients referring to dental clinics in Tonekabon were randomly divided into experimental and control groups. The intervention consisted of two sessions of motivational interviewing for 30 minutes in 5-member groups, followed by follow-up by telephone in the experimental group. Data were collected before and 6 months after interviews using a questionnaire which included questions on demographic data, knowledge, attitude and an algorithm of stages of change, along with brushing and flossing behavior checklist. Finally, data were analyzed with SPSS 17.0, using chi-squared, Mann-Whitney, Wilcoxon tests, t-test and independent t-test. The results showed significant increases in knowledge scores from 13.5 ± 5.6 to 21.6 ± 4.2 (p value < 0.001) and attitude scores from 32.40 ± 14.2 to 54.11 ± 15.9 (p value < 0.001) in the experimental group. It also significantly increased the number of patients in the active stages for smoking cessation, i.e. preparation (from 7.5 to 42.5 percent), action (from 0 to 25 percent) and maintenance (from 0 to 7.5 percent) (p value < 0.001). In addition, the experimental group exhibited improvements in self-care behaviors, including brushing (from 0.75 ± 0.20 to 1.19 ± 0.38, p value < 0.001) and flossing (p value < 0.001). Under the limitations of this study, it was shown that motivational interviewing is effective in promoting oral self-care behaviors among smoking patients referred to dental clinics.

In recent years use of self-etch primers has been suggested for fissure sealant therapy due to ease of procedural steps. The aim of this in vitro study was to investigate fissure sealant microleakage in permanent teeth with the acid-etch technique, using one-step and two-step self-etch systems. A total of 45 sound premolars were selected. Then the occlusal grooves were freshened by the tip of a #1/4 round bur and divided into 3 groups with 15 samples in each group. In the first group after etching by 37% phosphoric acid, Clinpro sealant was applied on the grooves. In the second and third groups, Clearfil SE Bond two-step self-etch and AdheSe One all-in-one one-step self-etch bonding systems were used, respectively. The teeth were subjected to thermocycling for 1000 cycles at 5‒55ºC thermal range. Then the samples were immersed in 0.2% alkaline Fuchsin for 24 hours. After bucco-lingual cross-sectioning, dye penetration under the sealants was evaluated under a stereomicroscope. Data were analyzed by Kruskal‒Wallis and Mann–Whitney tests. The results showed significant differences between the three groups (p value < 0.001). However, there was no significant difference between Clearfil SE Bond and acid-etch groups in microleakage (p value = 0.902). Significantly greater microleakage was observed in the AdheSe One group compared to other groups (p value < 0.0001). According to the results of this study, microleakage of fissure sealants with Clearfil SE Bond two-step self-etch adhesive was comparable to that of conventional etch-and-rinse technique. However, there was more microleakage with AdheSe One one-step self-etch adhesive compared to other two groups.

Rotary files cannot be used in calcified, S-shaped and open apex canals and working with these tools requires training and sufficient expertise. The aim of this study was to determine knowledge, attitudes and skill of working with rotary files among general dental practitioners in Isfahan, Iran in 2012‒2013. In this descriptive study 200 general dentists were randomly selected in Esfahan. A questionnaire was prepared by two endodontists to collect demographic information and to assess knowledge, attitudes and skill in relation to the use of rotary files among the subjects. Data was analyzed with SPSS 20 using Mann‒Whitney and Kruskal‒Wallis statistical tests (α = 0.05). Of 182 participants completing the questionnaires, 86 (47.25%) used rotary files; 5.8% provided correct replies in knowledge, with 1.4% in attitudes and 9.9% in skill areas. Female dentists were significantly more knowledgeable than male dentists (p value = 0.002) and males had more skills than females (p value = 0.003). There was no significant difference in attitudes between the two sexes (p value = 0.09). No significant differences were observed in knowledge, attitudes and skill of dentists in relation to location, work experience and university between the groups (value > 0.05). Use of rotary files should be accompanied by sufficient training to assist dentists improve treatment quality. Lack of training in all the three fields was evident in this study.

Some investigations have shown a direct and significant correlation between BMI (body mass index) and dental caries. The aim of this study was to determine the association between obesity and dental caries in the permanent teeth of 12‒14-year-old female students of guidance schools in districts 5 and 6 in Tehran, Iran in 2011. In this cross-sectional descriptive study, 950 female students, aged 12‒14 years old, were selected randomly from guidance schools in districts 5 and 6 in Tehran. The frequency of brushing, flossing, daily consumption of snacks, DMFT (Decayed, Missing, Filled) and BMI were assessed using interviews and clinical examinations. The association of the variables was determined by Pearson’s correlation and linear regression statistical tests at a confidence interval of 95%. The means of DMFT index were 3.56 ± 2.652, 4.26 ± 2.961 and 4.38 ± 2.899 in 12-, 13- and 14-year-old students, respectively. Evaluation of the effect of demographic variables, oral hygiene habits and obesity on DMFT showed that age (p value = 0.001), toothbrushing frequency (p value = 0.025) and frequency of snack consumption daily (p value = 0.043) are effective on tooth decay. However, no correlation was found between frequency of flossing (p value ≤ 0.083) and BMI (p value ≤ 0.205) with tooth decay. There was no statistically significant association between DMFT and BMI of 12‒14-year-old female students in Tehran. There was no relationship between the frequency of sweet snacks consumption and age with BMI. Toothbrushing frequency and frequency of sweet snacks consumption have an effect on tooth decay.

Due to ever-increasing need for diagnostic radiographs in dentistry, it is necessary to observe techniques to minimize the absorbed patient dose. The aim of this study was the comparative evaluation of inherent visual characteristics such as contrast and density and the gross fog of standard occlusal films with those of occlusal films taken with intensifying screens. In this experimental research, standard occlusal films and occlusal films prepared by cutting extraoral films to the size of occlusal films and placing them between intensifying screens were used. After determination of the most appropriate exposure time and maximum kVp and mA, radiographs were taken from one step wedge and processed using the same condition. A total of 25 radiographs were taken from each of the two film types and then the radiographs underwent densitometry at similar points. In order to evaluate the gross fog, densitometry was carried out at 5 similar points on one unexposed film from each type. Data were analyzed using SPSS 11.5 software and Mann-Whitney test (α = 0.05). Based on the results of this study, the density of the standard occlusal film was more than that of the occlusal film with intensifying screens (p value < 0.001). The contrast of the film with intensifying screens was more than that of the standard occlusal film (p value < 0.001). The gross fog of the film with intensifying screens was less than that of the standard occlusal film (p value = 0.006). Occlusal films with intensifying screens have higher contrast and lower gross fog and density, but in the diagnostic range, in comparison with standard occlusal films; therefore, films with intensifying screens are recommended because they decrease patient absorbed dose by decreasing exposure time.

The relationship of the mandible to the cranial base influences both sagittal and vertical facial disharmonies. The aim of the present study was to analyze the relationship between facial height and sagittal position of the glenoid fossa in subjects with Class II malocclusion associated with mandibular retrusion.

This descriptive-analytical study was carried out on 60 subjects (21 males and 39 females, aged 7‒12 years), with Class II malocclusion associated with mandibular retrusion, who had different facial heights (normal, short, long). The cephalometric measurements were carried out based on three parameters of GF-S on FH, GF-PTM on FH and GF-FMN. Data were analyzed by SPSS16 using one-way ANOVA and Duncan analysis (α = 0.05).

The means of GF-FMN distances in subjects with short, normal and long faces were 72.6 mm, 70.4 mm and 69 mm, respectively. The means of GF-S distances on FH in the three groups were 11.6 mm, 12.7 mm and 11.27 mm, respectively and the means of GF-PTM distances on FH were 30.09 mm, 28.6 mm and 28 mm, respectively. There were no statistically significant differences in the sagittal position of glenoid fossa between the three groups (p values < 0.05). There were significant differences between long and short faces in the GF-FMN distance (p value = 0.048).

Under the limitations of this study there was no significant relationship between facial height and the sagittal position of glenoid fossa in subjects with Class II malocclusion associated with mandibular retrusion.

Dentists must be aware of the impact of bleeding disorders on the management of their patients. The aim of this study was to determine dentists’ knowledge about management of patients with bleeding disorders in Kermanshah, Iran. Ninety dentists were randomly selected for the purpose of this cross-sectional research from the public and private sectors in Kermanshah in 2012. The knowledge was evaluated by using a self-administrated questionnaire containing 11 questions about high-risk dental procedures for bleeding (11 scores) and 8 questions about coagulation tests (8 scores). Pearson’s correlation coefficient and one-way ANOVA were used for evaluation of association between variables (α = 0.05). The response rate was 88% (79 from 90 cases). The mean of total score of knowledge was 10.9 ± 3.2 out of maximum 19 scores; 63.3% of dentists had acceptable knowledge (knowledge score above 60% of maximum score). Approximately 40% of dentists scored lower than seven in the section on high-risk dental procedures for bleeding. Only 34% of dentists scored higher than 5 in the section on coagulation tests. There was a negative association between job experience and use of tests to control coagulation status (p value = 0.02). According to the results, dentists in Kermanshah have insufficient knowledge about bleeding disorders. Planning of educational courses for dentists is necessary in this respect.

Oral malodor or halitosis has a prevalence of approximately 33%. In 90% of cases the causes of halitosis are located in the oral cavity. Diagnosis and treatment of oral malodor are primarily the responsibility of dentists.Review of Report: This is a review study in which electronic searches were run for halitosis in Pubmed and Medline from 1980 to 2012. Physiologic and pathologic halitosis, pseudo-halitosis (false halitosis) and halitophobia (fear from oral malodor) are discussed in this article. Pseudo-halitosis is a condition in which halitosis is non-existent but the patient is convinced that he or she has halitosis and if this idea persists after therapy for either genuine or pseudo-halitosis it is referred to as halitophobia. When the causes of halitosis are periodontal diseases or gingivitis, scraping of tongue is strongly advised in addition to conventional periodontal therapy and oral hygiene procedures. Diagnosis and treatment of halitosis with psychologic origin are more difficult than others and most patients receive unnecessary treatment. There are different treatment modalities for halitosis based on etiologic factors, which are presented in this article. It is important for the dentist to have a proper understanding of this prevalent oral condition and provide effective intervention and correct treatment.

The aim of the present case report is to describe the diagnostic and confirmative role of radiographic examination of Stafne idiopathic bone cyst (SIBC) before implant insertion without any need for histopathologic evaluation. Comprehensive evaluation of any type of pathologic lesion in the jaw region is necessary before insertion of any implants. The aim of the present case report is to describe a diagnosis of a Stafne idiopathic bone cyst during pre-implant evaluations by comparative assessment of the lesion on radiographs taken 11 months apart. A 73-year-old female was referred to the clinic for CBCT examination before implant treatment. A well-defined radiolucency measuring 3.1×6.2 mm was visible on CBCT images in the left mandibular angle region. In the past patient’s radiologic documents, a panoramic radiograph taken 11 months previously showed the same radiolucency with almost the same dimensions and location. Due to the absence of any clinical symptoms, well-defined borders and absence of changes in dimensions during the 11-month period, a definitive diagnosis of SIBC was reached. Based on CBCT findings, implant placement is possible in cases of SIBS without any need for histopathologic examination and invasive surgical exploration.