مجله دانشکده دندان پزشکی اصفهان
سال دهم شماره 3 (پیاپی 44، امرداد 1393)

Knowledge of the exact location of the inferior alveolar nerve (IAN) bundle is a very important factor for safe and quick removal of bone. The aim of this study was to evaluate the relationship between the mandibular third molar and the mandibular canal by different algorithms of cone-beam computed tomography (CBCT). In this cross-sectional study 94 mandibular CBCT images taken with CSANEX 3D machine (Soredex, Finland), in which there was close proximity between the wisdom teeth and the inferior alveolar nerve, were selected using convenience sampling technique. Vertical and horizontal relationships between the mandibular canals and the third molars were depicted by three different image processing algorithms of Nerve option, Panorama and Cross-sectional. Data were analyzed with SPSS 20 by calculating kappa ratio and by using chi-squared test (α=0.05). There were significant differences (p value < 0.05) in the vertical and horizontal relationships between the three different image processing algorithms. Kappa ratio for comparison of the vertical distance between the Nerve option view and Cross-sectional view was 0.713 (p value < 0.001). Kappa ratio for comparison of the vertical distance between the Panoramic view and Cross-sectional view was 0.696 (p value < 0.001). Kappa ratio for comparison of the horizontal distance between the Nerve option view and Cross-sectional view was 0.283 (p value < 0.001). Kappa ratio for comparison of the horizontal distance between the Panoramic view and Cross-sectional view was 0.197 (p value = 0.001). The results of this study showed differences in the position of the inferior alveolar nerve with different views of CBCT. Therefore, to determine the exact relationship between the nerve and tooth the use of only one view is not enough and it is better to use different views of CBCT for better diagnosis.

Biocompatibility of dressing materials is one of the most important properties to be studied. Calcium hydroxide is one of the most widely used dressing materials. The aim of this study was to compare the cytotoxic effects of colchicine with those of calcium hydroxide.

In this experimental in vitro study, different concentrations (10, 5, 2.5 mg/mL) of calcium hydroxide and colchicine were prepared and added to C165 human gingival fibroblast cells after they were incubated in the culture medium. After 24 and 72 hours and 7 days of incubation, tetrazolium salt was added to the cells, and the amount of formazan was determined by spectrophotometry using an ELISA reader. To assess the cytotoxicity of these two materials and after drug treatment, 0.4% trypan blue dye was used to stain the cells; viable cells were counted under a light microscope. Data were analyzed using Kruskal-Wallis and Mann-Whitney tests and t-test.

The control group, without adding any material, had the highest optical density. Optical density of different concentrations (10, 5, 2.5 mg/mL) of calcium hydroxide at all the time intervals was higher than that of colchicine (p value < 0.05). In addition, trypan blue dye showed that the mean of fibroblast cells destroyed by colchicines was significantly higher than that by calcium hydroxide (p value < 0.001).

Based on the results of this study, the cytotoxic effects of both calcium hydroxide and colchicine were higher than the control group and cytotoxicity of colchicine was higher than that of calcium hydroxide. Therefore, it seems that calcium hydroxide is still the best choice for canal dressing between treatment sessions.

Diabetic patients are vulnerable to periodontal diseases and caries due to systemic disorders. It is essential for diabetic patients to understand the importance of oral health self-care behaviors. The aim of this study was to determine the effects of educational intervention on oral health self-care behaviors in diabetic patients. In the present randomized controlled study, 150 diabetic patients were selected based on random sampling using a table of random numbers from those referring to a diabetes care service center in Qazvin. Control and experimental groups completed a questionnaire (demographic questionnaire, 26-item scale of TPB constructs and 7-day recalling scale for assessing brushing and flossing behaviors) at baseline and 30 months after education. Intervention was carried out in three 30‒45-minute group discussions in the experimental group. Data were analyzed with SPSS 20.0 using independent t-test and chi-squared, Mann-Whitney and Wilcoxon tests (α = 0.05). The results showed significant increases in mean scores of knowledge (from 4.5 ± 1.7 to 9.6 ± 2.2), attitude (from 19.4 ± 4.6 to 33.0 ± 6.1), subjective norms (from 10.2 ± 1.9 to 16.7 ± 2.7), perceived behavioral controls (from 10.8 ± 3.0 to 15.5 ± 3.3) and intention (from 4.3 ± 0.9 to 9.4 ± 1.2) (p value < 0.001). In addition, frequency of brushing (from 1.03 ± 0.3 to 1.6 ± 0.3) and flossing (from 0.4 ± 0.18 to 0.7 ± 0.2) improved in patients in the experimental group (p value < 0.001). The results of the present study showed the efficacy of theory-oriented educational interventions in changing oral health-related self-care behaviors in diabetic patients. Attention to orodental health in diabetic patients, use of educational interventions to change behaviors and use of individual techniques can dramatically reduce the economic and health burden of periodontal diseases and dental caries in diabetic patients.

Malocclusion and dental caries are two of the most frequent dental and oral cavity conditions. Studies evaluating the relationship between malocclusion and tooth decay have reported conflicting results. The aim of this study was to evaluate the association between DMFS index and different types of malocclusion in a population of 11‒14-year-old Iranian children. In this cross-sectional study 281 Iranian children aged 11‒14 (162 females, 119 males) were selected by multistage stratified sampling from elementary and guidance schools in Isfahan. DMFS index, overjet (mm), overbite (mm), anterior crowding (mm) and anterior spacing (mm) were measured. The results were analyzed by linear regression and Pearson’s correlation test at a significance level of 0.05. DMFS index showed significant relationship with crowding (p value = 0.002, r = 0.183). Other types of malocclusion, including overjet, overbite and anterior tooth spacing did not exhibit significant relationships with DMFS (p value > 0.05). Under the limitations of this study, it was shown that of all types of malocclusion, there was a significant relationship between DMFS and crowding, with no such relationship between overjet, overbite and anterior tooth spacing.

Of all the different techniques used to reconstruct local bone defects guided bone regeneration (GBR) has proved the best choice. Angiogenesis and blood products are important for GBR and are usually derived from blood vessels in the bone. Animal studies have not shown consistent effects of decortication on improving the results of GBR. The aim of this preliminary study was to assess the success rate of bone augmentation with and without bone decortication.

In this quasi-experimental preliminary study, 8 edentulous areas of the mandible were selected in 30-50-year-old patients, with adequate height but inadequate buccolingual width, for augmentation before implant surgery. In the first surgery buccolingual width of the ridge was measured at a height of 2-5 mm from the crest. Augmentation with GBR was performed without decortication of the buccal cortical bone, except in three cases. Seven months later, measurements of the buccolingual width were repeated and biopsies were taken, followed by evaluation of histopathological and histomorphometrical parameters. Descriptive variables were studied and reported.

In areas without decortication, at 2- and 5-mm distances from the crest the mean buccolingual width increases were 0.2 ± 0.05 and 0.6 ± 0.03 mm, respectively. The mean increases in width for decortication areas were 0.33 ± 0.24 and 2.5 ± 0.50 mm, respectively. In all the cases, contact of the newly formed bone with the xenograft was the dominant view.

Under the limitations of the present study, decortication before lateral augmentation of mandibular ridges by using GBR yielded better results in terms of bone reconstruction.

A thorough knowledge of the root canal morphology has a key role in successful endodontic therapy. The aim of this study was to investigate the root and root canal morphology of maxillary third molars in Kerman, a province in south east of Iran in 2010‒2011. One hundred fifty extracted maxillary third molars were collected randomly from different dental clinics in Kerman. Then access cavity was prepared in each tooth and the tooth pulp was completely removed by placing the teeth in 2.5‒3% NaOCl solution for 12‒24 hours. Then India ink was injected into the root canal system through the access cavity. After 12 hours the samples were decalcified in 5‒10% nitric acid, dehydrated in ascending concentrations of 70%, 95% and 100% ethanol for one day and cleared in 5% methyl salicylate. The following features were evaluated: the number and morphology of roots, number of canals per root, root canal configuration according to Vertucci classification and the incidence of dilacerated roots and C-shaped canals. The prevalence rates of three-rooted and two-rooted teeth were 42.6% and 39.3%, respectively; 10 % of the samples had 1 root and 39.3% had 2 roots. In this investigation, 12.8% of the teeth had at least 1 dilacerated root. The incidence of C-shaped canal was 3.5% in this study. Based on the results of the present study, 3 roots seems to be the most common anatomy in the Kermani population under study.

Long-term and predictable endodontic treatment requires complete and effective debridement of the root canal system. The aim of this study was to evaluate and compare the effects of propolis and some commonly used conventional irrigating solution as a root canal irrigants on Enterococcus faecalis.

A total of 60 one-rooted teeth with a root length of 13 mm were selected and the crowns were cut away. The samples were then cleaned, shaped and divided into 5 groups of 12. The irrigation solutions of 2.5% NaOCL, 1% iodine potassium iodide, 0.2% chlorhexidine, alcoholic extract of propolis and sterile ionized water (control group) were used in the study groups, respectively. Subsequently, the canals were contaminated with Enterococcus faecalis and cultured once. Then the specimens were rinsed again with the irrigants mentioned above and cultures were obtained. Data were analyzed with SPSS 20 using t-test and one-way ANOVA (α = 0.05).

The first and second cultures in all the groups were significantly different from the control group (p value = 0.001). The first cultures exhibited significant differences between propolis and sodium hypochlorite (p value = 0.025). In the second cultures there were significant differences between propolis and other groups and between iodine potassium iodide and other groups (p value < 0.05) except for sodium hypochlorite (p value = 0.116). In addition, there were significant differences between chlorhexidine and sodium hypochlorite (p value = 0.002).

Based on the results of the present study, propolis exhibited better antibacterial effects on E. faecalis compared to other materials. In addition, all the irrigants had better antibacterial activity compared to water.

Attention to patients’ satisfaction with treatment centers has a major role in management programming in health services. The aim of this study was to determine the level of patients’ satisfaction with dental services in Fasa, Iran.

The present applied study was carried out in a descriptive/analytical manner. A researcher-designed questionnaire with five-scale Likert design, consisting of three sections, was completed through interview. A total of 400 patients were interviewed. Data were analyzed with SPSS 20 and Minitab 16 using Spearman’s correlation coefficient and chi-squared test (α=0.05). Validity of the questionnaire was provided through criterion and content methods. To determine reliability, Cronbach’s alpha was calculated at 0.91.

Of the demographic and contextual variables, there were statistically significant relationships between satisfaction and education, job and sex (p value < 0.001). Correlation coefficient between the patient's overall satisfaction and loyalty index was calculated at 0.673 (p value < 0.05). The key priorities of improvements in dental services were cost of dental services, careful evaluation of the patients, taking patient history and thorough physical examination by a dentist, attitudes and behaviors of the dental office personnel toward patients and respect for them and determining suitable appointments, respectively.

The results of this study showed that patients were satisfied with the services of dentists; however, it appears that by reforming system's defects based on patients’ opinions higher satisfaction rates would be obtained.

Mass media are an important source to convey health information to the general population. The aim of this study was to assess the oral health information coverage in Iranian mass and health-related media, with general population audience, in 2011‒2012. In this cross-sectional study, a health-related TV program, one health-related and two general newspapers nationally published or broadcast in 2011‒2012 were analyzed. The data on programs and articles containing information on various oral health topics were collected. A 7-item checklist was developed to analyze the quality of information concerning oral diseases and prevention separately (scores ranged from 0 to 14). Descriptive statistics were applied for data analysis. Of 853 resources evaluated, 102 articles and programs comprising oral health topics were found. Dental caries and preventive methods for primary dentition were the most common topics described in 37% of articles, followed by orthodontic treatments and nutrition (16% each) and oral hygiene topiucs on the use of toothbrushes and dental floss (14%). The coverage of other topics was less than 10% for each area. The mean quality score of 38 preventive articles was 12.5. Oral health topics were shown to have inadequate coverage in Iranian mass media, with no coverage of all the topics needed. It is expected that mass media show a more effective role in oral health promotion campaigns through more coverage of oral health information.

Periapical diseases are the final outcome of untreated pulpitis or failure of root canal treatment, collectively referred to as periapical lesions. Pulpitis is the final consequence of advanced dental caries or severe dental trauma, affecting the pulp. Spread of odontogenic infections into adjacent oral tissues and distinct structures by blood and lymph vessels can lead to more serious complications. Therefore, early and correct diagnosis and treatment of these lesions is necessary to prevent their potential complications. Considering the importance and high prevalence of periapical lesions, this study was undertaken to evaluate the periapical inflammatory lesions and spread of odontogenic infections. In this study, studies performed from 2000 to 2013 about clinical, radiographic, and histopathologic features and treatment of periapical lesions, and also spread of odontogenic infections were evaluated by running a search in PubMed, EBSCO, ISC and Google Scholar databases. Periapical periodontitis is one of the most common odontogenic diseases; the chronic type of it or periapical granuloma is more prevalent than its acute type or periapical abscess. Radicular cyst, the most common odontogenic cyst, is a sequela of periapical granuloma. Inflammatory lesions with an odontogenic origin can spread to the bone marrow, causing osteomyelitis. In addition, these lesions give rise to acute and serious diseases such as soft tissue abscesses and cellulitis if they are not managed on time. Early diagnosis of periapical lesions leads to easier management, more successful treatment and better prognosis.