Zahedan Journal of Research in Medical Sciences
Volume:16 Issue: 7, Jul 2014

This study aims to evaluate the root canal system and its curvature and the relationship between the root concavity and the dentin thickness of danger zone in the mandibular first molar using the cone beam CT method. A sum of 101 fresh extracted mandibular first molar were gathered and scanned by CBCT (planmeca romexis 3D) machine. The root canal configuration was evaluated according to Vertucci’s classification. Then, the canal curvature was evaluated according to schneider''s method in clinical and proximal views. Finally, the relationship between the root concavity and the dentin thickness of danger zone was evaluated using the Pearson correlation coefficient. The most common canal configuration of the mesial roots was vertucci type IV (49.5%), followed by type II (46.5%). Root canal configuration of the distal root revealed type I in 50.5% and type II in 29.7%. The average angles in proximal dimension for MB, ML, DB and DL canals were 18.80, 18.77, 8.22 and 16.86, respectively. These values in clinical dimension were 22.50, 21.90, 13.83 and 12.04, respectively. No meaningful relationship was found between the dentin thickness and the root concavity of danger zone. The clinician''s awareness of the anatomy of the root canal system and the canal curvatures and the internal and external anatomy of the root is helpful and necessary in diagnosis and treatment of the endodontic cases.

Lichen planus is a chronic inflammatory mucocutaneous disease with immune system''s origin. There is no definite cure for that and present treatment methods are symptomatic. According the effects of topical medications and anti-inflammatory properties of licorice, this study is designed for comparison the effectiveness of the adhesives containing licorice with topical steroid on treatment of oral lichen planus. In this double-blind clinical trial, 40 patients randomly divided into two groups: licorice and topical corticosteroid therapy and were followed up for 12 weeks, we asked patients used the drugs four times in a day and after applying drugs avoid of eating, drinking and smoking for an hour. Data were analyzed by SPSS-19, using the independent samples t-test and Mann-Whitney U tests. In this study the use of topical licorice as topical corticosteroids were effective in reducing pain, but the improvement of clinical signs was not effective as corticosteroids. The severities of lesion according Thongprasom classification were 1.2±1.03 in corticosteroid group and 2.6±0.9 in licorice group. There was a statistical significant difference between groups (p=0.006). Based on the findings of this study topical licorice 5% is not a good alternative for topical corticosteroids in the treatment of lichen planus.

One of the complications of Iron drop recommended for 6-24 months children is the potential reduction in microhardness of primary tooth enamel because of low pH. The objective of this study is to assess the protective effect of amorphous calcium phosphate caseine phosphopeptide (ACP-CPP) and silicone oil in primary teeth. Thirty extracted primary anterior teeth were divided into three equal groups. The initial micro hardness was measured by Vicker’s microhardness tester. The first group without a protective layer and the second and third group after application of ACP-CPP and silicone oil respectively, were immersed in iron drop. Microhardness was remeasured. One tooth in each group along with a tooth not exposed to iron drop were randomly chosen for SEM qualitative analysis. Analysis was performed with Repeated measures ANOVA with SPSS-18. All groups exhibited significant decrease of micro hardness (p=0.001), however, no contrasting pattern was found between various groups. Neither ACP-CPP nor silicone oil could not provide a significant protection against micro hardness reduction after exposure to iron drop.

Postoperative pain following root canal therapy is of concern for endodontic patients and dentists. Despite the fact that the pain relief afforded by endodontic is effective, it is rarely immediate and complete. The purpose of this double blind study was to compare the efficacy of betamethasone, indomethacin, ibuprofen, used commonly to control post endodontic pain or a placebo. This randomized, double blind, placebo controlled study included 100 patients with symptomatic, vital and one canal tooth. Patients were randomly allocated into one of the four groups to receive treatment three times a day with ibuprofen (400 mg), betamethasone (2 mg), indomethacin (75 mg) or placebo following completion of root canal treatment. The patients recorded pain intensity on a special chart (visual analogue scale) at time intervals of 6, 12, 24, and 48 hours after treatment. ANOVA and t-test was used to determine statistical significance. p-value<0.05 was considered statistically significant. In the placebo group, the mean pain score was significantly higher than in all the groups in different time after treatment. In the ibuprofen group, patients experienced significantly more pain than in the indomethacin and betamethasone groups, in 6 and 12 hours after treatment but the difference was not significant in 24 and 48 hours. The mean pain score was not significant difference between indomethacin and betamethasone group. The results demonstrate that the betamethasone and indomethacin may be more effective than ibuprofen for the management of postoperative pain after nonsurgical endodontic treatment when patients present with moderate to severe pain.

The aim of the present study was to compare hematologic problems in patients with recurrent aphthous stomatitis, with a control group. In this cross sectional study, 30 subjects with recurrent aphthous stomatitis and 30 healthy individuals were included as the case and control groups, respectively. After diagnosis was established a 10 ml sample of the subjects'' blood was used to determine serum levels of iron, ferritin, vitamin B12, folic acid and zinc in each subject. Independent t-test was used to analyze data. The average serum iron, serum ferritin, vitamin B12, folic acid and serum zinc levels in the case and control groups were assessment, demonstrating no statistically significant differences between the two groups (p>0.05). According to the results of the present study, hematologic deficiencies cannot play a role in etiology of aphthous stomatitis.

Successful local anesthesia is the bedrock of pain control in endodontics. Pain control is essential to reduce fear and anxiety associated with endodontic procedure. The aim of study was, identifying and comparison of the anesthesia efficacy of articaine and articaine plus morphine for buccal infiltration in mandibular posterior teeth with irriversible pulpitis. This randomized double-blind clinical trial included 75 patients with symtomatically irreversible pulpitis in mandibular teeth. Patient divided 3 groups randomly received either a buccal infiltration of 4% articaine with 1:100000 epinephrine or articaine morphine with 1:100000 epinephrine or IAN block of 2% lidocaine with 1:800000 epinephrine. Self-reported pain response was recorded on VAS scale before and after local anesthetic injection during access preparation. For statistical analysis were used χ2, t-test, one way ANOVA and Mann Whitney. Statistical analysis result show success rate of articaine (68%), articaine morphine (52%) and lidocaine (64%). There was no statistically difference in the success rate between groups. Addition of the morphine to articaine does not increase success rate of buccal infiltration.

Oral lichen planus (OLP) is a chronic immunological disorder with unknown etiology. The aim of this study was to determine psychological factors and salivary cortisol, IgA level in patients with oral lichen planus. In this experimental study 20 patients with OLP and healthy person were admitted to this study. Saliva samples were collected between 9-10 Am. saliva cortisol, IgA level was detected by ELIZA method. In this study, patients with anxiety and depression were measured using the SCL-90 questionnaire. Data analyzed by t-test. The mean salivary cortisol level in patients with OLP was 3.2±1.9 ng/mL and the mean saliva cortisol level in healthy person was 3.5±1.9 ng/mL. Significant difference was observed in the salivary cortisol levels in the 2 study groups (p=0.04). The mean salivary IgA level in patients with OLP was 0.69±0.29 ng/mL and the mean saliva IgA level in healthy person was 0.9±0.43 ng/mL but no significant difference was observed in the salivary cortisol levels in the 2 study groups. Results showed that anxiety levels in patients with oral lichen planus were slightly higher than controls but there was no significant difference between healthy subjects. Finding revealed the mean salivary cortisol level in patient with OLP less than healthy persons. Significant difference was observed in the salivary cortisol levels in the 2 study groups. Based on the t-student test, no significant difference was observed in the salivary IgA levels in the 2 study groups. Anxiety levels in patients with oral lichen planus were slightly higher than controls.

Considering probable incidence of pathological changes in the follicles of impacted teeth, this study is conducted to evaluate pericoronal radiolucency of impacted third molars. In this cross-sectional study, widths of follicular spaces of 201 impacted third molars were measured on panoramic radiographs. Under local anesthesia, the teeth along with the dental follicles were surgically removed. After routine procedure, they histopathological were examined. After evaluating 201 dental follicles it was observed that, 50.7% of cases (102 cases) showed pathological changes and all of them were dentigerous cysts. Incidence of cystic changes in the follicles of third molars of patients aged 21 years and above, is 1.465 times more than patients who were under 21 years old. Also in dental follicles of lower third molars, the incidence of pathological changes was 1.957 times more than maxilla. Cystic changes in the evaluation of follicular widths up to 1.5 mm, was observed in 48% of cases, up to 2 mm, in 73.5% of cases, up to 2.5 mm, in 87.2% of cases and up to 3 mm, in 92.1% of cases. It seems that occurrence of cystic changes in dental follicles increases with increase in age and width of follicular space. However, considering the high incidence of cystic changes in pericoronal radiolucency around the impacted third molars, this study supports the prophylactic removal of impacted third molars.

Central giant cell granuloma, (giant cell reparative granuloma), is a non-neoplastic proliferative lesion with unknown etiology which commonly occurs in the mandible. This lesion presents a wide variety of radiological and clinical manifestations that may lead to misdiagnosis. CGCG is diagnosed through histopathological examinations.

Neurofibroma is a benign neoplasm derived from peripheral nerve cells. Neurofibroma can occur as a solitary tumor also it may associate with neurofibromatosis. Intraosseous neurofibroma is a rare tumor particularly in the oral cavity. So far, few cases of solitary intraosseous neurofibroma of the mandible have been reported.In the present study, a 39 years old woman which has a diagnosis of solitary intraosseous neurofibroma of the mandible is reported. Clinical, radiographic, histopathologic and immunohistochemical features are described.