Journal of Islamic Dental Association of IRAN
Volume:26 Issue: 3, 2014

Pain relief is important during orthodontic treatment. The aim of this study was to compare the efficacy of ketoprofen and benzocaine chewing gums for pain reduction during fixed orthodontic treatment. Thirty patients aged 15-25 years experiencing orthodontic pain were randomly divided into 3 groups, each receiving one of the experimental chewing gums namely ketoprofen, benzocaine and the placebo. Instructions were given to the patients and they received the gums taking into account the wash out period. Patients recorded their degree of pain perception at 2, 6 and 24 hours, and 2, 3 and 7 days using the visual analog scale (0-100). Friedman and Wilcoxon tests were used to compare the mean pain scores among the 3 groups. The mean pain score decreased over time in both sexes and all groups (P 0.017). The mean pain score recorded in benzocaine group was lower than that in the ketoprofen and placebo groups but a significant relationship was observed in the ketoprofen gum group only during the first two hours using Friedman and Wilcoxon tests (P=0.042). Compared to the control group, both ketoprofen and benzocaine chewing gums significantly decerased pain at all time points except for day 7. Ketoprofen and benzocaine gums were both significantly effective for orthodontic pain reduction.

Malocclusion is a misalignment or incorrect relation between the teeth and its frequency increases with age. Knowledge about normal occlusion can help determine the degree of deviation from the normal position. This study aimed to find a relationship between condylar angles and patient’s malocclusion. This cross-sectional study was conducted on 81 patients aged 15-25 years randomly selected from those presenting to the Orthodontics Department of School of Dentistry, Tehran University of Medical Sciences from 2001 to 2008. Subjects with craniofacial syndromes, congenital rheumatic diseases, thyroid problems and those taking hormonal medications were excluded from the study. Lateral cephalograms of patients were obtained and type of malocclusion was determined using Wits analysis and measurement of ANB angle. the. The angle between the condylar head, condylar neck and articular eminence slope and the angle between the bisector of the afore mentioned angle and the articular slope were measured on the cephalograms. Data were analyzed using Spearman’s test correlation test, paired t-test and two-way ANOVA. The right and left correlation coefficient was 0.459 in patients with class I malocclusion (P=0), 0.276 in patients with class II malocclusion (P=0.011) and 0.334 in patients with class III malocclusion (P=0.02). There were no significant associations among these measurements and age, gender or type of malocclusion. The effect of two independent variables was not statistically significant either. This study showed that there was no correlation between the type of malocclusion and the angle between the articular eminence slope and the horizontal line, the angle between the condylar head and condylar neck or the angle between the bisector of the aforementioned angle and the articular slope.

Host modulation therapy has been considered as a new modality in the treatment of periodontal disease. Omega-3 fatty acid had shown protective and anti-inflammatory activity in the treatment of inflammatory diseases such as periodontitis. This study compared the effects of omega-3 fatty acid and low-dose aspirin with doxycycline in the treatment of chronic periodontitis. Forty five patients with chronic periodontitis were selected and clinical parameters were recorded for them. They underwent phase I of periodontal therapy and were accidentally divided into three groups. Each group was given the one of the following daily drug regimen accidentally: omega-3 fatty acid pills and 80mg Aspirin tab, 20mg capsule of doxycycline, placebo tablet (control). Clinical parameters were recorded again after six weeks. Wilcoxon, paired t-test, Kruskal–Wallis and one-way ANOVA were used to analyze the data. The mean of BOP, PPD and CAL in both test groups decreased significantly comparing to the placebo group (P <0.05). The decrease in the omega-3 group was statistically significantly more than doxycycline(P <0.05). Omega-3 fatty acid, can reduce clinical parameters of periodontal disease, even better than doxyxycline which is used as a routine drug for host modulation therapies.

Radiography wide usage in root canal treatments and developer age important role on attaining definite diagnosis, the present study examined the developer age effects on the diagnostic accuracy of endodontic file's length using D-speed, E-speed and E/F-speed films. In this diagnostic study, radiographies were processed by developer weekly up to 6 weeks. The films were viewed by 5 postgraduate Endodontics and Radiology students who assessed file tip position, using a 3-point confidence scale. The area under the curve (Az) were calculated and used as a diagnostic accuracy scale. Film types and endodontic file size effects were analyzed by one-way analysis of variance (ANOVA), Tukey post hoc and student t tests. E-speed and D-speed film diagnostic accuracy were similar being higher than E/F speed films (p<0.0001). D, E, and E/F films. Az values in fresh, 2 week and 4 week developer were 0.5882, 0.5538, 0.3578 and 0.5782, 0.5718, 0.3498 and 0.6196, 0.6724, 0.2080 respectively. Developer age did not decrease the D and E film diagnostic accuracy but reducing E/F films on 4 weeks. The 6 weeks developer caused the radiographies not to be readable. All observers showed higher diagnostic accuracy viewing endodontic file size of 15 than 10 (p<0.0001). The mean Az values in endodontic file size of 10 and 15 using fresh, 2 weeks and 4 weeks developer age were 0.3984, and 0.6016, 0.3732, and 0.6268, 0.2774 and 0.7226. The developer age up to 4 weeks did not significantly affect the diagnostic accuracy of D-speed and E-speed films. E/F films cannot be used in developer older than 2 weeks; however, its usage was associated with lower accuracies compared to E and D-speed films.

An endodontic irrigation solution with low toxicity and high antimicrobial activity is required in the process of endodontic treatment. Using a combination of intracanal irrigants is one solution to achieve this goal. The aim of this study was to evaluate the synergistic antimicrobial efficacy of chlorhexidine and hydrogen peroxide against bacteria in the infected extracted human root canals. Forty-two teeth with periapical lesions were chosen for this study. The teeth were extracted and preserved in normal saline at 37°C for less than 24 hours. Canals were prepared with nickel titanium rotary files (S1 to F3) and irrigated with 10cc of the respective irrigants (group 1:14 teeth irrigated with 3% hydrogen peroxide; group 2: 14 teeth irrigated with 2% chlorhexidine and group 3: 14 teeth irrigated with a combination of 3% hydrogen peroxide and 2% chlorhexidine). Samples were obtained with paper cones before and after root canal preparation (S1, S2) and transferred to a microbiology lab for colony counting. Data were analyzed using the Kruskal-Wallis and Mann-Whitney tests. The results showed that all the understudy irrigants significantly decreased the bacterial colony count. A combination of chlorhexidine and hydrogen peroxide was significantly more effective than hydrogen peroxide. Chlorhexidine is an effective irrigant with high antimicrobial activity but its antimicrobial efficacy does not significantly increase in combination with hydrogen peroxide.

Recognition of factors that cause procedural errors in dental practice and their prevention increase the success rate of endodontic treatment. This study aimed to evaluate the rate of procedural errors in a clinical training setting using conventional and digital radiography systems. In this study, digital and conventional radiographs available in the archives of the Department of Endodontics, Shahed School of Dentistry were used, including 684 conventional radiographs of 171 patients (treated by the 5th and 6th year under-graduate dental students and the 1st and 2nd year post-graduate students) and 852 digital radiographs of 213 patients (treated by the 5th and 6th year under-graduate dental students and the 1st, 2nd, and 3rd year post-graduate students). The errors investigated in this study included missing a canal, canal transportation, ledge formation, apical perforation, furcal perforation, strip perforation, overfilling, under-filling, poor obturation and broken instrument. Radiographs were examined by 3 observers in terms of type of error during endodontic treatment. Once examined, cases that were agreed upon by at least two observers were accepted. In the under-graduate student group, the most frequent errors found in conventional radiographs were poor obturation and under-filling with 8.13% prevalence rate. The most frequent error in post-graduate student group was poor obturation as well with 10.58% frequency. In digital radiographs, in both under-graduate and post-graduate groups, the most frequent error was poor obturation, as well (11.86% in undergraduate and 9.47% in post-graduate groups). The number of error-free anterior teeth (82.05%) was significantly more than that of posterior teeth (65.29%)(P<0.05). Also, 11,96% of anterior teeth had problems in terms of length and quality of filling, while in these respects, 23.5% of posterior teeth were unacceptable, and there was a significant difference in the frequency of these procedural errors between the anterior and posterior teeth (P<0.05). It appears that the educational system in the Department of Endodontics at Shahed School of Dentistry must place a stronger emphasis on the internal anatomy and principles of root canal treatment of the posterior teeth, as well as on the final stage of endodontic treatment (canal filling) for all teeth. It should be noted that an inappropriate canal filling might be secondary to improper canal preparation.

Severely damaged teeth with no support at the coronal portion of root canal are very difficult to restore. The aim of this in-vitro study was to evaluate intra-radicular reinforcement by dual cure composite resin and two different types of fiber reinforced posts (translucent and opaque) in structurally compromised roots. Root canal therapy was performed for 48 maxillary central incisors. The teeth were divided into four groups, and specimens from three groups were prepared to simulate the teeth with flared canals. In the 1st group, no weakening was done. In the 2nd group, the compromised area of the root canal was filled with gutta percha. In the 3rd and 4th groups, universal DT light and DT white posts were used respectively in the root canal to 8 mm below the margin of the palatal wall. The posts were cemented with dual-cure composite. In all groups, the access cavity was restored with light-cure composite resin. After being mounted, all specimens were pressed at an angle of 45º relative to the long axis of the teeth. The amount of force at fracture was recorded. Results of fracture load were evaluated by one-way ANOVA and LSD post hoc test and results of mode of fracture were evaluated by chi–square test. The mean fracture load for the four groups was 170.12, 71.40, 125.8 and 148.59 kgf, respectively. There was a significant difference between the mean fracture load of 1st and 2nd groups and that of other groups (P=0.001). The mean fracture load of the 4th group was significantly (P=0.002) higher than that of the 3rd group. The frequency of restorable fractures was significantly different between these two groups (P<0.001). Using dual cure composite resin and fiber-reinforced posts in a root with thin walls will reinforce the compromised teeth but the type of post will affect the outcome.

Tooth decay is the most common chronic disease. Fissure sealant therapy is among the suitable treatments to prevent occlusal caries. The ability of fissure sealant to prevent fissure caries is due to the sealant retention. Considering the fact that several bonding agents are available in the market, clinical studies are required to assess the durability of sealants after using bonding agents.The purpose of this study was to compare the durability of fissure sealants bonded with dentin and enamel bonding agents after 12 months. A total of 30 healthy 6 to 12 year-old patients presenting with at least one caries-free, fully erupted molar tooth at each side of their mandible were selected. All fissures of 60 molars were sealed using the following two techniques: Group1: acid etchant + Single Bond (3M, ESPE) dentin bonding agent +Eco-S (VERICOM); group2: acid etchant + Margin Bond (Coltene/Whaledent AG) enamel bonding agent +Echoseal sealant. Cotton roll isolation was performed in both groups. Sealants were evaluated 12 months after placement. Data were analyzed using Wilcoxon test. There was no significant difference between the two examined groups. Clinical success was 60% in group 1(dentin bonding) and 56.66% in group 2 (enamel bonding). Although no significant difference was found between the two groups, it seems that bonding agents with hydrophilic groups show more favorable results especially when appropriate isolation is not achieved.

Recurrent aphthous stomatitis (RAS) is among the most common oral conditions and psychological disorders are among its predisposing factors. The purpose of this study was to determine the frequency and type of psychological disorders in patients with RAS. Seventy-five patients referred to Mashhad Dental School were enrolled in this cross-sectional stud: 35 patients with RAS)15 males, 20 females) constituted the study group and 40 healthy patients (15 males/25 females) comprised the control group. The SCL-90 questionnaire consisting of 90 multiple choice questions was completed by all subjects and a psychologist scored and analyzed the results in order to evaluate the psychological status of patients. The overall frequency of psychological disorders was 44%; this rate was 68.6% in the RAS patients and 22.5% in the control group (P<0.0001). The frequency of anxiety disorder was 42.9% in RAS patients and 7.5% in the control group (P<0.0001). The frequency of somatization disorder was 17.1% in RAS patients and 0% in the control group (P=0.008). The frequency of depression was 28.6% in RAS patients and 15% in the control group (P=0.004). All these differences were statistically significant. There was no statistically significant difference between the two groups in other psychological disorders. The results showed that psychological disorders were generally more frequent among RAS patients compared to the control group. The most common psychological disorder was anxiety disorder and the frequency of anxiety, depression and somatization was higher in RAS patients.

Plaque pH drop after consumption of sugary materials may dissolve enamel minerals. Casein phosphopeptide amorphous calcium phosphate (CPP-ACP) is a paste enriched with calcium and phosphate. The new formulation of this paste, casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF), contains 900 ppm fluoride. This paste can neutralize the low pH of bacterial plaque. This study compares the efficacy of CPP-ACP and CPP-ACPF for neutralizing plaque acidity at different time points. This clinical trial was conducted on 40 students. Plaque pH at the distal of first molar was measured before and 10 minutes after the consumption of 10% sucrose solution. In the next step, CPP-ACP and CPP-ACPF pastes were applied as recommended by the manufacturers to the tooth surface. Plaque pH was measured at 30 minutes, 60 minutes and 24, 48, 72 and 96 hours. Data was recorded and analyzed by repeated measures ANOVA (P<0.05). Both CPP-ACP and CPP-ACPF increased plaque pH similarly in the first 48 hours. However, the pattern changed from this time point on. CPP-ACP and CPP-ACPF had similar efficacy for up to 48 hours, but CPP-ACPF was capable of keeping the pH high by up to 96 hours.