Journal of Isfahan Dental School

Relationship between the Position of the Mandibular Third Molar with Different Vertical Skeletal Dimensions on the Panoramic Images in Patients Referred to Isfahan (Khorasgan) University Dental School

Fatemeh Eskandari — 2023-03-06

Introduction: Due to the increased prevalence of third molar impaction and the complications and existence of disagreements regarding the predicting factors for the impaction of this tooth, the aim of this study was to evaluate the relationship between the position of the mandibular third molar with different vertical skeletal dimensions on the panoramic images.
Materials & Methods: This cross sectional study was carried out on lateral cephalogram and orthopantomogram records of 130 orthodontic patients visiting to Isfahan (Khorasgan) University Dental School. Age range of the sample was 20-35 years. Various facial forms were determined with mandibular plane angle (SN-GoGn), jarabak index and Y-axis; S-GN– Frankfort plane. Beta angle; which is the angle between intersecting long axis of mandibular second molar and mandibular third molar was measured to determine the angle of eruption of mandibular third molar. Eruption pattern was classified as per Pell & Gregory and winter’s system. The data were analyzed by Chi-square test (p value < 0.05).
Results: There was a significant difference in the frequency distribution of growth pattern on the left side of the jaw (p value = 0.048). There was no significant difference in the frequency distribution of the eruption pattern in the right side of the jaw (p value = 0.11). There was no significant difference in the frequency distribution of eruption surface in the right face between different facial forms (p value = 0.49) But on the left side of the jaw there was a significant difference between the three facial forms (p value = 0.049). Frequency distribution of mandibular third molar impaction was significantly different between the three facial forms (p value = 0.03). There was no significant difference between the three facial forms in terms of frequency of eruption angle in the right side of the jaw (p value = 0.25) and also in the left side of the jaw (p value = 0.15).
Conclusion: The incidence of impaction was significantly more in patients with long face than in other two groups. The prevalence of surface and pattern of third molar eruption in only one side of jaw was significantly different between the three facial forms. There was no significant difference between the frequency of angle of eruption and facial skeletal types in both jaws.

Analysis of Hemodynamic Changes after Administration of Mepivacaine HCL 3% with Prilocaine 3% Solution + Felypressin

Ehsan Aliabadi — 2023-03-06

Introduction: With regards to the usage of local anesthetic drugs in hypertensive patients, this study is designed for comparing the effects of mepivacaine 3% and prilocaine 3% + felypressin in hemodynamic changes after inferior alveolar nerve block to help dental practitioner select anesthetic solutions for hypertensive patients considering their hemodynamic effects in order to provide patient safety.
Materials & Methods: In this double blind clinical trial 32 patients were referred to oral and maxillofacial surgery department of Shiraz dentistry school in 2021 were divided into 2 groups with 16 patients in each group. In first group, inferior alveolar nerve block was accomplished by mepivacaine 3% and in the other group, prilocaine 3% and felypressin. Then systolic and diastolic blood pressure, heart rate and oxygen saturation were measured at 4 different time points consisting of before injection, immediately after injection, 10 minutes after injection and 30 minutes after tooth extraction. The data were analyzed by ANOVA and T-test (p value < 0.05).
Results: There were no statistically significant differences in systolic blood pressure, diastolic blood pressure, heart rate and oxygen saturation changes between mepivacaine and prilocaine groups during all four sampling time points. But in each group, individually there were significant differences in systolic and diastolic blood pressure, heart rate and oxygen saturation in different times. In addition mepivacaine causes a significant increase in systolic blood pressure immediately after injection but in contrast prilocaine + felypressin didn’t do so.
Conclusion: We recommend prilocaine + felypressin in comparison with mepivacaine for local anesthesia in hypertensive patients.

Effects of Oral Liquid Medicaments in Children on Shear Bond Strength of Resin Composite in Primary Teeth

Sara Fotoohi Ashin — 2023-03-06

Introduction: Due to the prevalence of the use of oral liquid medications in children with chronic diseases (asthma, heart problems, seizures and kidney problems) and also in children with transient diseases (influenza, colds, tonsillitis, ear infections, sinusitis and seasonal allergy) and due to the fact that several studies have shown that children’s' common medications affect topography and enamel structure, and composite bonding is dependent on enamel structure, the aim of this study was to investigate the effect of oral liquid medications used in children on composite bond strength to primary canine dental enamel.
Materials & Methods: In this experimental-laboratory study, 90 teeth were divided into 9 groups, 8 drug groups and 1 control group (artificial saliva). Each group of 10 teeth was immersed 3 times a day for 1 minute in 10 ml of the desired drug. After 7 days and after 14 days, 5 teeth from each group were bonded with composite and their shear bond strengths were measured. Data were analyzed by one-way ANOVA, paired T-test and Pearson correlation coefficient tests. (α = 0.05).
Results: In all groups, in comparison with the control group, the mean bond strength was not significantly different in the first and second weeks (p value > 0.05). Also, there was no significant difference between the mean composite shear bond strengths in each of the nine groups in the first and second weeks (p value > 0.05). Pearson correlation coefficient showed that there was no significant relationship between PH value with shear bond strength of composite in first weeks (p value = 0.53) and second (p value = 0.83).
Conclusion: Based on this study, short-term use (up to 14 days) of medications did not significantly change the shear bond strength of the composite to enamel.

Evaluation of Oral Health- Related Quality of Life after Implant Treatment versus Root Canal Treatment

Golnoush Momeni — 2023-03-06

Introduction: Preserving the natural tooth by endodontic treatment or tooth extraction and implantation is an important dilemma that requires careful evaluation of the factors that affect the final treatment and patients' quality of life. The aim of this study was to evaluate the quality of life related to oral health after single tooth implant treatment in comparison with endodontic treatment.
Materials & Methods: This study is a cross-sectional analytical study to evaluate the quality of life of 80 patients referred to Isfahan Azad Dental School in 1399-1400 in two groups (endo and implant) whose anterior teeth have been endodontically treated and had also a history of anterior single tooth implant with functional crown in a recent year, with using Oral health-related quality of life questionnaire (OHIP-12). The collected data were analyzed using Shapiro-Wilk test and independent T-test with an error level of 0.05% (p value < 0.05).
Results: Mean patient's oral health-related quality of life after single tooth implant and after endodontic treatment was respectively 16.95 and 16.83 and all the studied parameters were shown to be above average. There was no significant difference between the type of treatment and patient's oral health-related quality of life
(p value = 0.885). There was a significant difference between patient's gender and oral health-related quality of life in implant treatment (p value = 0.036).
Conclusion: The oral health-related quality of life after single tooth implant treatment was comparable to endodontic treatment in patients and it was higher than average in both treatments.

Evaluation of the Harmony of Smile Appearance with Personality Traits in Patients Applying for Smile Makeover

Sajad Babaei — 2023-03-06

Introduction: Dentists have always sought to harmonize the shapes of the teeth with the entire face based on parameters such as gender, personality, and age. The Visagism concept helps dentists to be able to create a smile that is not only for esthetics but also in harmony with all the psychological characteristics of the patient. The aim of this study was to investigate the match between smile design and personality traits of patients applying for smile design.
Materials & Methods: This is a descriptive-analytical study. Standard photographs in three different modes of rest, gentle smile, and full smile were taken from 104 patients aged 30-18 years referred to the School of Dentistry of the Islamic Azad University of Isfahan in 2016 for smile design. Patients were given a questionnaire about temperament and an interview questionnaire for understanding their dental needs. The photos were checked by one professional observer and classified according to the Visagism concept and the photos were analyzed with the results of the questionnaire and the interview form. The Data were analyzed by Chi-square and One-Way ANOVA test (p value < 0.05).
Results: Consistency percentage between personality and smile was 71.1% (p value < 0.0001). The most consistent in these 2 factors was Phlegmatic temperament (81.1%).
Conclusion: Since there is a significant relationship between smile design and personality, it is recommended that in reconstructing a smile dentists should not limit themselves to aesthetic aspects from a dental point of view, but by creating a patient's psychological evaluation, create an esthetic smile plan in harmony with patients' psychological characteristics.

Three-Dimensional Printing of a Polycaprolactone-Fluorapatite Nanocomposite Scaffold and Simulation of Its Mechanical Properties

Mojtaba Momeni — 2023-03-06

Introduction: The use of porous nanobiocomposite scaffolds for maxillofacial fractures and internal surface optimization of artificial grafts utilizing nanotechnology can improve cell adhesion, mechanical properties, and adsorption rate. Porous scaffolds have been the subject of numerous investigations, especially for broken and damaged parts of the facial bone. The goal of this study was to look into the biological, experimental, and numerical study of the mechanical properties of porous scaffolds under static loading conditions.
Materials & Methods: In this study, a bone scaffold of polycaprolactone- Fluorapatite (PCL / nFA) nanocomposite materials containing (0, 10, 20, 30 %wt.) Fluorapatite nanoparticles was designed and manufactured using a 3D printer with Fused Deposition Modelling (FDM) process. The scaffolds were designed in SolidWorks software with 70% porosity and then transferred to Abaqus software for simulation.
Results: In addition, following 28 days of immersion in the simulated body fluid, the bioactivity test of pure and composite scaffolds showed that the PCL /20nFA composite sample produced the most apatite on the surface. DAPI staining and fluorescent microscopy observation, confirm cell viability on the 3D printed scaffold.
Conclusion: The Von Mises stress and compressive test simulations revealed that the porous scaffold model may be used for maxillofacial bone replacement and has good mechanical strength and stability.

Evaluation of Odontogenic Tumors Frequency in Biopsies Sent to Isfahan, Shiraz and Yazd Dental Schools

Seyed Mohammad Razavi — 2023-03-06

Introduction: Odontogenic cysts and tumors are lesions found in the upper and lower jaw and oral soft tissue. The understanding and correct diagnosis of odontogenic tumors is essential because they can be invasive or recurrent in nature and even rarely show malignant changes. The aim of this study was to evaluate the frequency of odontogenic tumors in Isfahan, Shiraz and Yazd cites.
Materials & Methods: This is a cross-sectional descriptive- analytical study that was performed in the mentioned centers. The records of registered samples from the first year of establishment to 2018 have been reviewed which is approximately 18,000 cases. Samples data were extracted and recorded based on sex, age, jaw and location of involvement in affected jaw. Data were analyzed using descriptive statistics and Chi-square test (p value < 0.05).
Results: In this study, a total of 498 odontogenic tumors were evaluated. The number of odontogenic tumors in Isfahan, Shiraz and Yazd cities was 313, 130 and 55, respectively. The mean age of the patients was 30.1 ± 15.9 and most of the patients were in the age group of 20 to 40 years and 53.4% were female. The most common sites of involvement were the right mandibular (29.1%) and then the left mandibular (28.3%) and the most common tumor was ameloblastoma (50.2%) and then complex odontoma (16.7%).
Conclusion: Due to the frequency observed for odontogenic tumors, understanding the clinical and pathologic features of these lesions is essential for rapid and appropriate diagnosis and treatment.

Immunohistochemical Expression of Alpha Smooth Muscle Actin Positive Myofibroblast and Laminin 5 gamma 2 in Squamous Cell Carcinoma and Verrucous Carcinoma of the Oral Cavity

Homeyra Mardani — 2023-03-07

Introduction: Squamous cell carcinoma is the most common type of oral cancer that shows certain tissue changes. Laminin-5γ2 is a protein that plays a central role in migration of the neoplastic cells during tumor invasion. Expression of this protein in cells and stroma adjacent to tumor can confirm the cellular invasion. The aim of this study was to evaluate stroma in verrucous carcinoma and squamous cell carcinoma of the mouth using two markers α SMA and laminin 5 gamma 2.
Materials & Methods: In this retrospective descriptive-analytical study, 60 samples were selected with the diagnosis of squamous cell carcinoma and verrucous oral carcinoma. Then, two markers of α SMA and laminin 5 gamma 2 were examined in epithelium and mesenchymal stroma by immunohistochemistry. The vasculature was used as a positive immunoreactivity control for alpha-smooth muscle and the normal mucosa was used to control the positive immunoreactivity of laminin 5 gamma 2. The results were analyzed using Chi-square and Spearman correlation tests (α = 0.05).
Results: Out of 31 SCC samples, 80.6% showed laminin 5 gamma 2 and 90.3% showed alpha smooth and out of 9 samples of varocus carcinoma, 66.7% showed laminin 5 gamma 2 and 77.8% showed alpha smooth actin. The higher the positive percentage of laminin, the higher the percentage of positive α SMA.
Conclusion: Expression of alpha smooth muscle actin and lamminin 5 gamma 2 was significantly higher in oral squamous cell carcinoma and there exists a correlation between expression of alpha smooth muscle actin and the increase in myofibroblasts takes place during the carcinogenesis process.

Comparison of Diagnostic Accuracy of 2 Cone Beam Computed Tomography System (Newtom &Planmeca) for Detection of External Root Resorption in Vitro

Marjan Bolbolian — 2023-03-07

Introduction: External root resorption is a clinical problem that is difficult to diagnose, therefore radiographic examination is important for diagnose. The purpose of this study was comparing the diagnostic accuracy of 2 Cone Beam Computed Tomography in detecting of external root resorption, in vitro.
Materials & Methods: This study was done on 48 single-rooted teeth. Cavities of 0.3, 0.2 and 0.15 mm in depth with round bur 0.3 mm were drilled on buccal and lingual surfaces in the cervical, middle and apical thirds of some of roots. Then CBCT were taken and 4 observers assessed the scans. Sensitivity, specificity and Kappa value were determined. The statistical analysis was performed with the Z-test (p value < 0.05).
Results: In comparison of the accuracy, sensitivity and specificity of the two devices, there was no significant difference. In the apical, middle and cervical as well as at various depths there was no significant difference between the two devices, but in the numerical point of view, the sensitivity for both devices in the midsection, was in the highest amount. The highest value for the specificity is related to the apical region. For both devices, the sensitivity level GBJ, by increasing the depth. The lowest agreement between observers was 0.61. The highest agreement rate was in the middle section and the least amount of agreement was related to the apical region.
Conclusion: CBCT brand type is not effective factor in the detection of external root resorption. The location and depth of external root resorption can be effective factors in diagnostic accuracy.

Evaluation of the Relationship between rs17561 and rs1143634 Genetic Polymorphisms and the Risk of Chronic Periodontitis

Jaber Yaghini — 2023-03-07

Introduction: Genetic diversity in cytokines such as interleukin α1 and interleukin 1β is involved in altering the immune response in inflammatory diseases such as chronic periodontitis and changes the risk of this disease. The aim of this study was to investigate the association of genetic polymorphisms 4845G> T interleukin 1α and 3954C> T interleukin 1β with the risk of chronic periodontitis.
Materials & Methods: Participants including 133 healthy individuals and 133 individuals with chronic periodontitis referred to Isfahan Dental School, were included in the study. The genotype of blood samples at the site of the above polymorphism was determined by PCR-RFLP method. The relationship between the studied polymorphisms and chronic periodontitis was calculated by logistic regression test. Statistical analyzes were performed by SPSS software. The p value level < 0.05 was statistically significant.
Results: Data analysis showed a significant relationship between CT and TT genotypes and T allele of polymorphism 3954C> T interleukin 1β and increased risk of chronic periodontitis and no significant relationship between polymorphism 4845G> T of interleukin 1α and the risk of Showed chronic periodontitis.
Conclusion: Based on the above data, T> 3954C polymorphism is a risk factor for chronic periodontitis and serves as a potential biomarker for screening people prone to this disease.

Investigation of Morphological Variations of Canal and Root of First Mandibular Molar in Tomographic Images Computer with Cone Beam in Patients of Arak City

Mahsa Kianifar — 2023-03-07

Introduction: Being the first teeth to erupt, first molars have the most complex root system and canal morphology and are among the most susceptible teeth to decay and destruction. The aim of this study is to determine the frequency of morphological variations of the canal and root of the mandibular first molar in cbct images so that appropriate treatment can be performed with a better understanding of the anatomy of the root and canal of the molar tooth.
Materials & Methods: In this descriptive cross-sectional study, the morphological variation of the mandibular first molar canal and root was investigated in 170 cbct radiology image samples. In this study, the age and gender of the individual, the number of roots and canals of the mandibular first molar, the morphology of the canal in each root, the presence of the midmesial canal and the presence of the distolingual root were also investigated. In the end, frequency and percentage indicators were used to analyze data and chi-square test was used to compare frequencies.
Results: The average age of the subjects studied was 39.2 years. The subjects included 86 women and 84 men. The most seen sample was a molar tooth with two roots and three canals. In terms of canal morphology in the mesial root, the most common canal morphology was type 4 and then type 2. In terms of canal morphology in the distal root, the most common canal morphology was type 1. In the studied samples, midmesial canal was not found in 99.4% of cases and distolingual root was not found in 94.7% of cases.
Conclusion: Two-rooted and three-channel molar without midmesial canal and without distolingual root was the most common case found in this study. The most common canal morphology in the mesial root was type 4 and the most common canal morphology in the distal root was type 1.

Cytotoxicity Effects of Polyhydroxybutyrate/Chitosan/Bioglass Nanocomposite Scaffolds on Human Osteoblast-like Cells (SAOS-2 Cells)

Batool Hashemi-Beni — 2023-03-07

Introduction: In tissue engineering, a porous material is applied as the extracellular matrix or scaffold for cell growth. Then growth factors are added to this scaffold whose cytotoxicity must be assessed. In this study, the cytotoxicity effects of polyhydroxybutyrate/chitosan/bioglass nanocomposite scaffolds on human osteoblast like cells (SAOS-2 cells) are explored.
Materials & Methods: This study was experimental and was done in Isfahan Dental School. The polyhydroxybutyrate/chitosan/bioglass nanocomposite scaffold was fabricated using the electrospinning method. Scanning Electron Microscopy (SEM) analysis was used to evaluate the morphological characteristics of the nanofibers and their diameter distribution. Additionally, bioglass nanoparticles in the fibers were identified via SEM. The MTT assay was performed to assess cell viability after 3, 5, and 7 days. The collected data were analyzed using SPSS 20.0 through statistical tests including Kruskal-Wallis test (p value ≤ 0.05).
Results: According to SEM images, the scaffold fibers were fully porous and no beads were observed. Furthermore, the polyhydroxybutyrate/chitosan/bioglass scaffold showed greater cell viability and proliferation compared to the groups lacking bioglass.
Conclusion: The polyhydroxybutyrate/chitosan/bioglass scaffold has no cytotoxic effect on osteoblast– like cells.

The Ability of Mesenchymal Stem Cells for Periodontal Tissue Regeneration: A Comprehensive Review of Literature

MohammadMostafa Aghamohseni — 2023-03-07

Introduction: Stem cells and tissue engineering have shown great potential in the treatment of periodontal diseases since their introduction. Mesenchymal stem cells are undifferentiated cells that can differentiate into different tissues. The aim of this study was to evaluate the effectiveness of different types of these cells in the treatment of periodontal defects.
Description: Mesenchymal stem cells exist around different tissues and can be obtained and used from different intraoral or extraoral sources for periodontal tissue regeneration procedures. Among extracellular stem cells, bone marrow stem cells followed by adipose tissue stem cells have shown promising results regarding the ability of these cells to regenerate the periodontium. Among intraoral sources, periodontal ligament mesenchymal stem cells and then dental pulp cells have shown more results and ability compared to other cell types to regenerate periodontal tissue. Periodontal ligament stem cells have also been able to generate sharpey fibers in periodontal regeneration procedures in various studies.
Conclusion: Mesenchymal stem cells have shown promising results for use in periodontal tissue regeneration processes. However, due to the limited clinical and preclinical studies performed so far, more studies are needed for assessing the clinical use of these generative of cells.

Treatment of Severe Anterior Open-bite Accompany with Impacted Canine: A Case Report

Fataneh Ghorbanyjavadpour — 2023-03-07

Introduction: The anterior open bite is a multifactorial malocclusion and a challenge between orthodontists. Based on the origin, divided in two types as dental and skeletal, and appear in the anterior or posterior segments, (unilateral or bilateral). Dental open-bite in the most of patients have environmental etiologic factor such as oral habits, tongue trust, mouth breathing, large tongue. In skeletal type, excessive vertical growth of the maxilla is etiologic factor and accompany with downward-backward rotation of the mandible.
Case Report: The case was a 27 years woman with an anterior open bite and unilateral impacted upper canine and congenital missing of lower 2nd premolar in the left side and retained 2nd lower deciduous molar and upper canine in the left side. She consulted for orthodontic treatment in Tehran Dental School of Shahid Beheshti University of Medical Sciences in October of 2017.The Orthodontic treatment was down with MBT slot 22 system (USA. Orthoorganizer, inc) for apply extrusive force on impacted upper canine in left side with auxiliary 014 ss, segmented arch wire. loop arch wire technique with 16 × 22 ss rectangular continuous arch wire was used for space closing in extraction site and correction overbite. The extracted teeth were right lower 2nd premolar and left 2nd deciduous molar and 1st premolars in upper arch. As recommended advancement genioplasty for correction chin deficiency the patient refused it.
Conclusion: In this technique we used Orthodontic treatment alone instead of Orthognathic surgery for open bite correction.