Journal of dentistry (Shiraz, Iran)最新文献

Statement of the problem: Considering side effects of non-steroidal anti-inflammatory drugs (NSAIDs), herbal medicine including Urtica dioica might help reduce the pain.

Purpose: The present study aimed to compare the effects of premedication with essential oil of Urtica dioica and ibuprofen on post-endodontic pain.

Materials and method: The present randomized clinical trial study was conducted on 60 patients with symptomatic irreversible pulpitis of mandibular first or second molars. The patients were randomly assigned to three groups (n=20) for premedication with 400 mg ibuprofen, 400 mg essential oil of Urtica dioica (Netonal; Barij, Iran), and placebo. The medications were taken 30 minutes prior to the procedure. The patients' pain score was recorded before the intervention and treatment onset (Time1 or T1), after the intervention prior the treatment onset (10 minutes after anesthetic injection) (T2), upon completion of treatment (T3), and at 8 (T4), 12 (T5), and 24 hours after endodontic treatment (T6) using a visual analog scale (VAS) and Wong-Baker FACES Pain Rating Scale (WBS), and compared. Data were analyzed by Chi-square test, one-way and repeated measures analysis of variance (ANOVA), kruskal-wallis test, and LSD post-hoc test using IBM SPSS statistics version 21 with significance value of p< 0.05.

Results: The pain score was not significantly different among the three groups at T1, T2 and T3 according to both scales (p> 0.05). On the other hand, significantly lower pain scores were recorded in ibuprofen and Urtica dioica groups at 8, 12, and 24 hours after treatment compared with the placebo group (p< 0.001). The pain score was not markedly different between the ibuprofen and Urtica dioica groups (p> 0.05).

Conclusion: It seems that analgesic effect of premedication with leaf extract of Urtica dioica is the same as ibuprofen. Further studies are warranted to find the optimal dosage of Urtica dioica for widespread use.

Statement of the problem: Root canal preparation with rotary files causes dentinal cracks in root canals of primary teeth affecting their longevity.

Purpose: Nickel-titanium rotary files have been widely used for root canal preparation in primary teeth. The present study compared occurrence of dentinal microcracks in root canals of extracted primary molar teeth prepared using Hedstrom (H) files, ProTaper Universal rotary files, and ProTaper Next rotary file systems.

Materials and method: In this in vitro experimental study, 80 primary molar mesial root canals were randomly divided into four groups of 20 canals each (n=20). Group I was prepared with H files. Group II was prepared with ProTaper Universal rotary files using shaping files SX and S2. Group III was instrumented with ProTaper Next rotary files X1 and X2 while Group IV was left unprepared and served as control. Roots were stained with 1% methylene blue solution and sectioned perpendicular to the long axis at 2mm, 4mm, and 6mm from the apical foramen. Slices obtained were examined under the stereomicroscope. Data obtained were subjected to statistical analysis using chi square tests.

Results: Dentinal microcracks were observed in groups prepared using H files, ProTaper Universal, and ProTaper Next rotary files. Highest percentage of cracked root canals (20%) was seen in Group I, prepared by H files. These cracks were complete in nature, found in apical sections and statistically significant (p= 0.016). Group III prepared with ProTaper Next showed 10% dentinal cracks, followed by ProTaper Universal group with 5% cracked root canals.

Conclusion: H files may be considered more aggressive at apical third due to complete cracks produced.

Statement of the problem: Squamous cell carcinomas (SCCs) and premalignant disorders such as leukoplakia are common oral cavity lesions. Although these lesions are epithelial in nature, they are also associated with juxta-epithelial chronic inflammation. Mast cells play a significant role in inflammation initiation and propagation.

Purpose: Previous studies have yielded conflicting results in this field. Therefore, this research aimed to assess the number of mast cells in oral SCC and dysplastic leukoplakia and explore their possible role in these lesions.

Materials and method: In this retrospective cross-sectional study, sixty-three archival cases, including 22 OSCCs, 28 dysplastic leukoplakias as epithelial dysplasia (ED), and 13 normal oral mucosal tissues, were examined for mast cells, using toluidine blue staining. Hotspot areas were identified at 10× magnification and mast cells were counted in 5 fields at 40× magnification. The average cell numbers were calculated, and the severity of inflammation was scored. Statistical analysis was performed using SPSS statistical software 20, including One-way ANOVA, Two-way ANOVA, paired-t test, and independent t-test. p Value < 0.05 was considered significant.

Results: Among the 51 pathologic lesions, 54.9% were males and 45.1% were females, with a mean age of 56.34±15.35 years. The most common locations were the tongue and buccal mucosa. The mast cell count was significantly lower in SCC compared to ED (p= 0.009). There was no correlation between mast cell count and inflammation score (p= 0.345).

Conclusion: In this study, the mast cell count was higher in ED compared to OSCC, suggesting an increase in these cells during the pre-malignant stages. However, the number of mast cells decreased after connective tissue invasion and microenvironmental changes occurred.

Cemento-osseous dysplasia (COD) is classified, by the World Health Organization as a benign fibro-osseous lesion related to the tooth and periapical area of the jaws and is considered as a benign reactive process appearing from the apical periodontium in close relation with the apices of teeth. Usually, it is asymptomatic, discovered accidentally, and affecting particularly middle-aged African women. There are four subtypes distinguished of the lesion: periapical (PCOD), focal (FCOD), florid (FLCOD) and familial florid cemento-osseous dysplasia (FFLCOD). Pseudocysts found in the jaws go by various names, including solitary bone cyst, traumatic bone cyst, or simple bone cyst (SBC). These two pathologies have been reported separately; however, their co-occurrence remains rare and the first case of FLCOD with co-occurrence of SBC was reported by Melrose et al. in 1976 and later a few cases been reported in the literature. The aim of this report is to describe a case of a 46-year-old oriental female diagnosed with FLCOD with co-occurrence of SBC. Under local analgesia, a surgical exploration of the cyst was performed. In addition, a biopsy with a trephine was done in the region of missing right first mandibular molar. Based on the patient clinical, radiographic, and histological findings, a diagnosis of FLCOD was made in co-occurrence with a mandibular SBC. An examination of another female family member unveils a distinctive case, and the familial factor has been ruled out. No further treatment was planned and only follow-up was suggested.

Statement of the problem: Determination of remaining growth potential of patients is the most important factor in orthodontic treatment.

Purpose: This study aimed to assess the correlation of clivus length and angle with age, gender, sagittal growth pattern of the jaws, and skeletal maturation using lateral cephalometry.

Materials and method: This cross-sectional study was conducted on 390 lateral cephalograms (Vatech, paX-i3D Green, South Korea) of patients aged 6 to 25 years. The patients were assigned to three groups of skeletal class I, II, III (n=130) with equal gender distribution. The clivus length and angle, Welcher angle, maxillary and mandibular effective length, sella turcica to Nasion (SN), and the angles between SN and point A (SNA), between SN and point B (SNB), and between NA and NB (ANB )were measured. Correlations of variables with age and gender, and cervical vertebral maturation stage (CVMS) were analyzed using the Pearson and Spearman's correlation tests, independent t-test, and one-way ANOVA at 0.05 level of significance.

Results: Clivus length had a significant correlation with SNA (r= 0.103, p= 0.042), SNB (r= 0.108, p= 0.033), maxillary (r= 0.547, p< 0.001) and mandibular (r= 0.589, p< 0.001) effective lengths, SN length (r= 0.586, p< 0.001), and CVMS (r= 0.697, p< 0.001). Clivus angle had a significant correlation with SNA (r= 0.105, p= 0.039), SNB (r= 0.155, p= 0.002), maxillary (r= 0.507, p< 0.001) and mandibular (r= 0.596, p= 0.001) effective lengths, SN length (r= 0.566, p< 0.001), and CVMS (r= 0.699, p< 0.001). The mean clivus length (p= 0.006) and angle (p= 0.002) were significantly higher in males, and had a significant correlation with age (r= 0.636 and r= 0.718, p< 0.001). The mean clivus length and angle were not significantly different in class I, II, III (p> 0.05).

Conclusion: All parameters were greater in males, and increased with age (except Welcher angle). Clivus length and angle had significant correlations with position of both jaws but not with sagittal relationship.

Statement of the problem: The satisfaction of patients with dentures on implants has different points of view that become fundamental aspects for the development of research on the quality of life of these patients, the eventual biomechanical complications to which these prostheses and implants can be subjected, and design considerations for cantilever extensions.

Purpose: The objective of research was to assess the implants and prosthesis survival rates, biomechanical complications relative to the length of the distal extensions (cantilevers), and the satisfaction of the patients with a fixed implant-supported full-arch fiber-reinforced composites prosthesis.

Materials and method: A retrospective clinical and radiographic cohort study was developed. Clinical records of a selected cohort were analyzed according to inclusion and exclusion criteria. Data on a patient who underwent to fixed implant-supported full-arch fiber-reinforced composites prosthesis at least of five years of function were collected. Data analysis was performed using Kaplan-Meier curves and Fisher's Exact Test. P values less than 0.05 were considered statistically significant.

Results: After insertion, 1 of 29 prostheses failed, the overall prosthetic survival rate observed at 5 years was 96.5%. Of the 120 implants placed in 28 patients, only 4 patients experienced loss of an implant during the 5 years of observation; the implant survival rate throughout the observation period was 86.2%. Distal extension seems to negatively affect the prognosis of implant-supported rehabilitation. Regarding the level of satisfaction of the patient with the prosthesis, none reported being uncomfortable or dissatisfied neither with their appearance nor with the taste of food throughout the studied period.

Conclusion: No relevant associations were found between the variables involved. The study found the improvement in quality of life following the installation of fixed rehabilitation on the patients. Once the potential benefits of patients are obtained, controlled clinical trials are encouraged.

Statement of the problem: Chemotherapy-induced mucositis is the most common complication during cancer treatment. This complication can lead to pain, increased risk of infection and malnutrition. Therefore, it is important to find a solution to reduce the severity and duration of side effects.

Purpose: This study aimed to assess the efficacy of Mucosamin spray as an adjunct for prevention of oral mucositis in children under chemotherapy.

Materials and method: This parallel-design clinical trial evaluated 48 patients aged 5 to 15 years with leukemia and lymphoma presenting to the Hematology Department of Mofid and Mahak Hospitals. The patients were randomly divided into two groups (n=24). Before starting chemotherapy, all patients received oral hygiene instructions (toothbrushing without flossing). Patients in both groups were requested to use a mouthwash composed of nystatin, aluminum-magnesium hydroxide suspension (aluminum MgS), and diphenhydramine for 1 min every morning on a daily basis starting the day before treatment. Patients in the intervention group were also requested to spray their entire oral mucosa with Mucosamin spray 3 times a day in addition to using the mouthwash. Patients were requested to refrain from eating and drinking for 1h after spraying. The patients were clinically examined by a senior dental student once every other day for 20 days regarding the occurrence, severity, and duration of oral mucositis. Data were analyzed using the Chi-square and Mann-Whitney tests, Kaplan-Meier survival analysis, and log rank test.

Results: No significant difference was noted between the two groups in the incidence, severity, or time of development of mucositis (p> 0.05). The 7-day non-recovery percentage was 72.7% (SE= 13.4) and 25.0% (SE= 15.3) in the control and test groups, respectively, indicating shorter duration (faster healing) of mucositis in the intervention group (p= 0.01).

Conclusion: Within the limitations of this study, it seems that prophylactic application of Mucosamin spray can shorten the course of oral mucositis, in case of its occurrence.

Statement of the problem: Immediate dentin sealing (IDS) was introduced to overcome the disadvantages of delayed dentin sealing like pollution of dentin tubules, microleakage, and bond strength destruction over time. The effect of IDS on the bond strength of indirect restorations is still debatable.

Purpose: This study was conducted to determine the effect of IDS on the bond strength of ceramic restorations to dentin.

Materials and method: In this systematic review and meta-analysis, the study protocol was registered on the PROSPERO database under the registration number CRD420202014 27. MEDLINE (PubMed), Web of Science, Scopus, and ProQuest databases were searched until January 2021 and updated in January 2022. Worldcat.org and Opengrey.eu, ProQuest dissertation and thesis, and Google Scholar were searched to explore the grey literature. The in vitro studies evaluating the bond strength of ceramic restoration to dentin with and without IDS were included. Seven criteria were assessed to evaluate the risk of bias in the study. Statistical analyses were conducted using RevMan 5.3. The inverse variance method was used to determine the mean difference of micro-tensile bond strength (µTBS) and shear bond strength (SBS).

Results: A total of 10 studies (20 datasets) were included in the meta-analysis. Regarding the µTBS analysis, IDS had a significantly higher bond strength than Delayed Dentin Sealing (DDS) (MD:1.16, 95%CI:0.28_2.03, I²=0%). However, no significant difference was found between them in the SBS analysis (MD:0.25, 95%CI: -0.56-1.06, I²=96%). All studies were categorized to have a moderate or high risk of bias.

Conclusion: Most in vitro evidence showed favorable results for the effect of IDS on the bond strength and durability of indirect restorations. The adhesive system and the type of ceramic and its treatment before cementation are determining factors. Due to the heterogeneity of the outcomes and studies with a moderate/high risk of bias, the quality of the evidence was low.

Statement of the problem: It is challenging to perform a pulpectomy procedure in primary tooth because of its physiological root resorption and variation in root morphology. Working length measurement is considered to be one of the critical steps, as it determines the extent of obturation and apical seal.

Purpose: To compare the accuracy of electronic apex locator (EAL) and digital radiography (DR) for working length determination in primary teeth.

Materials and method: In this systematic review, electronic databases and grey literature were searched from 1st January 2005 to 1^st January 2023 for randomized control trial, non- randomized control trial, in vitro studies, ex vivo studies that compared accuracy of EAL and DR in primary teeth. Two reviewers independently identified studies, retrieved data, and assessed risk of bias using the revised and validated MINORS (methodological index for non-randomized studies) criteria.

Results: Ten studies were included in qualitative analysis. Seven out of ten studies showed low risk of bias whereas other three studies showed high risk of bias. In view of methodological heterogeneity of the findings, a meta-analysis was not conducted.

Conclusion: Available evidence suggests a moderate quality of evidence in this systematic review. Analyzing the ten studies included in this systematic review, the majority of studies showed statistically insignificant difference between EAL and DR. However, EAL was closer to actual WL as compared to DR. Based on the evidence that is currently available; EAL can be considered as an alternative for working length measurement in primary teeth.