Journal of dentistry (Shiraz, Iran)最新文献

Background: Enterococcus faecalis (E. faecalis) is a multidrug resistant pathogen that can cause persistent infections within the root canal system, which poses major challenges in dentistry and is involved in the majority of endodontic failures.

Purpose: This investigation was conducted to evaluate the antibacterial properties of Mentha Longifolia (M. longifolia) essential oil as a root canal irrigant against E. faecalis and its compounds.

Materials and method: In this in vitro study, 60 primary canines were divided into five groups: G1: Normal saline (negative control), G2: Normal saline, G3: 2.5% sodium hypochlorite (NaOCl), G4: 2% Chlorhexidine (CHX), and G5: M. longifolia essential oil based on minimum inhibitory concentration (MIC). The standard strain suspension of E. faecalis (ATCC 29212) was injected into the canal of all groups, except for the negative control group. After four weeks, the groups were washed with 2 ml of the introduced solutions and sampled by paper point to compare the antibacterial effect of these solutions. Broth microdilution method was used to determine the MIC, while Gas chromatography-mass spectrometry (GC/MS) was used to evaluate the chemical compositions of the essential oil. Data were analyzed based on one-way analysis of variance (ANOVA). Then, pairwise comparisons of groups were performed using Tukey's test.

Results: The MIC of M. longifolia against E. faecalis was 10%. As a root canal irrigant, its highest antibacterial impact was associated with 2.5% NaOCl, 2% CHX, 10% essential oil, and normal saline. The difference was not statistically significant in antibacterial effect between 2.5% NaOCl and 2% CHX (p Value=0.64). However, the difference was statistically significant in antibacterial effect between 2.5% NaOCl and 10% M. longifolia, 2.5% NaOCl and normal saline, 2% CHX and 10% M. longifolia, 2% CHX and normal saline, and 10% M. longifolia and normal saline (p< 0.001). Nineteen compounds were identified in the chemical analysis of M. longifolia, among which Piperitenone oxide (64.68%) and Piperitone oxide (23.68%) were the major compounds.

Conclusion: M. longifolia essential oil (10%) was effective against E. faecalis. The highest antibacterial effect of root canal irrigants was observed in 2.5% NaOCl, 2% CHX, 10% essential oil, and normal saline, respectively.

Background: Progesterone (PR) plays a role in the differentiation and growth of various tissues. One of the most common carcinogenic mechanisms of PR is increasing cell proliferation and inhibiting their apoptosis. There are contradictory results from various studies about the expression level of PR receptors in salivary tumors.

Purpose: Considering the sporadic studies and the contradictory results, this study was conducted to determine the expression level of PR receptor in the most common benign and malignant salivary gland tumors.

Materials and method: In this descriptive cross-sectional study, 58 paraffinized blocks (36 pleomorphic adenoma samples and 22 mucoepidermoid carcinoma samples) were selected. PR receptor immunohistochemical staining was performed on the samples and the resulting slides were examined under a light microscope with 100x magnification. The gleaned data were analyzed with SPSS25 using descriptive statistics, Fisher's exact test, and Chi-square test.

Results: Out of 36 pleomorphic adenoma samples, one sample expressed PR receptor moderately and two expressed it weakly. Besides, out of 22 mucoepidermoid carcinoma samples, only one sample expressed PR receptor. The comparison of PR receptor expression between two groups was not statistically significant (p Value=0.719).

Conclusion: Based on the findings of this study, it can be concluded that PR receptor cannot probably play a direct role in carcinogenesis and prognosis of benign and malignant salivary tumors.

Jawbone metastatic lesions are a diagnostic challenge because of their rarity and variable clinical, radiographic, and histopathologic characteristics. This paper presents a 57-year-old female with a chief complaint of lower face swelling. Cone beam computed tomography (CBCT) showed a multilocular radiolucency with right angle septa in the left mandibular area with cortical destruction. She had a history of right breast cancer about six years ago. Histopathologic examination revealed sheets of malignant small round cells. Immunohistochemistry (IHC) was only positive for cytokeratin (CK) and GATA3. CA15-3 tumor marker was higher than the normal range. Based on the aforementioned data, the diagnosis of metastatic breast carcinoma was performed. The whole-body and computed tomography (CT) scan showed just involvement in the left mandibular area. The radiographic appearance of metastatic lesions might be misleading, and microscopic sections might be poorly differentiated, therefore, a precise past medical history, IHC staining, and tumor markers are valuable issues in diagnosing oral cavity metastasis.

Background: In orthodontics, radiography-based methods are frequently used for the assessment of skeletal maturity. Concerning X-ray exposure hazard, a new objective and less invasive method is needed to identify the optimal orthodontic treatment timing.

Purpose: In this study, the pattern of salivary alkaline phosphatase and insulin-like growth factor-1 in the circumpubertal period was investigated. Moreover, new regression models were built to predict skeletal maturity more accurately.

Materials and method: In this cross-sectional study, fifty-five subjects aged 7 to 20 years were enrolled to compare the levels of salivary alkaline phosphatase and insulin-like growth factor-1 at different skeletal maturity stages by using 6-stage cervical vertebral maturation method. Moreover, three new multinomial logistic regression models based on these biomarkers, as well as chronological age, and gender were built to predict the cervical stage. Statistical analysis was performed using SPSS (version 24) software. In addition to descriptive statistics, the Shapiro-Wilk test, the one-way analysis of variance test, the independent Samples T-test, the Pearson correlation coefficient, the Chi-square test, and the overall correct classification rate was performed.

Results: A significant difference was observed for salivary alkaline phosphatase and also insulin-like growth factor-1 levels between cervical stages (< 0.001). The peak level in both salivary alkaline phosphatase and insulin-like growth factor-1 levels was observed at CS3. The levels of these biomarkers had a significant positive correlation with the cervical stages from CS1 to CS3 and a significant negative correlation from CS3 to CS6. Based on the regression model analysis, we found that Model 3´ which combined gender with chronological age, alkaline phosphatase, and insulin-like growth factor-1 had the highest predictive ability (76.4%).

Conclusion: The notably larger predictive ability of the new model which combined gender with chronological age, salivary alkaline phosphatase, and salivary insulin-like growth factor-1 might be responsible for the identification of the optimal orthodontic treatment timing in an objective and less invasive manner in healthy growing individuals.

Background: The overwhelming increase of antibiotic-resistant bacteria, and the adverse reactions of using synthetic drugs such as chlorhexidine (CHX) and calcium hydroxide (Ca(OH₂))- based intracanal medicaments have made it mandatory to search for effective substitutes. Herbal medicines like Achyranthes Aspera (A.aspera) and Trachyspermum Ammi (T.ammi) have been used in many clinical conditions and it appears to be a distinct material next to Ca(OH₂) in the field of dentistry.

Purpose: Evaluate the antibacterial potential and cytotoxic effects of novel polyherbal gel containing A.aspera and T.ammi, CHX gel, and Ca(OH₂) paste based intracanal medicaments in root canal treatment against Enterococcus faecalis (E.faecalis).

Materials and method: In this in vitro study, Ethanolic extracts of A.aspera and T.ammi were prepared by the Soxhlet apparatus method. The individual plant extracts and the plant extract mixtures (1:1, 2:1, and 1:2), CHX, and Ca(OH₂) were assessed for minimum inhibitory concentration (resazurin microtiter assay), fractional inhibitory concentration and minimum bactericidal concentration (spread plating method) against E.faecalis. The polyherbal intracanal medicament was assessed for zone of inhibition (well diffusion method) and cytotoxicity ( MTT assay) on human periodontal ligament cells. All experiments were performed in triplicate.

Results: Polyherbal gel containing A.aspera and T.ammi, CHX gel, and Ca(OH₂) paste-based intracanal medicaments showed statistically significant antibacterial activity (p <0.05) against E.faecalis with CHX showing superior properties followed by polyherbal gel. The results of the cytotoxicity assay demonstrated the good biocompatibility of the polyherbal intracanal medication, which exhibited 95.13% of surviving cells.

Conclusion: The use of herbal alternatives as an intracanal medicament proved to be advantageous considering the several undesirable characteristics of CHX and Ca(OH₂).

Squamous cell carcinoma (SCC) is the most common oral malignancy. Conventional types are classified as well-, moderately- and poorly differentiated, which are usually easy to diagnose microscopically. Still, uncommon variants such as basaloid, verrucous, spindle cell, papillary, adenosquamous, acantholytic, cuniculatum, clear cell, and pigmented SCC make a diagnostic challenge for pathologists. This report presents four rare cases of oral SCC with histopathologic diagnosis of spindle cell carcinoma, carcinoma cuniculatum, papillary SCC, and basaloid SCC focusing on microscopic characteristics and differential diagnosis. The apprehensive knowledge about the unique histopathologic features of these uncommon variants is crucial to avoid their misdiagnoses and provide appropriate treatment.

Background: Favorable esthetic and mechanical qualities, together with rapid advancements in CAD/CAM technology, have increased the adoption of zirconia restorations. Despite acceptable optical characteristics of zirconia, achieving natural tooth color resemblance remains challenging.

Purpose: This study was conducted to determine how the try-in paste shade, tooth region, and framework design affect the color properties of zirconia restorations.

Materials and method: In this in vitro study, a maxillary central incisor was prepared and scanned. Frameworks with four different designs were fabricated. Ten crowns were designed in each group categorized as simple core (SC), dentin core (DC), trestle design core (TC), and monolithic crown (MC). Veneering was performed for all groups except MC. Subsequently, all crowns were cemented with try-in paste Bisco CHOICE 2 cement in shades A1-A3 and B1. The color data (Lab) were determined using the SpectroShade Micro II device. Color difference (ΔE) with the Lab B2 color sample as the target color was calculated using the CIE ΔE 2000 formula. Data analysis was performed using the repeated measure ANOVA test.

Results: Zirconia core design, tooth region and cement shade, significantly impacted the ΔE and there were interactions among these factors. The highest ΔE was observed when no cement was used, while the lowest ΔE was observed with A2 cement. Among the various framework designs, the lowest and highest ΔEs were observed in MC and, SC frames, respectively (p Value < 0.05).

Conclusion: In the light of the findings of current study, minimum ΔE can be achieved with trestle design framework at the middle portion of the tooth. The try-in paste shade also has a considerable impact on the final ΔE value.

Background: Some alterations in the enamel structure of primary teeth have been reported following iron drop consumption. The efficacy of different remineralizing agents for this problem is still challenging.

Purpose: This study aimed to assess the efficacy of remineralizing agents for prevention of microhardness reduction and change in primary enamel mineral content after exposure to iron drop.

Materials and method: In this experimental study, 36 sound primary anterior teeth were assigned to four groups of control, casein phosphopeptide amorphous calcium phosphate (CPP-ACP), fluoride varnish (FV), and CPP-ACP+FV (MI varnish). The baseline microhardness of the teeth was first measured by Vickers hardness tester using 50 g load for 10 seconds. Next, the microhardness was measured after remineralizing agents were applied on the specimens. After the application of iron drop for 5 minutes, and pH cycling for 10 days, the final microhardness of specimens was registered. Specimens were also subjected to energy dispersive X-ray spectroscopy (EDS) in the control group, after remineralization and after the application of iron drop. Data were analyzed by one-way ANOVA, Tukey's test, and Tamhane's test.

Results: The final microhardness was significantly higher in all remineralized groups compared to the control group (p Value= 0.003). The final microhardness was significantly higher in MI varnish compared to FV (p= 0.027), CPP-ACP (p= 0.03), and control (p< 0.0001) groups. According to EDS, calcium (Ca) and ferric (Fe) content were significantly different between the remineralizing groups and control groups in the final step (p< 0.00001).

Conclusion: Application of CPP-ACP, FV, and MI varnish prior to iron drop exposure can improve microhardness. MI varnish had significantly higher efficacy for this purpose than the other two remineralizing agents.

Background: The quality of dental services is an important factor in patient satisfaction and health outcomes. However, there is a lack of studies, which compare the quality of dental services provided in different settings such as dental schools and private clinics and measure the gap between patients' expectations and perceptions.

Purpose: This study aims to assess and compare the quality of dental services in Shiraz Dental School and private clinics using the SERVQUAL model and identify the dimensions that affect patient satisfaction.

Materials and method: In this cross-sectional descriptive study, 440 patients of the Shiraz dental school and private clinics in Shiraz participated in answering the SERVQUAL questionnaire to measure the perceptions and expectations of patients in six dimensions (tangibility, reliability, responsiveness, assurance, empathy, and access).

Results: The mean gap score was (-1.27±0.59) for private clinics and (-0.40±0.45) for dental school, which was significant (p< 0.001) between expectations and perceptions in all dimensions in both settings. In private clinics, the largest gap was in the empathy dimension (-1.64±0.65) and the smallest gap was in the assurance dimension (-1.05±0.64). In the Shiraz dental school, the largest gap was in the tangibility dimension (-0.72±0.60) and the smallest gap was in the assurance dimension (-0.59±0.65).

Conclusion: The patients were satisfied with the services provided in the Shiraz dental school and private clinics of Shiraz, but the expectations of the patients were not met in all dimensions, which require periodic evaluations along with policies to respond to the needs and expectations of the patients in providing services in both sectors.

Background: The presence of orthodontic appliances in the oral cavity increases the number of cariogenic microorganisms, highlighting the risk of periodontal disease and dental caries. Many approaches can be employed to overcome this problem.

Purpose: This study was conducted to compare the effect of kefir drink with chlorhexidine (CHX) mouthwash on the growth of oral bacteria in patients undergoing orthodontic treatment.

Materials and method: In this single-blind clinical trial study, 30 candidates for orthodontic treatment were selected and randomly divided into two groups (N=15). The intervention group received 100 ml of Kefir drink twice daily, while the control group used 10 ml of 0.2% mouthwash for 20 days. Microbial sampling was done three times including before intervention, immediately after intervention, and 20 days after intervention. Data were analyzed using SPSS software V.23 with a significance level of less than 0.05.

Results: The findings suggested that the number of bacteria in the CHX group was significantly higher than in the intervention group (p= 0.003). However, no significant difference was observed between the two groups after 20 days (p= 0.148). Furthermore, the number of bacteria decreased significantly in both groups over time.

Conclusion: Both CHX and Kefir have antibacterial properties against oral bacteria.