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   2018| January-February  | Volume 15 | Issue 1  
    Online since January 19, 2018

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Clinical evaluation of Class II and Class III gingival recession defects of maxillary posterior teeth treated with pedicled buccal fat pad: A pilot study
D Deepa, KV Arun Kumar
January-February 2018, 15(1):11-16
Background: Buccal fat pad (BFP) is a specialized vascular tissue adequately present in buccal space and is close to the maxillary posterior quadrant. The aim of this clinical study was to evaluate the utility of pedicled BFP (PBFP) in the treatment of Class II and III gingival recession. Materials and Methods: Ten systemically healthy patients with age ranging from 35 to 55 years with Class II and Class III gingival recession in the maxillary molars were selected. Before the surgical phase, patients were enrolled in a strict maintenance program including oral hygiene instructions and scaling and root planing. A horizontal incision of 1–1.5 cm was made in the buccal sulcus of the maxillary molar region; buccinator muscle was separated bluntly to expose the BFP. The fat was then teased out from its bed and spread to cover defects adequately. It was then secured and sutured without tension. Clinical parameters such as probing depth, recession width, recession length (RL), and width of keratinized gingiva were recorded at baseline and at 6 months postoperatively, and weekly assessment was done at 1 week, 2 weeks, 3 weeks, and after 4 weeks for observations during the postoperative healing. Results: Treated recession defects healed successfully without any significant postoperative complications. Decreased gingival recession horizontal width values from 4.65 ± 0.4327 to 0.94 ± 1.350 and RL from 6.4 ± 1.075 to 0.7 ± 0.6750 were observed postoperatively (P < 0.05). Percentage of root coverage average was 89.3%. There was a statistically significant decrease in the width and depth of recession. Conclusion: Pedicled buccal fat showed promising results as the treatment modality in the management of Class II and Class III gingival recession of maxillary posterior teeth.
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Prevalence of orthodontic treatment need in permanent dentition of Iranian population: A systematic review and meta-analysis of observational studies
Faezeh Eslamipour, Zohreh Afshari, Arash Najimi
January-February 2018, 15(1):1-10
Background: Malocclusion is a common oral health problem and can affect the psychosocial well-being in the long term. Therefore, in the recent decades, demand for orthodontic treatment to correct malocclusion has greatly increased worldwide. This systematic review and meta-analysis was undertaken to assess existing evidence on the prevalence of orthodontic treatment need in Iran. Materials and Methods: National and international databases were searched for articles on the prevalence of orthodontic treatment need using index of orthodontic treatment need (IOTN) and dental aesthetic index (DAI). The required data were completed by hand-searching. After applying the inclusion and exclusion criteria, the quality of articles was checked by a professional checklist. Data extraction and meta-analysis were performed. A random effects model was employed, and publication bias was checked. Results: From a total of 443 articles that reported orthodontic treatment need in Iran, 24 articles were included in the meta-analysis process. Meta-analysis was performed on components of IOTN and DAI. The pooled prevalence of orthodontic treatment need based on Dental Health Component and Aesthetic Component of IOTN and DAI was 23.8% (19.5%–28.7%), 4.8% (3.3%–7%), and 16.1% (12.3%-20.8%). The results were found to be heterogeneous (P < 0.05). Conclusion: The results of this study revealed that orthodontic treatment need was not high in the Iranian population. Considering the differing prevalence of orthodontic treatment need based on normative index and self-perceived index, it is essential to improve the people's awareness of malocclusion and its side effects on their oral and general health.
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Innovative evaluation of local injective gel of curcumin on the orthodontic tooth movement in rats
Sohrab Asefi, Massoud Seifi, Ghazal Hatami Fard, Ali Lotfi
January-February 2018, 15(1):40-49
Background: Curcumin is the most active compound in turmeric. It can suppress the nuclear factor kappa-light-chain-enhancer of activated B cells pathway and prevent the osteoclastogenesis procedure. This study aimed to be the first to evaluate the effect of curcumin on the rate of orthodontic tooth movement (OTM). Materials and Methods: Forty rats were used as follows in each group: (1) negative control: Did not receive any appliance or injection; (2) positive control: received 0.03 cc normal saline and appliance; (3) gelatin plus curcumin (G): Received 0.03 cc hydrogel and appliance; and (4) chitosan plus curcumin (Ch): Received 0.03 cc hydrogel and appliance. They were anesthetized and closed nickel-titanium coil springs were installed between the first molars and central incisors unilaterally as the orthodontic appliance. After 21 days, the rats were decapitated, and the distance between the first and second molars was measured by a leaf gauge. Howship's lacunae, blood vessels, osteoclast-like cells, and root resorption lacunae were evaluated in the histological analysis. Data were analyzed by one-way ANOVA, Tukey's test, and t-test (P < 0.05 consider significant). Results: No significant difference was found in OTM between groups delivered orthodontic forces. Curcumin inhibited root and bone resorption, osteoclastic recruitment, and angiogenesis significantly. Conclusion: Curcumin had no significant inhibitory effect on OTM. While it had a significant role on decreasing bone or root resorption (P > 0.05).
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Analysis of interleukin-10 gene polymorphisms in patients with chronic periodontitis and healthy controls
Bita Moudi, Zahra Heidari, Hamidreza Mahmoudzadeh-Sagheb, Mehrnoosh Moudi
January-February 2018, 15(1):71-79
Background: Interleukin-10 (IL-10) is an anti-inflammatory cytokine that has important roles in the periodontal diseases. The IL10-1082, -819, and -592 polymorphisms in the promoter region of IL-10 gene have been associated with various IL-10 expressions. The aim of this study was to investigate the association between these gene polymorphisms with chronic periodontitis in a sample of Iranian populations from Southeast of Iran. Materials and Methods: IL-10 single nucleotide polymorphisms were analyzed in 210 patients with chronic periodontitis (CP) and 100 individuals without CP by polymerase chain reaction-restriction fragment length polymorphism method. Statistical analysis of data was performed using the Chi-square test. The risk associated with single alleles, genotypes, and haplotypes were calculated by performing a multiple logistic regression analysis to estimate the odds ratio (OR) and 95% confidence interval (CI). P < 0.05 for statistical significance. Results: The prevalences of AG and GG genotypes of IL10-1082 were significantly different between CP and control groups in comparison to AA genotype (OR = 2.671; CI = 1.482–4.815; P = 0.001 for AG vs. AA, OR = 4.151; CI = 2.128–8.097; P < 0.001 for GG vs. AA). In addition, subjects with at least one IL10-1082-G allele were significantly had an increased risk for CP (OR = 2.157; CI = 1.531–3.038; P < 0.001). The distribution of the IL10-819 and IL10-592 genotypes was not different between CP and control subjects (P = 0.109 and P = 0.139, respectively). The combination of different genotypes showed that GCC haplotype was significantly different between groups (OR = 4.379; CI = 1.077–17.807; P = 0.039). Conclusion: The results demonstrated that IL10-1082 polymorphism was a putative risk factor for chronic periodontitis and associated with increased susceptibility to CP.
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Effect of ceramic cooling protocols and zirconia coloring on fracture load of zirconia-based restorations
Behnaz Ebadian, Ramin Mosharraf, Mahsa Abbasi
January-February 2018, 15(1):17-24
Background: Residual thermal stresses in dental porcelains can cause clinical failure. Porcelain cooling protocols may affect the amount of residual stresses within porcelain and also porcelain–zirconia bond strength. The objective of this study was to assess the effect of cooling protocols on the fracture load of porcelain veneered zirconia restorations. Materials and Methods: Forty zirconia bars (31 mm × 6.5 mm × 1.35 mm ± 0.1 mm) were fabricated by computer-aided design and computer-aided manufacturing technology. Half of the specimens were immersed in the coloring agent for 2 min before sintering (yellow group). Thus, the specimens were divided into two groups of white (W) and yellow (Y) samples (n = 20). Heat-pressed ceramic was applied to all bars. After pressing, half of the samples in each group were immediately removed from the oven (fast cooling) while the other specimens remained in the partially open door (30%) oven until the temperature reached to 500°C. Samples were thermocycled for 5000 cycles and subjected to modified four-point flexural strength test by a universal testing machine at a crosshead speed of 0.5 mm/min. Two-way ANOVA, One-way ANOVA followed by post hoc Tukey honest significant difference tests were used for data analysis (α = 0.05). Results: Fractures were cohesive in all samples (within the porcelain adjacent to the interface). Two-way ANOVA showed that the effect of cooling protocol on the fracture load of samples was statistically significant (P < 0.001). In addition, the fracture load of W and Y groups was significantly different (P < 0.001). The white slow group showed the highest fracture load (179.88 ± 23.43 N). Conclusion: Slow cooling protocol should be preferably applied for zirconia restorations. Coloring agent used in this study had a significant negative effect on fracture load.
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Assessment of palatal rugae pattern for sex and ethnicity identification in an iranian population
Mahnaz Sheikhi, Mohammad Zandi, Maryam Ghazizadeh
January-February 2018, 15(1):50-56
Background: Palatal rugoscopy is a reliable method in the forensic personal identification and racial group specification. the aim of the present study is to use palatal rugae pattern in sex and ethnicity identification applications. Materials and Methods: Four hundred individual dental casts from four different ethnic populations of Iran were randomly selected. The pattern of the palatal rugae (shape, length, and number) investigated and its reliability to classify sex and minor ethnicity for each individual cast was evaluated. (P < 0.05) considered significant. Results: The most common rugae shapes were straight, followed by wavy and curved types. The least frequent shapes were converging and circular types. Palatal rugae patterns were unique to each person. However, they could not differentiate males and females and had low abilities to classify the racial subsets. Conclusion: The palatal rugae pattern was unique to each individual and palatal rugoscopy can be considered as a reliable forensic identification tool where utilizing other methods such as DNA profiling, fingerprint, and dental record comparison is impossible or difficult. In this study, palatal rugoscopy was not a reliable method to classify the sex of an individual and to differentiate between different racial subsets.
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Bond strength of self-adhesive resin cement to base metal alloys having different surface treatments
Farhad Shafiei, Marjan Behroozibakhsh, Aref Abbasian, Samaneh Shahnavazi
January-February 2018, 15(1):63-70
Background: This study aimed to assess and compare the shear bond strength of self-etch and self-adhesive resin cement to nickel-chromium-cobalt alloy with different surface treatments. Materials and Methods: In this in vitro study, a total of 120 disks were fabricated of VeraBond II base metal alloy. Specimens were divided into 15 groups of 8 based on the type of cement and surface treatment. The five surface treatments studied included sandblasting alone, application of Alloy Primer with and without sandblasting, and application of Metal Primer II with and without sandblasting. The three cement tested included Panavia F2.0, RelyX Unicem (RU), and G-Cem (GC). After receiving the respective surface treatments, the specimens were thermocycled for 1500 cycles and underwent shear bond strength testing. Data were analyzed using SPSS 20.0 and three-way analysis of variance. P values of the significant level of 0.05 were reported. Results: The results exhibited that the mean bond strengths in sandblasted groups were higher than nonsandblasted one. These differences were significantly higher in the sandblasted groups of Panavia F2.0 and RU cement (P < 0.05).The mean bond strength values between GC and Panavia F2.0 were not statistically significant (P > 0.05). The highest bond strength was recorded for Panavia F2.0 with the surface treatment of both sandblasting and Metal Primer II. Conclusion: Based on the results, sandblasting improves the shear bond strength of self-etch and self-adhesive resin cement to base metal alloys. The best results can be achieved with a combination of sandblasting and metal primers. The performance of resin cement depends on to their chemical composition, not to the type of system.
  2,644 136 3
Comparison of apical transportation and centering ability of Mtwo and Reciproc R25 in severely curved canals using cone-beam computed tomography
Abbas Mesgarani, Mahmoud Reza Hamidi, Sina Haghanifar, Shabnam Naiemi, Ali Bijani
January-February 2018, 15(1):57-62
Background: Apical transportation (AT) of the root canal moves the physiologic canal terminus to a new location on the external root surface and results in the accumulation of debris and residual microorganisms due to inadequate cleaning and shaping of the canal end. This study aimed to assess the prevalence of AT following canal preparation with Mtwo and Reciproc R25 using cone-beam computed tomographic (CBCT). Materials and Methods: In this in vitro study, 40 mesiobuccal root canals of the maxillary molars with 19–22 mm length and (>40°) taper were prepared in two groups using Mtwo and Reciproc R25 rotary systems along with irrigation with 2.5% NaOCl. CBCT scans were obtained of the canals before and after preparation under similar conditions, and the values were measured using the device software. The amount of AT was measured according to Gambill et al. Data were analyzed using SPSS 17 and Chi-square and t-tests. P < 0.05 was considered significant. Results: Both systems caused some degrees of AT. No significant difference was found between the two systems in terms of the amount and direction of AT (P > 0.05); overall, the frequency of AT toward the mesial wall was greater than that toward the distal direction. However, this difference was not statistically significant. Conclusion: The mean amount of AT and the ability to keep the instruments in severely curved canals were not significantly different in canals prepared by Mtwo and Reciproc rotary systems. Thus, these systems can be used in the clinical setting with the lowest risk of AT.
  2,623 129 1
Effects of ethanol concentrations of acrylate-based dental adhesives on microtensile composite-dentin bond strength and hybrid layer structure of a 10 wt% polyhedral oligomeric silsesquioxane (POSS)-incorporated bonding agent
Seyed Mostafa Mousavinasab, Mohammad Atai, Mehrdad Barekatain, Parisa Fattahi, Amir Fattahi, Vahid Rakhshan
January-February 2018, 15(1):25-32
Background: The aim of this study was to assess for the first time the effects of different amounts of ethanol solvent on the microtensile bond strength of composite bonded to dentin using a polyhedral oligomeric silsesquioxane (POSS)-incorporated adhesive. Materials and Methods: This experimental study was performed on 120 specimens divided into six groups (in accordance with the ISO TR11405 standard requiring at least 15 specimens per group). Occlusal dentin of thirty human molar teeth was exposed by removing its enamel. Five teeth were assigned to each of six groups and were converted to 20 microtensile rods (with square cross-sections of 1 mm × 1 mm) per group. The “Prime and Bond NT” (as a common commercial adhesive) was used as the control group. Experimental acrylate-based bonding agents containing 10 wt% POSS were produced with five concentrations of ethanol as solvent (0, 20, 31, 39, and 46 wt%). After application of adhesives on dentin surface, composite cylinders (height = 6 mm) were bonded to dentin surface. The microtensile bond strength of composite to dentin was measured. The fractured surfaces of specimens were evaluated under a scanning electron microscope to assess the morphology of hybrid layer. Data were analyzed using one-sample t-test, one-way analysis of variance (ANOVA), and Tukey tests (α = 0.05). Results: the mean bond strength in the groups: “control, ethanol-free, and 20%, 31%, 39%, and 46% ethanol” was, respectively, 46.5 ± 5.6, 29.4 ± 5.7, 33.6 ± 4.1, 59.0 ± 5.5, 41.9 ± 6.2, and 18.7 ± 4.6 MPa. Overall difference was significant (ANOVA, P < 0.0001). Pairwise differences were all significant (Tukey P < 0.05) except those of “ethanol 0% versus 20%” and “20% versus 31%.” All groups except “0% and 46% ethanol” had bond strengths above 30 MPa (t-test P < 0.05). Conclusion: Incorporation of 31% ethanol as solvent into a 10 wt% POSS-incorporated experimental dental adhesive might increase the bond strength of composite to dentin and improve the quality and morphology of the hybrid layer. However, higher concentrations of the solvent might not improve the bond strength or quality of the hybrid layer.
  2,590 135 1
Rhabdomyosarcoma of the maxillary gingiva
Mina Motallebnejad, Pouyan Aminishakib, Samira Derakhshan, Abbas Karimi
January-February 2018, 15(1):80-83
Rhabdomyosarcoma is a malignant skeletal muscle neoplasm. The tumor is much more common in children, and the most frequent site is head and neck region. Since this tumor is less frequent than other neoplasms in oral cavity, the clinicians sometimes ignore it, working the patients up. Rhabdomyosarcoma is a high-grade malignancy with poor prognosis. Considering the aggressive behavior and various clinical or histopathologic presentations of the tumor, early diagnosis has a significant impact on the treatment outcome and prognosis of the patients. We highlight the importance of combining the clinical, radiographic, and histopathologic examination to obtain a definitive diagnosis in sarcomas of the head and neck region, especially rhabdomyosarcoma. A case of rhabdomyosarcoma of the maxillary gingiva is presented in a 32-year-old woman in which the primary incisional biopsy was erroneously interpreted as an inflammatory process and consequently, the accurate diagnosis postponed for about 10 months.
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Evaluation of cavity size, kind, and filling technique of composite shrinkage by finite element
Toloo Jafari, Homayoon Alaghehmad, Ehsan Moodi
January-February 2018, 15(1):33-39
Background: Cavity preparation reduces the rigidity of tooth and its resistance to deformation. The purpose of this study was to evaluate the dimensional changes of the repaired teeth using two types of light cure composite and two methods of incremental and bulk filling by the use of finite element method. Materials and Methods: In this computerized in vitro experimental study, an intact maxillary premolar was scanned using cone beam computed tomography instrument (SCANORA, Switzerland), then each section of tooth image was transmitted to Ansys software using AUTOCAD. Then, eight sizes of cavity preparations and two methods of restoration (bulk and incremental) using two different types of composite resin materials (Heliomolar, Brilliant) were proposed on software and analysis was completed with Ansys software. Results: Dimensional change increased by widening and deepening of the cavities. It was also increased using Brilliant composite resin and incremental filling technique. Conclusion: Increase in depth and type of filling technique has the greatest role of dimensional change after curing, but the type of composite resin does not have a significant role.
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