Caspian Journal of Dental Research

13-19

Authors: Eshaghali Saberi , Narges Farhadmollashahi *, Elnaz Mousavi

Introduction: Antimicrobial activity of irrigants and interappointment intracanal dressing is an important consideration in endodontics. The aim of this study was to evaluate the clinical efficacy of chemomechanical preparation of the necrotic canals with different irrigants and intra canal dressing in the control of root canal infection and sinus tract closure. Materials &Methods: In this study, 65 patients with sinus tract were treated. They were randomly divided into 4 groups. Sodium hypochlorite (NaOCl) and chlorhexidine (CHX) was used as the irrigation solutions in the group one and two, then the canals were filled. In group three, after irrigation with NaOCl, Ca (OH) 2/sterile Saline was used as intra canal medicament, and similar to group three Ca (OH) 2/CHX was used in group four after irrigating by CHX. After 7 days, the intra canal paste was removed and the canals were filled. The sinus tract closure was followed up within 7, 14, and 21-day intervals. The data were analyzed using Chi Square and Kruskal-Wallis statistical tests. Results: The highest mean time of sinus tract closure was for Ca (OH)2/sterile Saline and the lowest was for Ca(OH)2/CHX. The differences of sinus tract closure between group 2&4 (p=0.04), group 3&4 (p=0.004). Groups were statistically significant. Conclusion: It was concluded that Ca (OH)2/CHX paste as intra canal dressing has good clinical efficacy in the control of root canal infection and sinus tract closure.

27-32

Authors: Zahra Minaei Basharik, Manouchehr Rahmati Kamel, Pouyan Amini Shakib, Maysam Mirzaie*, Ali Bijani

Introduction: The bonding process of the brackets to enamel has been a critical issue in orthodontic research. The purpose of this study was to evaluate the shear bond strength of 3 light-cured adhesives (transbond XT, Z250, light bond). Materials &Methods: In this study sixty extracted human premolars were collected and randomly divided into 3 test groups. All teeth were etched by 37% phosphoric acid. In first group brackets were bonded by Transbond XT adhesive, in group two brackets were bonded by Light bond adhesive and in third group were bonded by filtek Z250 composite. All of them were cured with Ortholux xt for 40 seconds. 24 hours after thermocycling, Shear Bond Strength (SBS) values of these brackets were recorded using a Universal Testing Machine. Adhesive Remnant Index (ARI) scores were determined after the failure of the brackets, using Stereo Microscope the data were analyzed using ANOVA and Chi-square tests. Results: Mean shear bond strength of Transbond XT, light bond and Z250 were 28.9±2.25 MPa, 25.06±1.98 MPa and 26.8±2.57 MPa, respectively. No significant difference was observed in the SBS among the groups and a clinically acceptable SBS was found for the three adhesives. ARI scores were not significantly different between the various groups (P>0.05). Conclusion: This study showed that the Z250 can be used as light bond and transbond xt to bond orthodontic brackets and ARI and SBS scores were not significantly different.

40-43

Authors: Gholamreza Ataei , Sina Haghanifar , Masomeh Karimi, Fereshteh Adel *

Introduction: As the absorption of radiation in environment is increasing, the present study was performed to evaluate the knowledge and practices of Babol’s dentists about x-ray protection. Materials &Methods: This cross-sectional study was designed to assess the knowledge and practices of dentists. The questionnaires were distributed among 70 dentists in Babol city. Analysis of the collected data was done using the Pearson correlation coefficient in SPSS software version 19 (α=0.05). Results: In this study, 70% and 30% of studied dentists had good and moderate knowledge, respectively. 96% of them were moderate in terms of practice and 70% of them had good awareness towards the use of a lead apron and thyroid collar but 78.6% and 75.7% of offices had no lead apron and thyroid collar. There was a significant relationship between experience and awareness (p=0.003). Conclusion: According to the results, their appropriate knowledge and practice were poor. Therefore, it is necessary to control the dental radiographic centers.

50-56

Authors: Valiollah Arash, Sepideh Rezapour, Reza Ghorbanipour , Babak Amoian , Fateme Majdzade *

Reports have shown that molars can be distalized successfully with virtually no orthodontic anchorage loss with an intraosseous anchorage, even with fully erupted second molars. The purpose of this study was evaluating the effects of mini-screws as skeletal anchorage for upper molar distalization. In this case series, three patients needing maxillary first molar distalization, were selected. mini-screw was inserted in the anterior part of the palate. The screws were anchored to the first premolars by transpalatal arch and immediately loaded (150-160 g) by 0.018-inch arch-wire and steel open-coil spring to distalize maxillary molars. The skeletal and dental changes were measured on cephalograms obtained before and after distalization. The amount of first molar distalization in the patients was 4 mm with 2°of tipping, 4 mm with 5°of tipping, and 3.5 mm with 2°of tipping respectively. Upper incisors and first premolars were stable during distalization.

10-16

Authors: Neda Lotfi, Behnaz Esmaeili, Ghazaleh Ahmadizenouz*, Ali Bijani , Hadi Khadem

Introduction: One of the main disadvantages of composites is marginal microleakage; using flowable composites as a liner beneath composite restorations has been recommended to reduce microleakage. The aim of this study was to assess the microleakage of class II restorations with different flowable composites liners. Materials &Methods: 45 extracted premolars teeth with class II cavity preparation (90 cavities) were divided into five groups and filled as follows: 1.control group: hybrid composite (Z250) 2. Z250+surefil SDR flow 3.Z250+filtek supreme xt flow composite 4.Z250+Grandio flow 5.Z250+Tetric flow. Mesial and distal cavities were filled using snowplow and layering technique, respectively. After that, the samples were immersed in 0.5% fuchsin solution and sectioned. Gingival microleakage was then graded. Data were analyzed using Kruskal Wallis and Mann Whitney U test. Results: There was no significant difference between the snowplow and layering methods. Microleakage of Tetric flow and Grandio flow liners was significantly higher than the control group. Other flowable composites showed no significant difference in comparison with the control group. Conclusion: In the present study, the results indicated that the flowable composites were not effective on reducing gingival microleakage.

23-29

Authors: Effat Khodadadi, Nastaran Shamsi, Soraya Khafri, Homayoun Alaghehmand*

Introduction: One factor affecting the degree of polymerization is the type of light-curing device. The aim of this study was to compare the effects of LED and QTH light curing units on the surface hardness of composite and compomer. Materials &Methods: In this experimental study, 30 samples of composite and compomer were divided into 3 groups of 10 each. One-half of the subgroups in each group were cured with LED and the other half with Halogen light curing units (LCUs). 49 points on the surface were marked and then the hardness of these points was measured by using Vickers hardness test. Results: The mean hardness of composites cured by using LED was more than the Halogen group but in compomer it was reversed and this difference was statistically significant (p<0.001). Z 250 composite had the highest level of hardness and the lowest hardness was related to the Heliomolar composite and had significant difference (p<0.001). Conclusion: In the present study, the results indicated that LED light curing unit had great effect on the hardness of composites but in compomer, the QTH showed a better result.

37-42

Authors: Seyed Mehdi Dejkam, Mohammad Kashefienejad * , Sina Mirzaeerad AliAkbar Moghadamnia , Hemmat Gholinia

Introduction: Feeling pain after root canal therapy has always been a major problem for patients and dentists. One of the suggested methods to manage the pain is using the prophylactic medication before treatment process. This study aimed at investigating the comparison of pretreatment with novafen versus gelofen on reducing the pain after root canal therapy. Materials &Methods: This double-blind randomized clinical trial study was conducted on 60 patients aged 18-65 who were indicated for root canal therapy. Patients were randomly assigned to receive gelofen capsules (400mg), novafen capsules (200mg) and placebo two capsules by every patient of these groups one hour prior to sampling. Pre/post-treatment pain was measured using Visual Analog Scale (VAS) before treatment and 4, 8, 12, 24 and 48 hours after treatment. Results: Both novafen and gelofen indicated significant analgesic effect during the study period (p<0.001). Pain severity within 8 hours after treatment was significantly lower in novafen group than two other groups (p=0.03). The difference between the severity of pain did not show any association to their place of life and gender in any groups. Conclusion: Our findings revealed that the prophylactic novafen in comparison to gelofen had a better analgesic effect in short-term and could be a good candidate for the management of post-endodontic treatment pain.

50-53

Authors: Reza Judi Chelan, Faezeh Abolghasemzade*

Introduction: Posterior composites are one of the most popular filling materials. The aim of this study was to evaluate the problems of general dentists during and after posterior composite restorations in city of Babol. Materials &Methods: In this study, data were collected using questionnaire about the problems during and after posterior composite filling. Then data were analyzed by chi square test. Results: The highest complains of patients after posterior composite filling were related to the food impaction (33.4%), the most clinician's problem during posterior composite filling was inadequate proximal contact (37.2%) and most of dentists used pressing matrix band for proper proximal contact (31.2%). Most of dentists used incremental technique for composite filling (49.3%) and two-step total etch adhesives (68.7%) according to the manufacturer's instructions (44.2%) and applied wet polishing technique (75.6%) and major criteria for choosing composite as restorative material in posterior teeth were the ability of isolation (41.8%). Conclusion: Increasing the knowledge of dentists about these restorations may reduce the associated problems during and after composite filling.

14-19

Authors: Mitra Tabari , Behnaz Esmaeili , Mona Alimohammadi *, Arash Poorsattar Bejeh Mir , Samane Gharekhani , Mahmood Hajiahmadi , Mobina Mollaie

Introduction: Simultaneous etching of enamel and dentin using the novel generation of adhesive systems with contracted operational steps, has shown a good clinical efficacy. The aim of this study was to evaluate the microleakage of composite restorations using the V and VII generations of adhesive systems on primary teeth. Methods: This study was performed on 45 human intact extracted primary teeth. Following class V cavity preparation, the samples were randomly divided into three groups included 15 teeth based on the type of bonding agent; Single Bond 2, Clearfil S3 Bond or G Bond. After applying the bonding agents, the teeth filled with composite Z250. The microleakage values of incisal and gingival margins were separately scored by 2% basic fuchsine staining based on a 0-3 ordinal ranking system. The data were analyzed by using Kruskal Wallis and Mann_whitney U tests. Results: In overall, the score of microleakage at incisal (0.58±0.94) and gingival (1.06±0.19) edges did not have significant difference. Also, there was no significant difference between incisal and gingival microleakage considering the different types of bonding. Conclusion: Regarding to less operational steps and lower risk of salivary contamination, the VII generation of dentin bonding agents can be applied for filling the class V cavities of primary teeth.

26-31

Authors: Fateme Arbabi-Kalati , Tahereh Nosratzehi *, Leila Farhadmollashahi , Marzie Asadi Idanlo, Zakaria Bameri

Introduction: Maintaining good oral hygiene is an important factor in health. Toothbrushes are commonly used to maintain oral health and prevent dental disease, but unfortunately how keeping the toothbrush is neglected. The aim of this study was to investigate the relationship between toothbrush keeping method and its microbial content. Methods: In this cross-sectional study, 60 volunteers were enrolled and divided into 3 groups based on the places of keeping their toothbrushes (bedroom, bathroom and lavatory). The participants were asked to brush once a day for one month using the first toothbrush which had been delivered; then the first toothbrushes were gathered and a second toothbrush was delivered. The participants were asked to brush once a day using the second toothbrush for 3 months. All toothbrushes were sent for culture and evaluation. All toothbrushes were evaluated by a blind microbiologist. Toothbrush bristles were washed in BHI broth medium; then the resulting liquid was cultured in MacConkey’s agar for gram-negative bacteria and in blood agar and chocolate agar for gram-positive bacteria. Colony counts of Streptococcus mutans, Candida albicans, Pseudomonas, Klebsiella, S. aureus, and E. coli were determined and multiplied by one thousand. Data were analyzed by SPSS version 18 and using Kruskal-Wallis test. Results: At the end of the study the results showed statistically significant differences in microbial load between the groups (p=0.014). Toothbrushes that were kept in bathroom had highest microbial load. Conclusions: Toothbrushes kept in the bathroom had the greatest microbial contamination after three months. According to the results of this study, bathroom is the worst place and bedroom is the best place for keeping toothbrushes.

39-45

Authors: Effat Khodadadi , Behnaz Esmaeili *, Naemeh Karimian, Soraya Khafri

Introduction: Sealing pits and fissures was introduced as an approach to prevent occlusal caries for more than two decades. The aim of this study was to compare the microleakage of flow able resin reinforced glass ionomer (Ionoseal) with other materials used as fissure sealants. Methods: In this in vitro study, 50 premolar teeth of human free of any caries were selected. Fissurotomy was done with fissure bur. The samples were randomly categorized into five groups (Fissurit FX, Fuji II light-cured,Grandio flow, Ionoseal). Ionoseal was assessed by using two methods: with and without etching and bonding agent prior to sealant application. After sealant placement, all surfaces of the teeth except 2 mm area around the sealant margins were covered with two layers of nail polish. The specimens were thermocycled, and they were sectioned after immersing into a 0.5 % basic fuchsine solution. The amount of microleakage was examined by stereomicroscope. Results: The microleakage comparisons of groups indicated that Ionoseal without etching and bonding application had significantly greater microleakage than the other groups (p<0.001), while there was statistically no significant difference between the microleakage of Ionoseal and the other groups after etching and bonding application (p>0.05). Conclusions: By considering isolation difficulties in children and observing high amount of Ionoseal microleakage (without etching and bonding application), the samples need to be etched and bonded like other resin-based materials before Ionoseal placement in order to achieve clinically desirable microleakage outcomes.

54-59

Authors: Ahmad Sodagar , Farhad Sobouti *, Negin Shahsavari

Introduction: Different factors such as respiratory disorders, genetics, facial growth pattern, tongue malfunction and malposition are associated with anterior open bite. Skeletal open bite is often appeared by increased posterior dentoalveolar height of maxilla and backward rotation of mandible. Many treatment approaches have been developed for treatment of increased facial height problems. Achieving absolute anchorage has been a very efficient device for intrusion of posterior segments. In this article, the treatment of patient with severe skeletal open bite and facial imbalances was explained .researchers of the present study used mini screws for leveling of upper arch by intrusion of premolars .Then, appropriate orthognathic surgery was done.

14-20

Authors: Maryam Ehsani *, Mohsen Monadi , Shooka Ranjbar, Ali Bijani , Nafiseh Ghasemi

Introduction: Noise in dental offices is one of the risk factors in the workplace. One of the major effects of noise is hearing loss. This study aimed to determine the effects of noise on hearing thresholds of dentists of Babol city. Methods: This descriptive analytical cross-sectional study was performed on 40 dentists in Babol City (as case group) and 40 office workers (as control group). Hearing thresholds were measured from all the subjects. The mean hearing threshold was calculated at different frequencies in each group and compared with the number 15 db. The data were analyzed by statistical software SPSS 17 and p≤0.05was considered significant. Results: The mean and standard deviation of hearing thresholds for the right ear of dentists and the control group without considering the different frequencies were 13.6156±9.14210 db and 10.0156±5.4488 db (p=0.036), respectively and for the left ear were 12.5115±8.7609 db and 10.059±5.9254 db respectively. Hearing threshold of right and left ear of young and middle age dentists was not significant. The hearing thresholds of the dentists with work experience of 15 years or less were not significant for the right and left ear. Auditory thresholds were significant between male and female only for the left ear (p=0.02). Conclusion: There was a change in hearing thresholds at all frequencies. A clear difference was in the left ear of men and women and hearing loss was higher in men. Also, age and working experience were not among the contributing factors to the incidence of noise-induced hearing loss.

28-34

Authors: Abdolhamid Alhavaz*, Sina Haghanifar , Yashar Vakili , Arash Poorsattar-Bejehmir

Introduction: Radiopacity is a necessary property for luting cements. The aim of this study was to investigate the radiopacity of some luting dental cements used in prosthetic dentistry. Methods: Five disclike samples of each material (6 x 1mm) were prepared from panavia F2.0 (Pa), Chioce2 (Ch.2), Glass ionomer GC (GI GC), zinc phosphate Hoffmann’s (ZP hof), zinc polycarboxylate Hoffmann’s (ZPC hof), Glass ionomer ariadent (GI ari), zinc phosphate ariadent(ZP ari) and zinc polycarboxylate ariadent (ZPC ari). The radiopacity of each material along with aluminium step wedge were measured from radiographic images using a digital radiography. The average measured radiopacities from five areas were taken into account, which were measured by Digora for windows (DFW) software using a PSP digital sensor. Results: There was a significant difference between radiopacity value of all luting materials (p≤0.001). ZP ari had the highest radiopacity with 7.7±0.55 mm aluminium. The Glass ionomer ariadent ari dent showed the lowest radiopacity value with 0.82±0.31 mm aluminium. Conclusion: All dental cements showed radiopacity values equivalent to or greater than the ISO 4049:2000(E) standard except ariadent Glass ionomer; and this could be considered suitable for use in restoration cementation.

41-46

Authors: Behnaz Esmaeili , Shaghayegh Razavi *, Mahdie Pakdaman, Ali Bijani , Hoda Amiri

Introduction: Discoloration of the resin-based composites is a common problem in restorative dentistry. There are many factors associatedwith the discoloration of dental materials in the oral environment. The purpose of this study was to evaluate the color changes in a nano-composite cured with a quartz-tungsten-halogen (QTH) and light emitting diode (LED) unit. Methods: 80 disk-shaped specimens were prepared using Filtek Z350 XT. The specimenswere cured with two LED units (Valo and BluephaseC5) andQTH )Astralis7(with two different energy density (400 & 750 mW/Cm²). The color of the materials was measured before and after immersingin tea and artificial saliva.Color change value (ΔE) were calculated and analyzed by 2-way ANOVA and Tukey’s test. Results:In artificial saliva group,the compositescured with Astralis7 and BluephaseC5 showed significantly more color stability. In tea group, the composites cured with BluephaseC5 significantly had the least color change. Conclusions:The type of light curing unitdoes not affectthe color stability. Exposure time and interaction between light source and photoinitiator content in composite may be the most important factors affecting color stability.

52-56

Authors: Maryam Pazhutan , Shirin Sakhdari*, Fatemeh Mashhadiabbas , Mahsa Afghahi , Fatemeh Khodaei

Introduction: Langerhans cell histiocytosis (LCH) refers to a group of rare reticuloendothelial system disorders and it occurs most often in young adults and children. A 57-year-old edentulous female patient who complained of dull pain in the posterior region of the mandible referred to the dental office, with a complaint of dull pain in the posterior region of the mandible. The lesion was diagnosed as LCH. Oral manifestations could be the first signs of Langerhans' cell histiocytosis. Therefore, the dentist must be aware of the oral symptoms so in order that the disease is not overlooked.

15-22

Authors: Effat Khodadadi , Nafiseh Ghasemi, Mehdi Pouramir* , Ali Bijani

Introduction: The antioxidant properties of chocolate and other flavored additives besides the sugar added to milk raises the question about the acidogenecity of flavored milk. This study was conducted to measure the pH changes of dental plaque and saliva after the consumption of flavored milk and evaluate the antioxidant property of them. Methods: This study was performed on 42 samples of dental plaque and 42 samples of saliva in 6-11 year old school going children. Milk with flavors of strawberry, chocolate, banana, honey and slim milk were evaluated, all from the same manufacturer with a similar production date. At the beginning of the study on the first day, children were given thorough oral propHylaxis and they were instructed to avoid any method of oral hygiene for 48 hours to permit enough plaque deposition. On the third day the children were divided into 7 groups, 6 children in each group. The supra-gingival plaque was collected through the help of an excavator #3 which was pulled twice with the same force on the tooth surface. The saliva was collected using spitting technique. Each child swished 10 cc of milk for 1 minute in his/her mouth. Fresh plaque samples after 5, 10, 20 and 30 minutes and saliva samples immediately, after 5, 10, 20 and 30 minutes were collected. The pH of the samples were recorded by a pH testing apparatus (Basic 20+, Crisom). To evaluate the antioxidant property of studied milk, Frap test was performed. The collected readings were reported as mean±SD and analyzed by ANOVA repeated measures, Post hoc Tukey and Paired T-test. In this study, p≤0.05 was considered as significant. Results: After 30 minutes, honey milk caused the least drop 0.74±0.30 and banana milk caused the highest drop 1.38 0.25 in plaque pH (p≤0.05). After 30 minutes, the pH of saliva showed no significant difference compared to the initial pH. Chocolate milk contained the highest (1000 micromol/liter) and banana milk the lowest (706.25 micromol/liter) antioxidant concentration. Conclusions: Because of the highest antioxidant properties and reduction of dental plaque PH to a lesser extent, milk with honey, chocolate and coffee is more recommended for children.

29-35

Authors: Mehdi Ravadgar , Valiollah Arash , Hamid Pachenari*

Introduction: In orthodontic treatment, it is essential to establish a satisfactory bond between enamel and bracket. After the self-etch primers (SEPs) were introduced for the facilitation of bracket bonding in comparison to the conventional etch-and-bond system, multiple studies have been carried out on their shear bond strengths which have yielded different results. This study was aimed at comparing shear bond strengths of the stainless steel metallic brackets bonded by three bonding systems. Methods: In this experimental in vitro study, 60 extracted human maxillary premolar teeth were randomly divided into three equal groups: in the first group, Transbond XT (TBXT) light cured composite was bonded with Transbond plus self-etching primer (TPSEP); in the second group, TBXT composite was bonded with the conventional method of acid etching; and in the third group, the self cured composite Unite TM bonding adhesive was bonded with the conventional method of acid etching. In all the groups, Standard edgewise-022 metallic brackets (American Orthodontics, Sheboygan, USA) were used. Twenty-four hours after the completion of thermocycling, shear bond strength of brackets was measured by Universal Testing Machine (Zwick). In order to compare the shear bond strengths of the groups, the variance analysis test (ANOVA) was adopted and p≤0.05 was considered as a significant level. Results: Based on megapascal, the average shear bond strength for the first, second, and third groups was 8.27±1.9, 9.78±2, and 8.92±2.5, respectively. There was no significant difference in the shear bond strength of the groups. Conclusions: Since TPSEP shear bond strength is approximately at the level of the conventional method of acid etching and within the desirable range for orthodontic brackets shear bond strength, applying TPSEP can serve as a substitute for the conventional method of etch and bond, particularly in orthodontic operations.

42-47

Authors: Ali Nozari , Tahere Esmaeilpour , Soleiman Fijan* , Mahin Salmannejad

Introduction: Tooth avulsion is defined as the complete displacement of the tooth from its alveolar socket which causes damage to the periodontal ligament structure, cementum, alveolar bone, gingiva, and dental pulp. The purpose of this study was to determine the ability of long-shelf life honey milk to serve as a temporary storage medium for the maintenance of periodontal ligament (PDL) cell viability on avulsed teeth. Methods: PDL cells were obtained from premolars extracted for orthodontic purposes which were clinically healthy and had healthy gingiva (i.e. not inflamed).Then, 8×10³ cells were seeded in each well of 96-well plate. and Afterwards treated with long-shelf life milk and honey milk, Hank’s Balanced Salt Solution (HBSS) and fresh milk. Different incubation periods were 1, 3, 6, and 9 hours. Dulbecco’s Modified Eagle Medium (DMEM) and dry medium were considered as positive and negative control media, respectively. Cell viability was determined by using the MTT (Thiazolyl Blue Tetrazolium Bromide) assay. Data were statistically analyzed with one-way anova, two-way anova and post hoc Scheffe tests. A level of p≤0.05 was accepted as statistically significant Results: The results indicate that all media performed significantly better in maintaining PDL cell viability than the negative control at all time periods. (p≤0.001) After 9 hours, Percentage of viable PDL cells in long-shelf life honey milk, long-shelf life milk and HBSS were 82±0.82, 75±8.13 and 87±2.78 respectively. Furthermore cells' viability in both long-shelf life honey milk and HBSS was significantly better than fresh milk medium (p=0.003). Moreover, the results of One-way ANOVA showed long-shelf life honey milk were more effective in preserving the PDL cell viability as well as HBSS after 9 hours. Conclusions: According to the study results, long-shelf life honey milk considered as appropriate storage media which are comparable to HBSS. These media are not only able to keep more cells viability after 9h compared to the expensive commercial solutions, but are also be easily accessible.