Vol 16, No 4 (2019)

Published: 2019-12-22

Original Article

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    Objectives: Application of fissure sealants is a practical method for prevention of occlusal pit and fissure caries. Microleakage is an important factor affecting the success of fissure sealant treatment. This study aimed to assess the microleakage of a self-adhesive flowable composite, a self-adhesive fissure sealant and a conventional fissure sealant in permanent teeth with/without saliva contamination.
    Materials and Methods: This in vitro, experimental study evaluated 108 extracted human third molars, which were randomly divided into six groups (n=18) of control, Denu-Seal conventional fissure sealant applied on etched enamel with/without saliva contamination, Vertise Flow self-adhesive flowable composite applied on rinsed and dried enamel with/without saliva contamination and Prevent Seal self-adhesive fissure sealant applied on rinsed and dried enamel with/without saliva contamination. Microleakage was assessed using the dye penetration technique and subsequent observation of samples under a stereomicroscope. Data were analyzed using the Kruskal-Wallis and Tukey’s test.
    Results: Microleakage of the conventional fissure sealant with/without saliva contamination was significantly lower than that of other groups (P<0.05).
    Conclusion: Microleakage of the conventional fissure sealant is less than that of self-adhesive fissure sealant and self-adhesive composite, irrespective of saliva contamination.

  • XML | PDF | downloads: 45 | views: 1576 | pages: 248-255

    Objectives: The purpose of this randomized clinical trial (RCT) was to compare the shear bond strength (SBS) of orthodontic brackets bonded to enamel with conventional acid-etch (AE) technique and self-etching primers (SEP).
    Materials and Methods: Twenty-two patients, requiring extraction of two bicuspids for orthodontic reasons, were recruited. In each individual, following blinding and allocation concealment, one intact premolar received conventional AE, whereas the contralateral premolar received SEP with a split-mouth design. Bonded brackets remained in the oral cavity for two months. Afterward, the teeth were extracted without debonding the brackets. SBS and adhesive remnant index (ARI) were measured using a Universal Instron machine and a stereomicroscope, respectively.
    Results: The mean SBS of the conventional AE and SEP groups was 9.53 and 9.20 MPa, respectively. Paired t-test showed no statistically significant difference between the two groups (P=0.096). Comparison of ARI between the two groups, using Wilcoxon test, indicated that significantly less adhesive remained on enamel with brackets bonded with SEP compared to brackets bonded with conventional AE (P<0.001) although the SBS was higher in the AE group.
    Conclusion: The present study indicated that although there is no significant difference in SBS between SEP and conventional AE for bonding orthodontic metal brackets, the amount of residual adhesive on the enamel surface is significantly less with SEP than with conventional AE.
    (IRCT registration number: IRCT201705099086N3).

  • XML | PDF | downloads: 67 | views: 1882 | pages: 256-264

    Objectives: Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular disorders. Because of the multifactorial nature of the problem, its management usually involves several treatment modalities to maximize their synergistic effects. This randomized clinical trial aimed to assess the efficacy of low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) as an adjunct to pharmaceutical therapy for treatment of MPDS.
    Materials and Methods: This clinical trial evaluated 108 MPDS patients. First, the initial pain intensity of patients was determined using a visual analogue scale (VAS). The first phase of the study included education, awareness, self-care, behavior and relaxation therapy. After 1 month, the pain score was measured again using VAS. Patients who acquired a pain score >1 were divided into three groups of LLLT with diode (GAAlAr) laser with 0.2 W power, TENS, and control, using block randomization. All groups received 10 mg fluoxetine once daily, 0.25 mg clonazepam once daily and 10 mg baclofen three times a day. ANOVA was used to compare the recovery rate of the three groups.
    Results: Pain in the trapezius muscle and pain on mouth opening resolved faster in the laser + medication group. The recovery rate was faster in the mean muscle pain, general pain reported by patients, pain in the masseter and pterygoid muscles and pain and limitation in lateral movements in both laser + medication and TENS groups.
    Conclusion: Combination of LLLT and TENS with medication accelerated pain relief and resolved movement restrictions in MPDS patients.

  • XML | PDF | downloads: 69 | views: 1832 | pages: 265-271

    Objectives: The aim of this study was to compare the microshear bond strength (µSBS) of various adhesive systems to dentin.
    Materials and Methods: In this in vitro experimental study, 60 sound human third molars were divided into four groups. Dentin discs were prepared of middle-third dentin measuring 4 mm in diameter and 2 mm in thickness. Dentin surfaces were bonded with one of the four types of adhesives: (A) Single Bond (3M ESPE), Scotchbond Universal (3M ESPE) in etch and rinse (B) and self-etch (C) modes and (D) Clearfil SE Bond (Kuraray Noritake Dental). After the application of adhesive systems according to the manufacturers’ instructions, composite cylinders (Vit-l-escence) were bonded to dentin surfaces. The μSBS test was performed using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with one-way ANOVA and Tukey’s test (α=0.05).
    Results: The µSBS was the highest in self-etch Scotchbond Universal (15.8±6.08 MPa) followed by Clearfil SE Bond (15.24±4.6 MPa), etch and rinse Scotchbond Universal (11.68±4.07MPa) and Single Bond (11.24±3.74 MPa). A significant difference was only found between Single Bond and etch and rinse Scotchbond Universal groups (P=0.04).
    Conclusion: Based on the results of this study, application of Scotchbond Universal in self-etch mode provides a reliable bond to dentin.

  • XML | PDF | downloads: 50 | views: 146 | pages: 272-278

    Objectives: This study aimed to compare the transportation of the mesiobuccal canal of maxillary molars following root canal preparation with HyFlex CM (HCM) and Edge Taper Platinum (ETP) rotary systems and stainless steel (SS) hand files using cone-beam computed tomography (CBCT).
    Materials and Methods: This in-vitro study was performed on 48 maxillary molars in three groups of 16. The teeth were mounted in acrylic blocks, and root canals were prepared using HCM in group 1 (up to #30/0.06), ETP in group 2 (up to F3/0.06), and SS hand files in group 3 (up to #30). CBCT scans were taken before and after root canal preparation. The amount of canal transportation was measured at 0, 3, 6, and 9mm from the apex. Data were analyzed using Kruskal-Wallis and Mann-Whitney tests.
    Results: The difference in canal transportation at 0 and 6mm from the apex was significant between the HCM and ETP groups (P=0.031 and 0.023) but none of the systems showed any significant difference with hand files at 0- and 6-mm levels (P=0.10, 0.56, 0.22, and 0.50), respectively. At 3mm from the apex, no significant difference was noted among the groups (P=0.30). At the 9-mm level, the amount of canal transportation was not significantly different between HCM and ETP (P=0.83) but they showed significant differences with hand files (P<0.001).
    Conclusion: ETP and HCM caused less canal transportation at the curvature of the mesiobuccal canal of maxillary molars compared to hand files. ETP showed superior efficacy in root canal preparation compared to HCM.

  • XML | PDF | downloads: 60 | views: 1814 | pages: 279-289

    Objectives: This study sought to assess the thickness of buccal and lingual alveolar bone plates according to the position of impacted mandibular third molars on cone-beam computed tomography (CBCT) scans.
    Materials and Methods: Eighty-four CBCT scans of impacted mandibular third molars were evaluated in this retrospective study. All images had been obtained by ProMax 3D CBCT system with the exposure settings of 78 kVp, 12 mA, 16 s time, 0.2 mm voxel size and 10 × 9 cm field of view. The impaction angle of teeth and the thickness of buccal and lingual cortical plates were determined on images by drawing lines in the anterior, middle, posterior, superior, central and inferior regions. Thickness of bone plates was analyzed according to the position of impacted molars relative to the buccal and lingual plates using the Student t-test and relative to the second molars using one-way ANOVA and Tukey’s test.
    Results: In the buccolingual direction, the buccal plate thickness was maximum in lingual position followed by central position, and minimum in buccal position of the teeth. The lingual plate thickness was minimum in horizontal and distoangular positions and maximum in the mesioangular position of impacted teeth.
    Conclusion: Risk of lingual plate preformation is higher in surgical removal of impacted third molars with distoangular and horizontal positions. Thus, further attention must be paid by the surgeons to such cases.

  • XML | PDF | downloads: 64 | views: 1760 | pages: 290-295

    Objectives: Attempts to retain primary teeth have led to introduction of materials and techniques for their preservation such as stainless steel crowns (SSCs). Due to variations in tooth anatomy among different populations, this study compared the buccolingual (BL) to mesiodistal (MD) ratio of primary mandibular first molars with that of SSCs in an Iranian population.
    Materials and Methods:  This cross sectional study was conducted on 96 primary mandibular first molars with intact cementoenamel junction, which had been extracted for severe caries. The MD and BL dimensions of the teeth and available maxillary and mandibular SSCs (3M) were measured. Two independent examiners measured the dimensions twice at two different time points using a digital caliper. Data were analyzed by one-sample t-test and McNemar's test via SPSS 21.0 software.
    Results: Significant differences were observed in both BL and MD dimensions between teeth and both maxillary and mandibular SSCs (P<0.001). According to McNemar's test, the dimensions of 65.6% of teeth matched those of mandibular SSCs while the dimensions of 38.5% matched those of maxillary crowns. Dimensions of 3.1% of the teeth did not match any of the crowns and in 7.4%, both maxillary and mandibular SSCs were appropriate.
    Conclusion: Comparing the variances of BL/MD ratio of teeth with SSCs revealed that the dimensions of two-thirds of the teeth matched those of mandibular SSCs, while the maxillary SSCs were appropriate for the remaining one-third. Significant differences were seen between the size of teeth and both maxillary and mandibular crowns.

  • XML | PDF | downloads: 71 | views: 113 | pages: 296-302

    Objectives: This study aimed to assess the effect of three commonly consumed beverages on surface roughness of polished and glazed zirconia-reinforced lithium silicate (ZLS) glass ceramics.
    Materials and Methods: In this experimental study, 104 rectangular specimens were cut from Vita Suprinity blocks with 2 mm thickness. After ultrasonic cleaning and firing of the specimens, they were finished and polished in two groups. Specimens in the first group were polished using a 2-step polishing kit while the second group specimens were glazed and heated in a porcelain firing oven according to the manufacturer’s instructions. Baseline surface roughness was measured using a profilometer. Specimens in each group were then randomly divided into 4 subgroups (n=13) for immersion in artificial saliva (control group), cola, orange juice and black tea. Surface roughness was measured again and data were analyzed using two-way ANOVA.

    Results: The highest and the lowest mean Ra were found in orange juice and saliva subgroups, respectively in both glazed and polished groups. The Ra values of both polished and glazed groups significantly increased after immersion in orange juice and cola (P<0.05). The polished surfaces showed insignificantly higher surface roughness compared with glazed surfaces (P>0.05).
    Conclusion: Orange juice and cola significantly increased the surface roughness of both polished and glazed ZLS ceramics. Type of surface finishing (polishing versus glazing) had no significant effect on the surface roughness of specimens following immersion in different beverages.

  • XML | PDF | downloads: 67 | views: 256 | pages: 303-318

    Objectives: The dental profession has a special place of trust in the society, and dental clinicians must adhere to ethical standards in all dental procedures. Ethical conduct is one of the main expectations of individuals from this profession. The aim of this study was to design and develop dental ethical codes for national implementation in Iran.
    Materials and Methods:  This qualitative study was performed using directed content analysis method and purposive sampling. Data were collected until saturation through 15 semi-structured face-to-face individual interviews and two expert panels with academic staffs from dental faculties in Tehran, Iran.
    Results: Data were classified into five principles and 90 codes. The principles included consideration of patients’ interest as a priority, respect for human dignity and patient autonomy, confidentiality of patient information, the excellence of knowledge and skills, and building trust.
    Conclusion: The ethical codes for Iranian dentists were drafted considering Islamic teachings and the prevailing culture. Some codes were exclusively developed for the cultural atmosphere of Iran especially on topics such as interaction with patients previously treated by other dentists. Some codes addressed the principles of consultation and continuing the therapeutic communication with such patients. Some items have not been considered in codes released by other associations, such as religious considerations in Islamic cover and alcohol consumption that were taken into consideration in this draft. These codes can serve as a guide for professional practice of dentists. It seems that these sets can help us reach the standardized code.

Case Report

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    Cranial radiotherapy has several side effects. One of the most important complications is radiation caries that endangers the treatment prognosis. In the literature, the use of crowns and bridges for irradiated patients has been suggested as a contraindication. In addition, due to the risk of osteoradionecrosis (ORN), there are doubts about tooth extraction and implant placement. Here, we present a treatment sequence and recalls for an irradiated young patient. For irradiated patients, it is recommended to replace teeth with implants when there is no possibility for supragingival prosthetic margin.