Vol 14, No 1 (2017)

Original Article

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    Objectives: The aim of the present study was to compare the effects of intranasal ketamine and midazolam on behavior of 3-6 year-old children during dental treatments. 
    Materials and Methods: In this randomized cross-over clinical trial, 17 uncooperative children requiring at least two dental treatments were selected and randomly received ketamine (0.5mg/kg) or midazolam (0.2mg/kg) prior to treatment. The other medication was used in the next visit. The children’s behavioral pattern was determined according to the Houpt's scale regarding sleep, movement, crying and overall behavior. Physiological parameters were also measured at different time intervals. The data were subjected to Wilcoxon Signed Rank test and two-way repeated measures ANOVA.
    Results: The frequency of crying decreased significantly following ketamine administration compared to midazolam (P=0.002); movement of children decreased with fewer incidence of treatment interruption (P=0.001) while their sleepiness increased (P=0.003). Despite higher success of sedation with ketamine compared to midazolam, no significant differences were found between the two regarding patients’ overall behavior (P>0.05). The patients had higher heart rate and blood pressure with ketamine; however, no significant difference was found regarding respiratory rate and oxygen saturation (P>0.05). 
    Conclusions: Ketamine (0.5mg/kg) led to fewer movements, less crying and more sleepiness compared to midazolam (0.2mg/kg). No significant differences were found between the two drugs regarding children’s overall behavior and sedation efficiency. Both drugs demonstrated positive efficacy for sedation of children during dental treatments.


  • XML | PDF | downloads: 316 | views: 666 | pages: 7-12

    Objectives: Mineral trioxide aggregate (MTA) is extensively used in endodontics. However, MTA is difficult to handle because of its granular consistency, low mechanical properties and initial looseness. The objective of this study was to assess the compressive strength (CS), diametral tensile strength (DTS), and pH of set MTA using methyl cellulose as liquid.
    Materials and Methods: White ProRoot MTA was used as the control group; modified MTA cement was prepared by mixing Portland cement, bismuth oxide and calcium sulfate (75%, 20% and 5%, respectively) as the experiment group. Methyl cellulose was used as hydrating liquid and compared with deionized water. The data were analyzed by two-way ANOVA.
    Results: The pH values of modified MTA cement set using deionized water and methyl cellulose were slightly, but not significantly, different (P>0.05). The DTS and CS tests for modified MTA cement hydrated with methyl cellulose showed a significant difference at one day and one week (P<0.05).
    Conclusions: The results suggest that using methyl cellulose as the hydrating liquid enhances some mechanical properties but does not compromise pH of white ProRoot MTA.


  • XML | PDF | downloads: 312 | views: 720 | pages: 13-20

    Objectives: The aim of this study was to evaluate and compare the retentive strength of orthodontic bands cemented with amorphous calcium phosphate (ACP)-containing and conventional glass ionomer cements (GICs).
    Materials and Methods: One-hundred-and-twenty mandibular third molars were embedded in acrylic resin blocks with the buccal surface of crowns perpendicular to the base of the mold. The teeth were randomly divided into four groups containing 30 teeth each. Groups 1 and 3 were cemented using conventional GIC and groups 2 and 4 were cemented using ACP-containing orthodontic cement. Groups 1 and 2 without thermocycling, and groups 3 and 4 after thermocycling (5000 cycles, 5° to 55°C) were tested for retentive strength using a universal testing machine (crosshead speed of 1mm/minute). Two-way ANOVA was performed to compare the retentive strength of the groups.
    Results: The highest retentive strength belonged to group 1, and it was significantly higher than that of group 2 (P<0.001) and group 3 (P=0.02). The mean strength for group 2 was significantly lower than that of group 1 (P<0.001) and group 4 (P=0.04).
    Conclusions: Although retentive strength decreased when ACP was added to GIC, the retentive strength of the samples cemented by ACP-containing GIC was remarkably high after thermocycling. It seems that in the oral cavity, ACP-containing GIC provides sufficient strength to endure forces applied on posterior teeth.


  • XML | PDF | downloads: 322 | views: 774 | pages: 21-30

    Objectives: This study aimed to assess the diagnostic value of conventional and digital radiography for detection of cavitated and non-cavitated proximal caries.
    Materials and Methods: Fifty extracted human premolars and molars were mounted in a silicone block. Charge-coupled device (CCD) and photostimulable phosphor plate (PSP) receptors and intra-oral films were exposed with 60 and 70 kVp with parallel technique. Two observers interpreted the radiographs twice with a two-week interval using a 5-point scale. Teeth were then serially sectioned in mesiodistal direction and evaluated under a stereomicroscope (gold standard). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.
    Results: Sensitivity of all three receptors for detection of enamel lesions was low (5.5-44.4%) but it was higher for dentin lesions (42.8-62.8%); PSP with 70 kVp and 0.03s exposure time had the highest sensitivity for enamel lesions, but the difference among receptors was not statistically significant (P>0.05). Sensitivity of all three receptors for detection of non-cavitated lesions was lower than that for cavitated lesions; PSP with 60 kVp and 0.07s exposure time had higher sensitivity and lower patient radiation dose for detection of cavitated and non-cavitated lesions, but the difference was not significant (P>0.05).
    Conclusions: Digital radiography using PSP receptor with 70 kVp is recommended to detect initial enamel caries. For detection of non-cavitated and cavitated dentin caries, PSP with 60 kVp is more appropriate. Change in kVp did not affect the diagnostic accuracy for detection of caries, and type of receptor was a more important factor.


  • XML | PDF | downloads: 387 | views: 796 | pages: 31-39

    Objectives: This study aimed to evaluate the effect of storage period on dimensional stability of Alginplus and Hydrogum 5.
    Materials and Methods: In this in vitro experimental study, 60 impressions were taken of an upper jaw typodont, including 10 impressions for each storage period to be tested (12 minutes, 24 and 120 hours) for each type of alginate. Then, the impressions were stored in an incubator with stable temperature and humidity, and poured using a type III dental stone. Subsequently, the mesiodistal dimension, occlusogingival height, and interarch distance were measured using a digital caliper with an accuracy of 0.01mm. The data were analyzed using ANOVA and t-test (P<0.05).
    Results: Alginplus and Hydrogum 5 impressions were not significantly different from the master model after 12 minutes and 24 hours in terms of dimensions (P>0.05). After 120 hours, all dimensions measured on casts were significantly different from those measured on the master model, except for the mesiodistal dimension of the Hydrogum 5 impressions.
    Conclusions: At a consistent temperature and humidity, the Alginplus and Hydrogum 5 impressions were dimensionally stable for at least 24 hours.


  • XML | PDF | downloads: 396 | views: 679 | pages: 40-47

    Objectives: The aim of this study was to compare the accuracy of dental implant impressions obtained by a combination of different impression techniques and viscosities of polyvinyl siloxane (PVS).
    Materials and Methods: Four parallel fixtures were placed between mental foramina in a master model of lower dental arch. Three different viscosities (putty/light body, medium body/light body, and monophase: heavy body) and direct and indirect techniques (six groups) were used, and seven impressions were obtained from each group (n=42). To measure the accuracy of impressions, drift, horizontal, and vertical angles of the implants, as well as the hex rotation of the implants in casts were evaluated using a digitizer device (1μm accuracy), in comparison with master arch. Data were analyzed using five-factor two-way ANOVA and Tukey’s post-hoc test.
    Results: The accuracy of impressions was assessed and the results showed that direct technique was not significantly different from indirect technique (P>0.05). Also, there were no significant differences between the mentioned viscosities except for the horizontal angle (P=0.006).
    Conclusions: Viscosity of impression materials is of high significance for the accuracy of dental impressions.


  • XML | PDF | downloads: 277 | views: 648 | pages: 48-54

    Objectives: Indicators of oral health-related quality of life (OHRQoL) in children are widely adopted to evaluate the effects of oral problems. Recently, the scale of oral health outcomes for 5-year-old children (SOHO-5) was developed based on the children’s self-reports. This study aimed to evaluate the validity and reliability of the Persian version of the questionnaire in a sample of Iranian children.
    Materials and Methods: This cross-sectional study was conducted on 160 children from four areas of Isfahan selected via non-random purposive sampling. After forward-backward translation of the questionnaire, content and face validity evaluation, a pilot test was carried out. Children forms were completed by interview, while parents forms were self-administered. Test-retest reliability was evaluated in 30 subjects. Construct validity, internal consistency and descriptive quality of life score were assessed with SPSS 18. The child-parent agreement was measured with correlation test and paired t-test (α=0.05).
    Results: The mean (±standard deviation) quality of life scores in children and parents were 2.3±3 and 1.3±1.9, respectively. The most prevalent impacts were difficulty sleeping and eating. The Cronbach's alpha coefficients were 0.82 and 0.67 for the child and parent versions, respectively. Significant correlation of the scores with the oral health rating, pain history and perceived need for treatment confirmed its construct validity (r: 0.4-0.6, P<0.05). The hypothesis of the agreement was not supported (P>0.05).
    Conclusions: Based on the findings, the Persian version of SOHO-5 has acceptable reliability and validity for use in the pediatric population of Iran while there were some conflicts by parents.


  • XML | PDF | downloads: 320 | views: 744 | pages: 55-61

    Objectives: The main disadvantage of fiber posts is their low bond strength to root canal wall. The aim of the present study was to assess the effect of different root canal post space treatments on push-out bond strength of fiber posts to root dentin.
    Materials and Methods: After post space preparation in 40 endodontically treated human premolars, the teeth were randomly divided into four experimental groups: Group 1: control group, group 2: Endsolv R, group 3: ultrasonic cleaning, group 4: Clearfil Repair. Afterwards, the posts were bonded with Panavia F 2.0 bonding cement. The bond strength of fiber posts to root canal wall in the middle part of canal was evaluated following thermocycling using push-out test. Data were analyzed using one-way ANOVA and Tamhane’s multiple comparisons test. The failure mode of each group was determined under a stereomicroscope.
    Results: There was a significant difference in the mean push-out bond strength among the groups (P<0.05). The lowest bond strength was noted in the control group. The control group had significant differences with ultrasonic and Clearfil Repair groups (P<0.05). The bond strength of Endsolv R group increased; however, it was not significant (P>0.05).
    Conclusions: It seems that ultrasonic cleaning and Clearfil Repair can modify the root canal wall and significantly increase the bond strength of fiber posts.