Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 1 2018 01 06 1 9 EN Sholeh Ghabraei Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Mohammad Marvi Dentist, Private Practice, Tehran, Iran Behnam Bolhari Associate Professor, Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Parisa Bagheri Postgraduate Student, Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran 2017 06 21 2017 08 14 Objectives: Enterococcus faecalis (E. faecalis) is the most commonly isolated microorganism from teeth with postoperative infection. Triple antibiotic paste (TAP) has the ability to eradicate microorganisms from the root canal system when used as an intracanal medicament. The aim of this study was to determine the minimum duration of application of TAP required for elimination of E. faecalis from the root canal system and its minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) in an ex-vivo model. Materials and Methods: Root canals of 34 extracted human single canal teeth were inoculated with E. Faecalis after instrumentation, and then 4 g of TAP (ciprofloxacin, metronidazole and doxycycline) was mixed with 4.5 mL of saline and applied as intracanal medicament. The teeth were sectioned longitudinally and dentin chips were collected and evaluated to determine the count of bacterial colonies. Micro-dilution broth test was used to assess the MIC and MBC of TAP. Data were analyzed using SPSS version 22 via the Wilcoxon signed rank test. Results: After seven days of application of TAP as intracanal medicament, E. faecalis was eliminated from the dentinal tubules of the apical half of root canal up to 400 µ depth. The MIC and MBC of TAP in its original concentration were both found to be 16 µg/mL.   Conclusions: The original concentration of TAP was found to be 5×104 times its MIC. Considering the risk of coronal discoloration of teeth following the use of TAP, application of its lower concentrations is recommended. https://fid.tums.ac.ir/index.php/fid/article/view/1996 https://fid.tums.ac.ir/index.php/fid/article/download/1996/985

Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 1 2018 01 06 63 68 EN Gholamreza Shirani Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Mahnaz Arshad Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran Xaniar Mahmoudi Dentistry Student, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran 2017 08 16 2017 11 05 This case report presents a 16-year-old boy with bilateral temporomandibular joint (TMJ) bony ankylosis due to trauma. The patient had undergone several unsuccessful therapeutic surgeries and was experiencing reduced mouth opening, difficulty in eating and speaking, poor oral hygiene, snoring, and depression. Bilateral gap arthroplasty and distraction osteogenesis (DO) were performed. After the surgery, we were able to move the osteodistractors forward and prevent the upward and backward movement of the proximal mandibular segment with the use of our custom-made Sh-device, which allowed bone growth and soft-tissue matching. The mandibular deficiency was treated, and the patient's sleep quality significantly improved after three months. The physical, orthodontic and speech therapies were continued. The facial asymmetry, difficulty in sleeping, eating and speaking, and low self-esteem were completely resolved. At the 8-year follow-up, the patient's condition was satisfactory. The Sh-device can be used as a contemporary treatment modality for TMJ ankylosis. https://fid.tums.ac.ir/index.php/fid/article/view/2106 https://fid.tums.ac.ir/index.php/fid/article/download/2106/992

Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 1 2018 01 06 10 19 EN Farhood Massoumi Assistant Professor, Dental Research Center, Research Institute of Dental Sciences, Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mina Taheri Postgraduate Student, Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Abolghasem Mohammadi Assistant Professor, Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Omid Amelirad PhD Student, Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran 2017 08 20 2017 12 04 Objectives: The position of dental implants in the alveolar bone can affect the surrounding bone from biomechanical and biological aspects. The purpose of this study was to evaluate the effect of implant position on stress and strain distribution in the surrounding bone by using finite element analysis (FEA). Materials and Methods: Thirteen computerized models of a 3.8-mm-diameter XiVE implant with the abutment and crown of a mandibular second premolar in a mandibular bone segment were designed. In the reference model, the implant was placed at the center of the alveolar ridge with its crest module located above the alveolar crest. In the other models, the implants were positioned buccally, lingually, coronally or apically by 0.5, 1 or 1.5mm. By using the ANSYS software program, a 100-N load was applied to the buccal cusp parallel to and at a 30-degree angle relative to the longitudinal axis of the fixture. The models were analyzed in terms of the distribution of stress and strain in the bone. Results: The different implant positions induced nonlinear stress and strain changes in the bone. The central, 1.5-mm apical, and 1.5-mm coronal implant positions induced high amounts of stress and strain under off-axial loads. Conclusions: Within the limitations of this study, the results showed that the stress and strain in the bone around the implant undergo small nonlinear changes with buccolingual and apicocoronal shifting of the implant and can be affected by the configuration of the implant in contact with the bone. https://fid.tums.ac.ir/index.php/fid/article/view/2108 https://fid.tums.ac.ir/index.php/fid/article/download/2108/986

Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 1 2018 01 06 20 29 EN Amir Ali Reza Rasouli Ghahroudi Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Afshin Khorsand Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Sanaz Mahmoodi Pharmacist, Private Practice, Tehran, Iran Sahar Chokami Rafiei Postgraduate Student, Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran 2017 06 20 2017 08 10 Objectives: The aim of this study was to compare the efficacy of bovine bone substitute (Compact Bone B. ®) alone versus bovine bone substitute and simvastatin for human maxillary sinus augmentation. Materials and Methods: This study was conducted on 16 sinuses in eight patients. Radiographic assessments were done preoperatively (T0), immediately (T1) and at nine months after sinus grafting (T2). Alveolar bone height and density were assessed on cone beam computed tomography (CBCT) scans using Planmeca Romexis™ Imaging Software 2.2. Results: The change in alveolar bone height and density between T0, T1 and T2 was significant in both groups. Alveolar bone height (h0, h1, h2) and vertical height of the grafted bone (g1, g2) in three lines (anterior, middle and posterior) were not significantly different between groups. The grafted bone height shrinkage (%) in the anterior, middle and posterior limits of the augmented area were not significantly different between groups. The existing alveolar and grafted bone density increased significantly in both groups between T1 and T2, except for the existing alveolar bone density in the control group. There were no statistically significant differences between the alveolar bone density values obtained in TI and T2 between groups, except for the existing alveolar bone density at T1. Conclusions: This study did not show any significant positive effect for simvastatin in maxillary sinus augmentation based on radiographic examination. https://fid.tums.ac.ir/index.php/fid/article/view/1997 https://fid.tums.ac.ir/index.php/fid/article/download/1997/987

Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 1 2018 01 06 30 40 EN Elham Khoshbin Assistant Professor, Department of Endodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran Zakiyeh Donyavi Assistant Professor, Department of Endodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran Erfan Abbasi Atibeh Assistant Professor, Department of Periodontics, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran Shahin kasraei Professor, Department of Restorative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Rasoul Yousefimashouf Associate Professor, Department of Microbiology, Hamadan University of Medical Sciences, Hamadan, Iran Ghodratollah Roshanaei Associate Professor, Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Faranak Amani Assistant Professor, Department of Endodontics, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran 2017 06 13 2017 08 22 Objectives: Laser irradiation, as an adjunct to root canal preparation, may increase the success rate of endodontic treatments. This study aimed to assess the effect of neodymium-doped yttrium aluminum garnet (Nd:YAG) and diode lasers on the apical seal of the root canals filled with AH Plus® and mineral trioxide aggregate (MTA)-based sealers. Materials and Methods: This in-vitro experimental study was conducted on 96 single-rooted, single-canal extracted human teeth with closed apices. The root canals were prepared by using ProTaper® rotary instruments and were randomly divided into six groups (n=16): 940-nm diode laser and AH Plus® sealer (group 1), Nd:YAG laser and AH Plus® sealer (group 2), AH Plus® sealer (group 3), 940-nm diode laser and MTA-based sealer (group 4), Nd:YAG laser and MTA-based sealer (group 5), MTA-based sealer (group 6), as well as positive and negative control groups. A bacterial leakage model was used for microleakage assessment. Qualitative assessment was done by using a scanning electron microscope (SEM). Data were analyzed by two-way analysis of variance (ANOVA) at the significance level of 0.05. Results: There were statistically significant differences between the experimental and control groups (P=0.002). The laser-treated groups showed a lower apical microleakage compared to the non-laser-treated groups, although the difference was not statistically significant (P>0.05). No significant differences were noted between the two lasers in terms of the apical microleakage, irrespective of the type of sealer (P>0.05). Conclusions: Laser irradiation, as an adjunct to root canal preparation, has no significant effect on the level of apical microleakage. https://fid.tums.ac.ir/index.php/fid/article/view/1958 https://fid.tums.ac.ir/index.php/fid/article/download/1958/988

Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 1 2018 01 06 41 46 EN Seyed Hossein Mohseni Salehi Assistant Professor, Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Afshin Khorsand Associate Professor, Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Sahar Chokami Rafiei Assistant Professor, Department of Periodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Faris Yousif Mirkhan Postgraduate Student, Department of Periodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran 2017 07 23 2017 10 29 Objectives: This study sought to assess the efficacy of modified pedicle grafting as a noninvasive technique for soft tissue augmentation around maxillary dental implants. Materials and Methods: This descriptive study was conducted on eight patients who met the inclusion criteria. Prior to the second-stage surgery for exposing the implants, the buccal keratinized mucosa width, vestibular depth, and mucosal thickness around the implants were measured. The same parameters were measured six months after the second-stage surgery and were compared with the baseline values. Also, the color match of the graft with the adjacent gingival and mucosal tissues was evaluated. Results: Forty-seven maxillary implants were evaluated. The minimum and maximum gains of keratinized mucosal width were respectively equal to 0mm and 7mm, with a mean of 4.31±1.19mm. The mean vestibular depth around the implants was 9.47±1.75mm (ranging from 5mm to 12mm) six months after the surgery. At the beginning of the study, a thin mucosa surrounded the implants, but after six months, the peri-implant keratinized mucosa width increased. The color match of the graft with the adjacent gingival and mucosal tissues was excellent based on the periodontists' opinion. Conclusions: Modified pedicle grafting is a safe and predictable technique for soft tissue augmentation around maxillary implants. This technique is reliable for increasing the width of keratinized mucosa in fully and partially edentulous patients with a shallow vestibular depth. The stability of the pedicle flap is achieved by fixing the flap to the tissue around the healing abutment. https://fid.tums.ac.ir/index.php/fid/article/view/2069 https://fid.tums.ac.ir/index.php/fid/article/download/2069/989

Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 1 2018 01 ay>19 240 249 EN Sayed Mostafa Mousavinasab Professor, Dental Materials Research Center, Department of Operative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Maede Ghasemi Assistant Professor, Dental Materials Research Center, Department of Operative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Mitra Yadollahi Assistant Professor, Department of Operative Dentistry, School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran 2017 12 26 2018 05 16 Objectives:The aim of this study was to evaluate enamel and dentinal microleakage in Class II cavities restored with silorane- and methacrylate-based resin composites using specific and nonspecific adhesives. Materials and Methods: Thirty-six caries-free human premolars were used. Two Class II cavities were prepared on each tooth. The gingival floor was set at 1 mm above (on the mesial surface) and at 1 mm below (on the distal surface) the cementoenamel junction (CEJ). The samples were randomly divided into four groups, and the cavities were restored with a methacrylate-based composite (Filtek™ P60) and a silorane-based composite (Filtek™ P90) with specific and nonspecific adhesives. Microleakage was tested using a standardized dye penetration method. All samples were examined under a stereomicroscope, and microleakage scores were statistically analyzed using Kruskal-Wallis and Mann-Whitney-U tests. One sample from each group was examined under a scanning electron microscope (SEM) to determine the bonding area. Results: No significant difference was found between the groups in terms of the enamel microleakage (P=0.086). There was a significant difference between the groups with regard to dentinal microleakage (P=0.003). No significant reduction in microleakage was observed in groups restored with Filtek™ P90 composite using its specific adhesive compared to those restored with Filtek™ P60 composite using its specific adhesive (P=0.626). Conclusions: The results indicated that the application of methacrylate- and silorane-based composites with specific or nonspecific adhesives had no impact on enamel microleakage, but it affected dentinal microleakage, and specific adhesives showed less microleakage. It seems that a phosphate-methacrylate-based intermediate resin is required to bond dimethacrylate adhesive to silorane-based composites. https://fid.tums.ac.ir/index.php/fid/article/view/2301 https://fid.tums.ac.ir/index.php/fid/article/download/2301/1017

Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 15 4 2018 08 19 250 258 EN Razieh Meshki Assistant Professor, Department of Pediatric Dentistry, School of Dental Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Leila Basir Assistant Professor, Department of Pediatric Dentistry, School of Dental Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Fatemeh Alidadi Dentist in private practice, Ahvaz, Iran Azam Behboudi Pediatric Dentistry Resident, Department of Pediatric Dentistry, School of Dental Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Vahid Rakhshan PhD Student, Department of Cognitive Neuroscience, Institute for Cognitive Sciences, Tehran, Iran 2018 03 04 2018 05 31 Objectives: Studies on modeling a pre-exposure technique for the prevention of anxiety in children are rare, and there is no study on interactive modeling using computer games. We assessed the effect of playing a dental simulation game before operation on pain and anxiety in 4- to 7-year-old children during their first dental treatment session. Materials and Methods: In this double-blind randomized clinical trial, 50 children needing unilateral pulpotomy and placement of stainless-steel crowns (SSC) on mandibular primary first molars were enrolled and randomly divided into experimental (a simulation game) and control (no intervention) groups. The experimental group played the game twice a day for two weeks before the scheduled visit. At the dental session, their pre- and post-operative pains were recorded using the Wong-Baker Facial Rating Scale (W-BFRS). Also, heart rate (HR; as an indicator of anxiety) was measured using a finger pulse oximeter at six treatment stages: (1) baseline (at the initial session, two weeks before treatment) and (2-6) during different stages of treatment. Effects of playing the simulation on pain and HR were analyzed using t-test and repeated-measures two-way analysis of covariance (ANCOVA). Results: Game playing significantly reduced the HR (P=0.031). The interaction of playing with the treatment period was also significant (P=0.004). When the groups were compared in each of the six time points, the experimental group showed reduced HR during anesthetic injection and cavity preparation using a high-speed handpiece (P<0.003). Conclusions: Based on the results, playing certain dental simulation games before the first dental visit might reduce the anxiety felt during anesthetic injections and drilling. https://fid.tums.ac.ir/index.php/fid/article/view/2437 https://fid.tums.ac.ir/index.php/fid/article/