Table of content

Journal of baghdad college of dentistry

مجلة كلية طب الاسنان بغداد

ISSN: 16800087
Publisher: Baghdad University
Faculty: Dentistry
Language: English

This journal is Open Access


A quarterly peer reviewed published scientific journal of the College of Dentistry,
University of Baghdad.
date of first issue 1986

Contact info

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Table of content: 2011 volume:23 issue:1

Evaluation of the effect of Poly Vinyl Pyrrolidone addition on the shear bond strength of acrylic resin artificial teeth to heat cured acrylic resin denture base material

Authors: Nabeel Abdul-Fattah --- Aula K. Rafeeq
Pages: 1-7

Background: The most common materials used for fabrication of denture bases are poly methyl methacrylate
(PMMA). Fracture or debonding of plastic teeth from denture base are common clinical problems which are facing
both the patient and the dentist. The aim of this study is to evaluate and compare the shear bond strength of
acrylic resin artificial teeth treated by different chemical surface treatments (solvents like acetone & thinner) to the
experimental prepared material and to the control material before and after thermocycling.
Materials and methods: Preparation of modified heat cured denture base acrylic resin was carried out by preparing
of (PMMA) (80%) and poly vinyl pyrrolidone (PVP) (20%) and the liquid part composed of methyl methacrylate
(MMA) monomer. Control: poly methyl methacrylate (PMMA) + methyl methacrylate ( MMA ) as control group ( 2.5
: 1 ) by weight (1). Experimental: PMMA (80% ) + PVP ( 20% ) + MMA as experimental group ( 2.5 : 1 ) by weight. Sixty
artificial acrylic teeth were prepared and cured by control and experimental denture base acrylic resin, then teeth
were divided into three groups and treated with different surface treatment; first group received no further
treatment (control), second group treated with acetone and third group treated with thinner. The denture teeth
were flasked and wax was eliminated with running hot water. Denture resin was packed and cured according to
manufacturer's instructions and specimens were deflasked upon the completion of resin processing. Then half of
specimens from all surface treatments were tested by using Instron machine and subjected to shear force until
failure. The other half of specimens which also include the surface treatments groups were thermocycled. Teeth
surfaces after treatment and fracture sites were examined and photographed visually and under reflecting light
Results: The results showed that all surface treatments produced significantly high improvement in shear bond
strength (SBS). Control group had shown significantly lower (SBS) than experimental group bonded to artificial acrylic
teeth. On the other hand, experimental denture base resin bonded to artificial acrylic teeth were affected more
significantly by thermocycling than the same teeth bonded to control denture base resin. Results indicated that
thinner treatment for acrylic teeth is recommended prior to denture base processing.
Conclusion: higher SBS of artificial acrylic teeth bonded to experimental denture bases rather than to control
denture bases.
Key words: Poly Vinyl Pyrrolidone, Shear Bond Strength and thermocycling. (J Bagh Coll Dentistry 2011;23(1):1-7).


Evaluation of apical microleakage of teeth sealed with two different root canal sealers using two instrumentation techniques


Background: The purpose of this in vitro study was to compare, using a dye penetration test, the sealing ability of two
commonly used root canal sealers, Endofil sealer (Produits Dentaires SA, Switzerland) and ZOB sealer (Meta Biodent,
Korea) after preparation of the root canals with rotary protaper (crown-down) technique and hand instrumentation
(step-back) technique.
Materials and methods: 40 single rooted freshly extracted human teeth were used in this study. The teeth were sectioned
at the cementoenamel junction and instrumented by either protaper technique or step-back technique. After that the
samples were divided in to 4 groups with 10 samples each. Then the samples obturated using either ZOB sealer or Endofill
sealer. All samples were stored in methylene blue with concentration of 1% for 7 days. Later on the teeth were removed
from the dye and sectioned longitudinally with diamond disc and examined under stereomicroscope to measure the
level of microleakage.
Results: The results revealed that protaper technique has higher values of microleakage than step-back technique and
a significant difference was found in comparing protaper + Endofill with step-back + Endofill.
Conclusion: Protaper technique exhibit higher microleakage values than step-back technique regardless of type of
sealer used.
Key words: Apical microleakage, Root canal sealers, Protaper technique. (J Bagh Coll Dentistry 2011;23(1):8-11)


Assessment of the accuracy of a fifth generation apexlocator (in vitro study)

Authors: Ahmed Gh. Subhi --- Manhal A.R. Majeed
Pages: 12-17

Background: The use of electronic apex locators for working length determination eliminates many of the problems
associated with the radiographic measurements (interference of anatomical structures, errors in projection such as
elongation or shortening, and lack of three-dimensional representation). Its most important advantage over
radiography is that it measures the length of the root canal to the apical constriction, not to the radiographic apex.
The aim of this study was to assess the accuracy of a new fifth generation apex locator (Joypex 5) in recording the
apical constriction and comparing it with a third generation apex locator (Root ZX) in vitro.
Materials and method: Twenty four single-rooted sound human premolars, extracted for the purpose of orthodontic
treatment and with fully-formed roots, were used in this study. Endodontic access cavity was prepared in each tooth
and canal patency up to the apical foramen was checked with a #15 stainless steel K-file. No root canal
preparation was performed. Root canal length measurement was done directly and electronically using two apex
locators (Joypex 5 and Root ZX). Direct measurement of the root canal length was done by introducing a #15 K-file
inside the root canal until its tip was just visible at the apical foramen, then removed from the root canal and its
length was measured (in mm) and subtracted by 0.5 mm. For electronic measurement, the teeth were fixed in a
sponge soaked in saline and the root canals were also filled with saline. The lip electrode was attached to the
sponge and the apex locators were used according to the manufacturers' instructions. The file holder was clipped to
the metal shaft of a #15 K-file and the file was then inserted inside the root canal and advanced until the display
reading on the LCD of the apex locator was "0.5". The file was then removed from the root canal and its length was
measured (in mm). The differences between the readings of each apex locator and the actual length of each canal
were computed, and the results were analyzed statistically by paired t-test using SPSS Version 13.
Results: The results of this study showed that the Joypex 5 apex locator showed a lower mean difference than the
Root ZX apex locator as compared with the actual length, which was statistically significant (p<0.05). Concerning the
accuracy of the two apex locators, Joypex 5 apex locator recorded the apical constriction exactly in 67%, while the
Root ZX apex locator in only 25%. Within ±0.5 mm from the actual length, the accuracy of the Joypex 5 and the Root
ZX were 83% and 67%, respectively. Within ±1 mm from the actual length, the accuracy of the Joypex 5 and the Root
ZX were 100% and 96%, respectively.
Conclusion: The Joypex 5 apex locator which is a fifth generation apex locator was more accurate in recording the
apical constriction as compared with the Root ZX apex locator which is a third generation apex locator.
Key words: Apex locator, fifth generation, accuracy. (J Bagh Coll Dentistry 2011;23(1):12-17)


Diagnostic accuracy of panoramic maxillary sinus projection in patients with midface fractures according to CT scan findings

Authors: Lamia H. Al-Nakib --- Ali S. Al-Haddad
Pages: 18-21

Background: Diagnostic imaging has been of recent and unique importance in substantiating the clinically
suspected existence of the midface fracture and it is essential to be aware of the various procedures available to
help initially in establishing an accurate diagnosis. The aim of the study is to evaluate the diagnostic accuracy of
panoramic maxillary sinus projection according to computed tomographical findings in patients with midface
fractures to be used as an emergency radiographic diagnostic aid.
Subjects, material and methods: Thirty patients with a midfacial trauma and twenty patients suspected to having
midfacial fractures. All subjects were examined radiographically using panoramic maxillary sinus imaging system to
evaluate the nasal, orbital, maxillary, and zygomatic bone and recorded as either “positive” or “negative”
according to the positive computed tomographical midfacial fracture findings.
Results: Panoramic maxillary sinus projection was 83.3% sensitive in detecting midfacial fractures line with 90%
accuracy and it can establish the diagnosis of any midfacial bones fracture with 100% confidence in any clinical
Conclusion: If panoramic maxillary sinus imaging is performed as the first imaging modality in case of suspected
midfacial fractures by an experienced investigator, the visualization of fracture line can avoid conventional imaging,
so that only an indicated computed tomography scan can be added.
Key words: midfacial fracture, dental panoramic, computed tomography. (J Bagh Coll Dentistry 2011;23(1):18-21).


Histological evaluation of intrabony defect repair induced by white ordinary portland cement (WOPC)

Authors: Shatha S. Mohammed --- Atheer A.Ali
Pages: 22-27

Background: Recently the ordinary Portland cement (OPC) has been analyzed and compared physically,
chemically and biologically to mineral trioxide aggregate MTA and because of the similarity between OPC and
MTA, So the Possibility of using Portland cement as a less expensive alternative to MTA in dental practice should be
considered. In view of this, the Present study is to evaluate the biological response of the jaw bone to intraosseous
ordinary Portland cement (OPC) implantation.
Materials and Methods: Fifteen local breed adult male rabbits divided into three groups of five rabbits, each rabbit
has receive two intrabony defects in the mandible bone, one filled with white ordinary Portland cement (WOPC),
the other left empty as a control The histological sections obtained after 1, 4 and 8 weeks postoperatively. The
histomorphometric analysis including counting of bone cells (osteoblasts & osteoclasts) ,inflammatory cell and
observation of the degree of inflammation and the type of bone reaction to OPC material.
Results: There was no significant difference in inflammatory response between OPC group and control group at all
period of time, , there was significant increase of osteoblasts number at one and four weeks interval of OPC group
when compare with the control groups but at eight week there were no significant difference of osteoblasts number
between them, control group showed highly significant increase of osteoclasts number at four and eight weeks
interval when compare to OPC groups. Most of OPC group and in all period of time showed bone deposition in
direct contact with ordinary Portland cement (Type I bone reaction).
Conclusions: As a result we can conclude that the OPC material show high degree of biocompatibility, induce bone
healing and act as bioactive material.
Key words: Portland cement,intaosseos inplantation, bone biomaterial. (J Bagh Coll Dentistry 2011;23(1):22-27).


Evaluation of inter-proximal alveolar bone level among menopause by using direct digital bitewing intra oral imaging system

Authors: Jamal Ali --- Haider A. Hassan
Pages: 28-33

Background Digital radiography uses conventional radiographic techniques, but the film is replaced with sensor that
transmits the image to a computer. These systems allow some manipulation of image to be carried out, which can
enhance the image quality. Although the equipment is expensive, this technique has grown in popularity over
recent years.
Materials and method: The study was completed by the participation of 40 individuals (postmenopausal group: 20
subjects; premenopausal group: 20 subjects). The age of the subjects (premenopausal group) was (35-40) yrs.
(Postmenopausal group) was (45-60) yrs. divided into three groups:-First age group: from (45-49), second age group:
from (50-54), third age group: from (55-60). They were collected from popular clinic in Babylon and referred to
diagnosis department of College of Dentistry/ University of Babylon, sample collection was from (2009-2010) yrs.
Results: There was highly significant difference in interproximal alveolar bone level measurements for
postmenopausal women at different age groups including in this study, and no significant difference in interproximal
alveolar bone level measurements for postmenopausal women at both jaws (upper and lower) was revealed. Also
no significant difference in interproximal alveolar bone level measurements for postmenopausal women at both
sides (right and left), but there was a significant effect for duration of menopause in interproximal alveolar bone
level according to the confidence level and highly significant difference in interproximal alveolar bone level
between premenopausal and postmenopausal c groups in all age groups.
Conclusions: There is a highly significant difference in inter-proximal alveolar bone level between premenopausal
and postmenopausal groups in age and duration parameters including in this study.
Key words: Inter-proximal bone level, menopause, bitewing x-ray. (J Bagh Coll Dentistry 2011;23(1):28-33).


Immunohistochemical analysis of estrogen and progesterone receptors expression in gingival lesions

Authors: Ahlam H. Majeed --- Alla S. Saeed
Pages: 34-38

Background: Some lesions in the oral cavity and mostly on the gingiva have predominant predilection towards
females. Such lesions occur most commonly in the first fourth decades of life when changes in sex hormones levels in
the blood are obvious , for example pyogenic granuloma is a tumor like lesion of oral cavity that is considered to be
non-neoplastic in nature and arises in response to local irritation.
The present study aimed to evaluate the role of female sex steroid hormones in pathogenesis of pyogenic
granuloma (P.G) , peripheral giant cell granuloma (P.G.C.G), and peripheral ossifying fibroma (P.O.F) , on human
gingiva as a target organ .
Materials and Methods: This Study conducted on 40 case of reactive gingival lesions as a study group and 10
specimens of normal gingival tissue as acontrol group. These samples are collected to evaluate the expression of
estrogen and progesterone by using immuinohistochemistry .The study group included 15 case of P.G, 13 case of
P.G.C.G and 12 case of P.O.F. An immunohistochemical staining with estrogen monoclonal antibody marker and
anti progesterone monoclonal antibody were performed. All tests were carried out on 4μm sections from formalin
fixed parraffin embedded tissues.
Results: The age range of the subject in this study is 10 -59 years and the male to female ratio was 14/26 (1:1.85) for
study group while it was 5/5 (1:1) for control group . The cases have been already diagnosed, three subtypes of
gingival lesions were studies . These include 15 case of P.G (37.5 %), 13 case of P.G.C.G (32.5 %) and 12 case of P.O.F
(30 %). After immunohistochemical staining, all subjects in the control group showed negative expression for estrogen
and progesterone, while in the study group, 11 estrogen and progesterone receptors were detected. Eight of these
receptors were ER and three were PR .Estrogen was detected in the three lesions while progesterone was not
detected in P.G. In order of decreasing frequency, the ERs and PRs were found in PG.C.G (n=6), P.G (n=3) and P.O.F.
(n=2). The expression of these receptors was distributed in three site including epithelial, inflammatory and
mesencymal cells. Progesterone expression was much less than that’s of estrogen in both quantity (proportion of
positive cell) and intensity. Significant difference for expression of these receptors was found between the three
types of the lesions. This study showed significant difference in ERs expression between males and females. The
positivity of ERs receptor in females was more than males. On the other hand no significant difference for PRs
expression was found between males and females.
Conclusions : Estrogen and progesterone may play a role in the pathogenesis of the three oral lesions , P.G , P.G.C.G
and P.O.F by mechanism other than hormone receptor interaction , such mechanism may attributed to levels of
circulating hormones .Increase levels of these hormone may induce the release of inflammatory mediators from mast
cell and stimulate the proliferation of fibroblast .
Key word: Gingival lesions, estrogen, progesterone, immunohistochemistry. (J Bagh Coll Dentistry 2011;23(1):34-38).


Evaluation of the effects of fixed partial denture on the Temporomandibular joint dysfunction by using Cadiax compact 2


Background: The controversy surrounding the role of occlusion in temporomandibular joint (TMJ) dysfunction led to
this study. Temporomandibular joint (TMJ) dysfunction has been the subject of considerable study for decades, yet
despite voluminous literature, the multifactorial aetiology of temporomandibular dysfunction, is even today a cryptic
issue.The cause of the signs and symptoms of TMJ dysfunction is not clearly understood and various opinions on their
aetiology have been offered. The aim of study was to evaluate the effects of the occlusal interference with fixed
prosthesis on the position of the terminal hinge axis and to stady the role of the occlusal interference with fixed
prosthesis in the etiology of Temporomandibular joint dysfunction by using cadiax compact 2.
Material and methods this study was carried out on 32 patients who came to the teaching hospital in the college of
dentistry at university of al Mustansiria suffering from missing teeth and need for substitution by fixed partial denture.
Everyone of the selected sample was examined in three visits with a new computerized axiography technology for
recording the transverse hinge axis and Bennett movement by cadiax compact 2 and an evaluation for TMD was
done by Helkimo index which was used to collect the TMJ dysfunction data, The 1st record in the 1st visit at the
starting date before dental preparation, the 2nd record immediately after cementation of fixed prosthesis and the 3rd
recorded 1 month after the 2nd record.
Result: The results of this study showed that no effect of occlusion adjustment on TMD by using fixed partial denture
even if patients have change in position of hinge axis and Bennett angle .the comparison between the angle
changes in the same side of treatment shows no significant changes (p value >0.05) and that is shown also by
Helkimo index because there was no score for all the patients.
Conclusion Occlusion interferance does not play a major role in the aetiology of TMD; the impact of occlusion is not
zero, however, and should be determined in each individual case.
Key words: Cadiax Compact 2, TMD, TMJ, Occlusal interference. (J Bagh Coll Dentistry 2011;23(1):39-46).


Immunohistochemical expression of Caspase 7 and Annexin V as apoptosis markers in oral squamous cell carcinoma (A clinicopathological study)

Authors: Riyadh O. Alkaisi --- Shatha A. Jabur
Pages: 47-50

Background: Oral squamous cell carcinoma (HNSCC) is an aggressive and lethal malignancy .It is an epithelial
malignancy with morphologic features of squamous cell differentiation without additional features suggestive of
other differentiated tissues. Caspase 7 is a caspase involved in execution phase of apoptosis. The genetic alteration
of caspase 7 might be involved in the development of human cancer. Annexin V belongs to a family of
phospholipids binding proteins. It binds in the presence of Ca+2 ions with high affinity to negatively charged
phospholipids like phosphatidylserine(PS) exposed on cell surface during apoptosis. The aim of the study: The aim of
the study is to evaluate the immunohistochemical expression of caspase 7 and Annexin V as apoptosis markers in
correlation with various clinicopathological parameters in oral squamous cell carcinoma
Materials and Methods: The study is a prospective one in which twenty cases of oral squamous cell carcinoma and
eleven retrospective of paraffin embedded formalin fixed of oral squamous cell carcinoma blocks. H&E stain was
done for each block for reassessment of histological examination. An immunohistochemical staining done by using
monoclonal antibodies for caspase-7 and annexin V.
Results: The results of 31 oral squamous cell carcinoma cases included in this Study. Age group of studying samples
was more than 50 years. Immunohistochimical expressions were as follows in all cases of oral squamous cell
carcinoma for caspase 7 and Annexin V tumor markers: The expression of caspase-7 was weak positive in 12 cases
(38%), strong positive in 11 cases (35%) and 8 (25%) cases were negative. The expression of Annexin V was weak
positive 16 cases (51%), strong positive 10 cases (32%) and 5 cases (16%) were negative. Statistical result for caspase
7 and AnnexinV with clinlinicopathological parameters was no significant correlation between them.
Conclusions: Immunohisto chemical expression were observed in studying samples of oral squamous cell carcinoma
of both annexin V and caspase 7, however, statistically non significant correlation with all clinicopathological
findings were found and between both markers.
Key words: oral squamous cell carcinoma, caspase 7, annexin V. (J Bagh Coll Dentistry 2011;23(1):47-50).


Experimental gingivitis in overweight subjects. Clinical and microbiological study


Background:Obesity is a complex multifactorial chronic diseasethat affecting the host immunity which may stimulate
a hyperinflammatory response in periodontal disease.Aims of the study is to determine and compare the gingival
clinical parameters between Obese, pre-obese, and normal weight. Along with estimating the effect of overweight
on healing process of experimental gingivitis, also to determine and compare the microbiological findings between
Obese, pre-obese, and normal weight.
Materials and Methods: Our study dealing with experimental gingivitis using the clinical parameters (plaque index
and gingival index), existent bacterial flora, oral hygiene improvement on normal weight, pre-obese, and obese
subjects showing healthy systemic condition, using the body mass index (BMI) and inter parametric comparison on
30 individuals, male with no previous medical history, age ranged from 20-30years old,10 of them are obese, 10 are
within overweight(pre-obese) and the other 10 are within normal weight.Dental plaque samples were taken from
each subjects when the gingiva reaches inflammation (Mean GI≥1).
Results: The G.I .parameter showed a significant higher score of inflammation on the pre-obese and obese samples
during the initiation of the disease (P≤0.002), and also showed a prolonged improvement response after the
recovery of the oral hygiene control (P≤0.001).The bacterial findings showed an equal percent of streptococci and
staphylococci but with predominance on other species in normal weight subjects. The pre-obese showed an
increase percent of klebsiella .The obese subjects showed insignificant differences and almost equal percent of
streptococci, staphylococci and pseudomonades with undetectable number of klebseila.
Conclusion: This study found that Obesity is an active risk factor for gingival and periodontal disease, and it’s playing
a role in elevating body response to dental plaque with increasing the healing period.
Key words: Obesity, experimental gingivitis, microbiology, healing period. (J Bagh Coll Dentistry 2011;23(1):51-54).


A figure 8 movement in extraction of lower molar teeth in comparison to the bucco-lingual movement

Authors: Ali H. Abbas
Pages: 55-57

Background: the purpose of this study was to evaluate figure 8 movement in extraction of lower molar teeth.
Materials and Methods:: seven hundred patients complaining from pain of badly carious lower first and second
molars, half of them their teeth were extracted by using figure8 movement, while the second half their teeth were
extracted by using the ordinary bucco-lingual movement.
Results: the study shows that extractions by using figure8 movements give better results with fewer complications
during and after extraction in comparison to the bucco-lingual movement.
Conclusion: it is better to use figure 8 movements in extraction of bulky lower molar teeth.
Key words: extractions of lower molar teeth. (J Bagh Coll Dentistry 2011;23(1):55-57).


Salivary antioxidants and nutritional status among chronic periodontitis patients

Authors: Basima Gh. Ali --- Samer S. Jaafer
Pages: 58-62

Background: Chronic periodontitis is an inflammatory disease that affects the supporting tissues of the teeth.
Malnutrition, particularly characterized by deficiencies of the essential necessary antioxidants micronutrients
including vitamins (C, E and A), which they had a significant effects in relation to oral health. The aims of this study
were to assess the salivary antioxidants vitamins (C, E and A) levels and their relation to periodontal parameter
among individuals with underweight and normal weight
Materials and Methods: The sample is consist from 80 males with age group (25-50) years old without any systemic
disease and divided into 4 groups: group 1 (20) individuals had underweight and chronic periodontitis, group 2 (20)
individuals had underweight and normal periodontium, group 3 (20) individuals had normal weight and chronic
periodontitis and group 4 (20) individuals had normal weight and normal periodontium. Nutritional status was
assessed by body mass index (BMI). Periodontal parameters used in this study were probing pocket depth (PPD) and
clinical attachment level (CAL). Unstimulated salivary samples were collected and then chemically analyzed.
Results: The salivary levels of vitamins were significantly lower in the groups of underweight in compare with the
group of normal weight and normal periodontium. For the group with (N.W. & CH.Perio.) the salivary levels of vitamins
C and A was significantly lower in compare with the group (N.W. & N.Perio.), For probing pocket depth, vitamin C
had a negative significant correlation with PPD≥7, vitamin A also had a negative significant with PPD≥7 and PPD≤6.
Concerning clinical attachment level vitamin E had a positive significant correlation with CAL≥6; vitamin A had a
negative significant with CAL≤5.
Conclusions: Periodontal disease revealed a higher occurrence and severity among individuals with malnutrition
therefore good nutrition and special oral health care are needed for them.
Key words: chronic periodontitis, antioxidants, nutritional status, body mass index. (J Bagh Coll Dentistry 2011;23(1):58-


Effect of alum in intrapocket irrigation (pathfinder study)

Authors: Hussain Owaid
Pages: 63-66

Background: The term of alum refers to various isomorphous double sulfates composed of trivalent metals and
univalent metals, especially aluminum potassium sulfate, KAl (SO4)2·12H2O, Alum as a compound has also been used
to treat different oral and medical conditions in modern herbal medicine. Using of alum as mouth wash in recent
dentistry was not completely explored and only a few studies was carried out regarding this subject. This study was
carried out to find and document the proposed effectiveness of alum as an intra sulcular irrigant in combination with
conventional root planning procedure.
Material and method: Fifty two patients with chronic periodontitis were randomly allocated into two groups. The first
group treated with conventional root planning procedure using periodontal curette while the second group treated
with the same conventional procedure followed by continuous intrapocket irrigation with 0.015 Alum solutions. PLI, GI
& PD were measured before treatment and two weeks after.
Results: Results of this research showed a significant decrease in all study parameters in both groups with non
significant differences between the two different modalities of treatment.
Conclusion: Alum solution can be a good adjunctive treatment for chronic periodontitis, but more studies needed to
explore this area on short and long terms.
Key words: Shab. Aluminum sulphate. Periodontitis. Mouth wash. (J Bagh Coll Dentistry 2011;23(1):63-66).


Treatment of pyogenic granuloma and peripheral giant cell granuloma by excisional biopsy and buccal sliding flap

Authors: Najah H. Salih --- Ali H. Abbas --- MuntherM. Radhi
Pages: 67-68

Background: The aim of the study to evaluate the use of buccal sliding flap to cover the bone after excision of the
Materials and Methods: Forty patients who have pyogenic granuloma on the gingiva, the patient's age range from
ten to eighteen years (mean age 19 years), the cases were selected irrespective of sex or economic status. Surgical
excision of the pyogenic granuloma and the exposed bone was covered by a sliding mucoperiosteal flap.
Results: Thirty seven patients have good results and the gingival condition return to normal within one month
Conclusion: The sliding mucoperiosteal flap is superior alternative to periodontal pack to cover the exposed bone
after surgical excision of the pyogenic granuloma.
Keyword: Pyogenic granuloma, Peripheral giant cell granuloma. (J Bagh Coll Dentistry 2011;23(1):67-68).


Horizontal and vertical position of the mental foramen on panoramic views of a selected Iraqi population

Authors: Salah J. Muhsen
Pages: 69-72

Back ground: The mental foramen is the opening of the short mental canal, through which the mental nerve the
terminal branch of the inferior alveolar nerve exits, knowing the exact position of the mental foramen is essential in
oral surgical procedures. This study determines this position in a selected Iraqi population.
Materials and methods: Two hundred and forty panoramic radiographs of Iraqi population selected from three
different oral and maxillofacial centers to identify the normal range of position of the mental foramen, both
horizontal and vertical position were studied, radiographs with any errors or taken for patients not co inside with our
criteria were excluded.
Results: In horizontal position, 51.31% were found apical to the lower second premolar, 43.64% between the first and
second premolars, 3.07% were found between second premolar and lower first molar, 1.09% were found apical to
the lower first premolar, 0.87% were found between lower canine and lower first premolar.
In vertical position, 60.08% were found inferior to the apex of the related tooth, 36.84% were found within the apex of
the related tooth while 3.07% were found superior to the apex.
Conclusions: the mental foramen can be found anywhere from lower canine to the lower first molar, although
94.95% of the studied radiographs showed that mental foramen was located either between the lower premolars or
at the apex of the second premolar.
Key words: mental foramen, position, panoramic radiographs, Iraqi population. (J Bagh Coll Dentistry 2011;23(1):69-


Analysis of 103 mandibular angle fractures

Authors: Jamal A. Mohammed --- Thaaer Abdul Lateef
Pages: 73-76

Background: The mandible is fractured more commonly than other bones of the facial skeleton and several studies
have shown the increased risk of mandibular angle fractures associated with the presence of mandibular third
molars. This retrospective study reviewed cases of mandibular angle fractures to identify personal data, etiology,
fracture characteristics, mandibular third molar status and treatment modality.
Materials and methods: From January 1970 until December 1989, 100 patients with 103 mandibular angle fractures
were treated by the department of Oral & Maxillofacial Surgery at Baghdad College of Dentistry, in Iraq. Information
was obtained from patient's case records and radiographs.
Results: The patient ages ranged from 5-65 years with a mean of 27.2 years, 79 of them were males and 21 females.
The mandibular third molar was present in 83 fractures (83%). The majority of case was treated by closed reduction
and indirect skeletal fixation 87%.
Conclusion: This study confirmed an increased risk of mandibular angle fractures in the presence of a lower third
molar, as well as motor vehicle accident was the main etiological factor in developing countries.
Keywords: angle fracture, lower third molar, closed reduction. (J Bagh Coll Dentistry 2011;23(1):73-76).


Oral health knowledge, attitude and behavior in Baghdad University

Authors: Mohammed A.H.AL-Bahadli
Pages: 77-80

Background: The risk behaviours for dental caries and periodontal disease include frequent intake of sugary foods
and drinks, irregular tooth brushing, smoking, alcohol consumption and irregular dental attendance. These risk
behaviours that can be detrimental to the oral health could be habitual from early childhood or be initiated during
adolescence related to an emerging autonomy from parental influence . Therefore, the aim of this study to assess
the oral health knowledge, attitude and behaviour of first stage students in some college in baghdad university
except medical and dentistry students.
Materials and methods: An epidemiological study was conducted in 2010. We were gave the questioners on 300
students from non dental or medical college of Baghdad university. Their age range from 18 to 20, all in first stage of
their studies. The assessment of oral health knowledge of this sample of students includes 14 questions.
Results: 76% believe the gingivitis not inheritance disease, 58% of them said periodontal pocket mean space
between gingiva and tooth, 21% said there are a relation between diabetes mellitus and periodontal disease, 92%
said that necessary to remove plaque from teeth, brushing of teeth not enough for good oral health according to
84% they answered, 11% of them used dental floss , only 20% believed that disclosing agent appear plaque, 24% said
that the calculus removing helpful to control periodontal disease, only 22% believed that the number of deciduous
teeth are 20, 16% of them said that the first molar is the first permanent tooth appear in mouth, 46% said that a cause
of teeth sensitivity related to presence of caries, because of esthetic, compensation of lost teeth is important 38%
said, 90% said there are mouth wash liquid to remove plaque, and finally only 36% of them believed that two time of
teeth brushing is enough for oral health.
Conclusion: The oral health behaviour of the students was dependent on the attitude, but did not show a linear
relationship with the oral health knowledge, indicating that knowledge was not enough to influence the oral health
behaviour. (J Bagh Coll Dentistry 2011;23(1):77-80).


The assessment of oral health related quality of life for children with malocclusion in comparison with their mothers


Background: The quality of life measures have been widely developed and used in dentistry because of their
importance in measuring the child and public perceptions for oral health. The purpose of this study was to compare
the responses to child perceptions questionnaire for measuring oral health related quality of life and their mother
perceptions questionnaire.
Materials and methods: The study was conducted on 80 pairs of mothers and their children, aged 11to14 years; with
malocclusion according to orthodontic index of treatment need dental health component. The children and their
mothers completed the questionnaire independently.
Results: The mean ratings were similar for total scores (children, 19.9; mothers, 19.1), oral symptoms (children, 4.9;
mothers, 4.2), and social well-being (children, 3.9; mothers, 4.4). However, the mothers group had a lower mean
score for functional limitations (children, 5.1; mothers, 3.2) and a higher mean score for emotional well-being
(children, 5.3; mothers,6.8). The correlations between children's and mothers' responses ranged from rs = 0.652 for
emotional well-being to rs = 0.422 for functional limitations. There were good correlations between their responses to
global (rs = 0.622) and life overall (rs = 0.499) questions
Conclusions: The maternal opinions were similar to those of their children concerning the impact of malocclusion on
overall aspects of their children life, but the mothers overestimated the emotional impact of malocclusion on their
children's life.
Keywords: oral-health, quality of life, child. (J Bagh Coll Dentistry 2011;23(1):81-85).


Facial dimensions and asymmetry in clinically symmetrical faces with skeletal Class I & Class III malocclusion in an adult sample aged between 18-28 years (digital panoramic study)


Background: Several studies attempted to find the relationship between facial asymmetry and malocclusion and many authors found some extent of asymmetry in individuals with normal occlusion. The purposes of this study were to assess the amount and direction of facial asymmetry and the differences in facial angles and dimensions in clinically symmetrical faces with class I normal occlusion and class III malocclusion for both genders. Materials and Methods: The sample consisted of 58 individuals with clinically symmetrical faces aged 18-28 years, divided into two groups; class I group consisted of 30 individuals (14 males and 16 females) and class III group consisted of 28 individuals (14 males and 14 females). Clinical examination and digital lateral cephalometric and panoramic radiographs were performed for each individual. Four angular (Go, Y-C-Go, Y-C-PTM and Y-C-O) and three areal measurements (Maxillary, Mandibular and dental) were measured for each individual’s panoramic radiograph using AutoCAD program 2008. Results and Conclusions: The results showed that clinically symmetrical faces demonstrate significant asymmetry with the left side being significantly larger than the right side and the amount of asymmetry was more at the level of the mandible and the least amount of asymmetry was found at the dental area. The amount of asymmetry was independent of neither gender nor skeletal jaws relationship. Facial structures in term of size and shape are larger in males than in females in both class I and class III groups.

Application of periapical radiographic view of 4 mandibular permanent teeth in orthodontic diagnosis

Authors: Ali I. Al-Bustani
Pages: 94-99

Background: Orthodontic treatment decisions during puberty are greatly influenced by the growth phase of the
patient. The possibility of providing a simple approach for pubertal growth diagnosis was the aim of this study.
Materials and Methods: The stages of root development of the mandibular permanent dentition (excepting the third
molars) have been determined radiographically for 62 Iraqi orthodontic patients (33 males and 29 females) aged 11-
15 years.
Results: showed statistically non-significant difference between mandibular right and left dental developmental
Conclusion: A modified, simplified Dental Maturation Index [DMI] System has been presented, which is based on
examining 4 instead of 7 mandibular teeth as seen in a panoramic radiograph or 2 periapical radiographs.
Keywords: Dental Maturation, Pubertal Growth Prediction, Orthodontic Diagnosis. (J Bagh Coll Dentistry


A cephalometric comparative study of pharyngeal sagittal dimension in different skeletal patterns


Background: Because of the close relationship between pharynx and the dentofacial structures, this study was
conducted to find whether the pharyngeal sagittal dimension could be affected by the positional relationships
between jaws, and to determine the pharyngeal parameters difference in both genders in different skeletal patterns.
Subjects and method: The study sample consists of 120 digital radiographs of Iraqi subjects (60 males and 60 females)
attending Orthodontic Clinic in the College of Dentistry; University of Baghdad. The 120 radiographs were divided
into three groups (40 radiographs for each group) according to the ANB angles: ANB angle smaller than one degree
(Class III), between two and four degrees (Class I), and larger than four degrees (Class II), each group was further
divided into two subgroups according to gender (20 radiographs for each gender), eleven linear and two area
measurements were used to assess the pharyngeal structures.
Results: Student's t-test showed a significant difference (P<0.05) for t-PPW and Hy-APW2 measurements in all of the
three skeletal groups, with males had shorter t-PPW plane than females, and females had shorter Hy-APW2 plane
than males, on the other hand, Hy-APW4 plane and oropharyngeal area showed highest mean values in skeletal
class III, intermediate values in class I, and lowest mean values in class II in both males and females, F- test analysis of
variance showed highly significant differences (P<0.01) between all skeletal groups for total males and females in
regard t-PPW plane, Hy-APW2 plane, Hy-APW4 plane, and oropharyngeal area.
Conclusions: It can be concluded that the pharyngeal sagittal dimension have not been affected by gender type
except for t-PPW and Hy-APW2 planes, and the larger the ANB angle, the less Hy-APW4 and oropharyngeal area
measurements, and this may be attributed to the different location of the tongue, hyoid bone, and mandible in
skeletal class II malocclusion than other skeletal configurations.
Keywords: Pharyngeal sagittal dimension, skeletal patterns. (J Bagh Coll Dentistry 2011;23(1):100-106).


Prevalence of malocclusion in mentally, physically, auditory and visually handicapped patients in Sammawa City aged (6-16) years old

Authors: Fakhri Abid Ali --- Hayder S. Al-Atabi
Pages: 107-111

Background: There has been an increasing concern by the dental profession regarding the problem of providing oral
health care to handicapped patients. These groups need dental treatment of the highest standard as part of their
general care to enable them to realize their maximum level of functioning and normalizing their life. The aim of this
study was to determine the prevalence of malocclusion in groups of handicapped patients and comparing with
those of healthy individuals.
Materials and methods: This study was conducted on (267) handicapped patients attending special institutes, some
houses and (80) control group in Sammawa city which lies 300 km south of Baghdad, were clinically evaluated to
determine the prevalence of various orthodontic anomalies. Four groups of mentally, physically, auditory and visually
handicapped patients from (6-16) years old were studied with respect to sagittal occlusion according to Angle's
classification, overjet, overbite, anterior crossbite , posterior crossbite ,scissorsbite, spacing and crowding.
Results: The mentally handicapped group had high prevalence of Angle's class III sagittal occlusion, reversed overjet,
anterior openbite, posterior crossbite, scissorsbite, spacing and crowding. The physically handicapped group showed
a high prevalence of class III sagittal occlusion, reversed overjet and anterior openbite, posterior crossbite, spacing
and crowding. The auditory and visually handicapped groups showed only higher frequencies of crowding.
Conclusion: The Prevalence of malocclusion in mentally handicapped group (89.4%) had very highly significant
difference when compared with control group (71.3%), while other groups had no significant difference.
Key words: Prevalence of malocclusion; handicapped patients. (J Bagh Coll Dentistry 2011;23(1):107-111).


The relation of the maxillary central incisor, nasal bone, anterior cranial base lengths and the body height in different skeletal patterns

Authors: Nidhal H.Ghaib --- Hussein A. A. M. Al-Najar
Pages: 112-115

Background: The reason for measuring the frontonasal field which include the length of the anterior cranial base , the
nasal bone, and the incisors is that all these structures deviate from normal structures in patients with malformations
of the frontonasal field.
Materials and Methods: Maxillary central incisor, nasal bone and anterior cranial base lengths were measured by
cephalometric analysis of 122 lateral cephalometric radiographs using autocad 2008 program, also body height was
assessed by height measuring standard for adult patients with different skeletal patterns, including CLI (n= 48), CLII
(n= 45), CLIII (n= 29), normal MP-SN angle (n= 70), low angle (n= 28) and high angle (n= 24) .
Results and Conclusion: The maxillary central incisor was longer in high angle males group c. Short nasal bone was
found in CLII males and females and in low angle males group. Longer anterior cranial base was found in low angle
males, while the anterior cranial base was shorter in high angle males.
Key words: Cephalometrics, Maxillary central incisor, Nasal bone, anterior cranial base, Body height. (J Bagh Coll
Dentistry 2011;23(1):112-115).


Advantages of breast milk feeding for cleft lip and palate infants: comparative study

Authors: Ihsan S. Mohammed
Pages: 116-119

Background: This study is conducted to record the advantages of breast milk feeding for infants with cleft lip and/or
palate and to assess whether education of parents has any role to play in diminishing the expected difficulties
associated with feeding techniques.
Materials and methods: The sample of this study consisted of 76 Iraqi infant (45 male, 31 female) with different types
of congenital cleft lip and/or palate. They were seen in the college of Dentistry, university of Baghdad .Every infant
was provided with feeding baby plate, and breast pump sucker and instruction through video films demonstrate
breast feeding to demonstrate breast feeding. Follow up was arranged regarding any possible change in feeding
and the health of infants .A detailed questionnaire forms were completed together with their families (the father or
the mother or both of them) Observational statistic were then performed.
Results: Using feeding baby plate and providing the proper information regarding different feeding interventions and
using expressed milk results in significant improvement when compared with artificial feeding for infants with cleft lip
and/or palate.
Conclusion: Cleft lip and /or palate infants suffer from difficulties during breast feeding. However appropriate and
proper education and counseling by health care provider to the parents of the infant with cleft lip and /or palate
anomalies can reduce problems for the infant with the added advantage of continuing breast feeding.
Key words: Cleft lip and palate, Breast feeding, artificial feeding, Lactation education. (J Bagh Coll Dentistry


Effect of water extracts of cinnamon on the microhardness of initial carious lesion of permanent teeth, compared to stannous fluoride (An in vitro study)

Authors: Maha J. Al Anni
Pages: 120-124

Background: The attention of this study was to assess the effect of water extracts of cinnamon on the microhardness
of artificially initiated carious lesion of the outer enamel surfaces, and compared with that stannous fluoride, while
de-ionized water was used as control negative.
Materials and methods: Teeth were subjected to Vicker's microhardness test before and after PH–cycle and
following the treatment with different concentration of selected solution.
Results: stannous fluoride in addition to water extract of cinnamon at 1%, 5 and 10% succeeded in the
remineralization of artificially initiated carious lesion. This was indicated by the increase in the values of the
Conclusion :maximum changes in he microhardness values of enamel was recorded for stannous fluoride 8%,10%
while water cinnamon extract at 10% the less changes in the microhardness for all study groups.
Key wards: microhardness, Cinnamon, SnF2, remineralization, demineralization. (J Bagh Coll Dentistry 2011;23(1):120-


Maximum bite force among a group of Iraqi children in relation to mandibular growth rotation

Authors: Nagham Al-Sahaf --- Ban Ali --- Muna S. Khalaf
Pages: 125-130

Background: A growing bone is susceptible to deformation resulting from muscle forces acting upon it. Abnormal force
during the growth period can produce abnormal form. This study was conducted to examine the existence of a correlation
between maximum bite force and mandibular growth rotation in Iraqi children.
Materials and methods: Maximum bite force was measured among 61 children (22 males and 39 females) by the use of a
gnathodynamometer. Cephalometric lateral views were obtained for each child and traced for measuring mandibular
rotational angles and distances.
Results: A clear correlation existed between maximum bite force and mandibular rotational angles. In boys the correlation
between maximum bite force and mandibular rotational angles followed a similar pattern of the total sample. In girls
maximum bite force was directly correlated to the height of the ramus only.
Conclusion: Maximum bite force in children can be used as an indicator for determining the direction of the growth of the
Key words: Bite force, children, mandibular rotation. (J Bagh Coll Dentistry 2011;23(1):125-130).


Children’s preference of dental injectors and its influenceon child cooperation

Authors: Muna S. Khalaf
Pages: 131-135

Background: Behavior management approaches in treating children are generally viewed as time demanding
activities that put dentists away from their most important function. Patients, particularly children, consider local
dental anesthesia to be a difficult and painful experience and a dentist who treats children should have a variety of
behavior guidance approaches. The aim of this study was to examine the preference of children concerning the
physical appearance of dental injectors. It also aimed at assessing the influence of the type of injector preferred on
the cooperation of the child during local anesthesia administration.
Materials and method: The study group consisted of 67 children between the ages of 4 and 11. The children were
divided into two groups. Group 1 were shown a plastic injector without stickers applied on the barrel and a metal
type injector. Group 2 were shown a plastic injector with stickers applied on the barrel and a metal type injector. The
children were asked which type they preferred to be used to give them local anesthesia. The reaction of the child
was observed and rated with code from 1 to 4 on Frankl scale adapted for local anesthesia.
Results: Among group 1 34.5% preferred the plastic injector while 65.5% preferred the conventional metal injector.
Among group 2 78.9% preferred the plastic injector while 21.1% preferred the conventional metal injector. The
cooperation of children of group 1 who received local anesthesia by the plastic syringe, mostly code 3 and 4 (70%)
while the positive cooperation of those who received anesthesia by the metal syringe was 58%. In group 2 the plastic
injector was more preferred and children who showed cooperation of code 3 and 4 during the procedure of local
anesthesia administration formed 73.3% of the group. Children who chose the metal injector showed cooperation
mostly of code 1 (37.5%).
Conclusion: The physical appearance of the dental injector is important to children and clearly effected
cooperation of the child during local anesthesia administration.
Key words: dental injectors, physical appearance, cooperation, children. (J Bagh Coll Dentistry 2011;23(1):131-135).


Dental caries in relation to salivary parameters among hypertensive patients in comparison to healthy individuals

Authors: Sulafa K. El-Samarrai --- Najlaa H. Masood
Pages: 136-140

Background: Hypertension is one of the serious systemic diseases that may cause general systemic changes, which
may be reflected in the oral cavity. The aim of this study was to investigate caries severity among patients with
hypertension, in relation to the level of pH, flow rate in stimulated saliva and to compare results with healthy
Materials and Methods: Study groups consisted of 30 newly diagnosed hypertensive males, 30 hypertensive males
under the Captopril treatment, in addition to 30 healthy looking individuals. Their age was (49-50) years. Diagnosis
and recording of dental caries was according to the WHO criteria and stimulated salivary samples were collected.
The average salivary flow rate was measured from the total volume, and the pH was determined using pH meter. All
data were analyzed using Minitab version 13.
Results: The total mean values of caries-severity were recorded to be highest among study groups compared to the
control with statistically no significant difference (P >0.05). Lowest values of salivary pH and flow rate were among
study groups compared to the control one with highly significant difference for the pH (P <0.01) and non significant
for the flow rate (P > 0.05).
Conclusions: The severity of dental caries among hypertensive patients was seen to be in similarity to healthy adults.
In regard to saliva, hypertensive patients had a lowest value of pH and flow rate with highly significant difference for
the pH.
Keywords: Hypertension, dental caries, salivary pH, salivary flow rate. (J Bagh Coll Dentistry 2011;23(1):136-140).


Effect of cinnamon extracts on streptococci and mutans streptococci, in comparison to chlorhexidine gluconate

Authors: Wesal A. Al-Obaidi --- Shaymaa k. Al-Joubori
Pages: 141-145

Background: Cinnamon is a powerful herb that none of other plants came close to cinnamon in its medicinal
applications. Due to its -essential oils- scientists define cinnamon as an anti-microbial and anti-inflammatory food. The
aim of the Study: To assess the effect of specific concentrations of cinnamon extracts on viability counts of
Streptococci and Mutans streptococci among a number of volunteers in compression to 0.2% chlorhexidine
gluconte and deionized water.
Materials and Methods: Both ultrasonic and oil cinnamon extracts were prepared at concentration 3% for ultrasonic
extract, while for oil extract it was 2.5% chlorhexidine gluconate was the control positive, deionized water was the
control negative. Stimulated saliva was collected from 20 female dental students' volunteers (21-22 years). After
withdrawal of oral hygiene measures, divided into four groups each group rinse with the mentioned agent for one
minute. The counts of these bacteria, salivary pH and flow rate were recorded at one minute prior to the rinse as a
base line, one minute after rinsing, 15 minute, 30 minute and one hour.
Result: Cinnamon extract had a high significant antibacterial activity against Streptococci and Mutans streptococci
in the following time points (15 minute, 30 minute and one hour) as it could reduce the viable counts of bacteria, also
for both cinnamon extracts the increase in salivary pH and flow rate continue after half an hour and then started to
decrease but still higher than the base line value.
Conclusions: Both ultrasonic and oil extracts of cinnamon were effective against Streptococci and Mutan
streptococci, increasing the salivary pH and flow rate.
Keyword: Cinnamon, Streptococci, Mutans streptococci. (J Bagh Coll Dentistry 2011;23(1):141-145).


Relationship between Herpes Simplex Virus Type- 1 and periodontitis

Authors: Sana A. AL-Shaikhly --- HindWael Al-Alousi
Pages: 146-150

Background: HSV-1 is responsible for the most commonly occurring viral infections of the mouth and perioral soft
tissues, HSV-1which primarily is associated with oral and labial lesions, .and it causes a recurrent infection, which
commonly occurs in the mouth. Additionally, HSV infection has been associated with periodontitis. The HSV-1 may
cause periodontal pathosis as a direct result of virus infection and replication, or as a consequence of virally
induced impairment of the periodontal immune defense, resulting in heightened virulence of resident bacterial
pathogens.The aims of the study are to show the relationship between HSV-1 and periodontitis, and to determine
HSV-1 Antigen in saliva of periodontitis patients by immunoflourescent, as well as to determine HSV-1 antibodies
immunoglobulin G (IgG) in saliva samples by enzyme linked immunosorbent assay (ELISA) test.
Materials and methods: Thirty periodontitis patients and thirty periodontitis patients and have recurrent herpes
labials (RHL) compare with thirty healthy control subjects were included in this study. Saliva samples were taken from
all subjects (patients and healthy) and examined by direct immunofluorescent and ELISA test. Two swabs from
patients with oral herpes labials were considered as a positive control.
Results: The present study indicated that there is relationship between HSV-1 and periodontitis and the herpes
simplex virus type-1 was detected in periodontitis patients by ELISA and immunofluoresecent method.
Conclusion: The study revealed positive association between HSV-1 and periodontitis and the virus may play a role
in the pathogenesis of the periodontitis.
Key words: HSV-1, periodontitis, ELISA, direct immunofluorescent, Saliva. (J Bagh Coll Dentistry 2011;23(1):146-150).


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