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

About

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

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Contact info

Website: www.codental.uobaghdad.edu.iq
E-mail: baghdad_dentistry@yahoo.com
Telephone: (+9641)4169375 Fax: (+9641)4140738

Table of content: 2016 volume:28 issue:4

Article
Evaluation the Effect of Addition of Plasma Treated Polypropylene Fiber and Silanized Silicon Dioxide Nanoparticles Composite on Some Properties of Heat-Polymerized Polymethylmethacrylate

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Background: Polymethylmethacrylate (PMMA) is the most commonly used material in denture construction. This material is far from ideal in fulfilling the mechanical requirements, like low impact and transverse strength and poor thermal conductivity are present in this material. The purpose of this study was to study the effect of addition a composite which include 1%wt silanized silicone dioxide nano fillers (SiO2) and 1wt% oxygen plasma treated polypropylene fiber (PP) on some properties of heat cured acrylic resin denture base material (PMMA). Materials and methods: One hundred (100) prepared specimens were divided into five groups according to the tests, each group consisted of 20 specimens and these were subdivided into two groups (unreinforced heat cured acrylic resin as control group)and reinforced acrylic resin with ( 1%wt Nano SiO2 and 1% wt oxygen plasma treated polypropylene fibers) group. The transverse strength¸ impact strength, indentation hardness (shoreD), surface roughness and water sorption and solubility were investigated. The results were statistically analyzed using descriptive and t-test. Results: The results of this study show that a highly significant increase in impact strength (10.4939 Kj/m2),surface hardness (89.9375) surface roughness (0.9498) and water sorption (0.0171mg/cm2) was observed with the addition of 1%wt silanized (SiO2) nanoparticles and 1%wt oxygen plasma treated polypropylene fibers to (PMMA) , also significant decrease in transverse strength (103.4753 N/mm2), nonsignificant decrease occurred in water solubility which was (0.0005mg/cm2). Conclusion: The incorporation of 1%wt silanized SiO2 nanoparticles and 1%wt oxygen plasma treated polypropylene fiber to heat cure PMMA form a composite improves the impact strength, surface hardness and surface roughness of acrylic resin, at the same time this addition increase the water sorption and decrease water solubility; while significant decrease in transverse strength


Article
Evaluation of Impact and Transverse Strength of Denture Bases Repaired with Nano Reinforced Resin

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Background: Failure of resin bases were a major disadvantage recorded in the constructed dentures. Reinforcements of the repair joint with nano fillers represent an attempt to enhance the strength and durability. The purpose of the research was to estimate the influence of nano fillers reinforcement with (ZrO2 and Al2O3) on impact and transverse strength of denture bases repaired with either cold or hot processing acrylic resin. Materials and methods: A hundred and forty (140) samples were processed with hot cured resin and organized in subgroups depending on the repair materials and condition (without repair (control), repair with hot cure, cold cure, hot and cold cure reinforced with either (5% Zr2O or 0.5% Al2O3). The samples in these subgroups were processed depending on the test applied (impact and transverse strength). The samples were immersed in distalled water for about four weeks at 37°C before testing, after that, the samples prepared for each test were subdivided depending on the selected subgroups of the study. Repairing the samples with cold cure resin was done with the aid of Ivomet; after that the samples incubated for 48 hours in 37°C distilled water. Transverse strength test was done by using INSTRON universal testing machine while the impact test was done by using CHARPY impact testing machine. Results: The reinforcement of the repair joint with nano-fillers improves both impact and transverse strengths. Conclusion: Repair strength is directly proportional to the mode of resin processing, reinforcement with nano-fillers improve the strength of the repaired joint significantly


Article
Effect of Disinfection on Some Properties of Heat-Vulcanized Maxillofacial Silicone Elastomer Reinforced by Nano Silicone Dioxide

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Background: The daily cleaning routine of the silicone maxillofacial prostheses by the patient may cause some alteration in the materials properties. The purpose of the present study was to investigate the effect of different disinfection procedures on some properties of silicon dioxide reinforced Cosmesil M511 HTV maxillofacial silicone. Materials and Methods: One hundred and sixty (160) specimens were prepared by mixing 5% SiO2 nano particles and 0.5% intrinsic cream color into the silicone polymer according to manufacturer's instructions. Specimens were divided into 4 groups according to the performed test (tear strength, surface hardness, surface roughness and color) with 40 specimens each. Each group was further subdivided according to the disinfection procedure conducted (control, microwave exposure, neutral soap and 4% chlorhexidine gluconate). Measurements for tear strength were done using universal testing machine. Surface hardness test was carried out with a Shore A Durometer. Surface roughness was analyzed with a portable digital Profilometer. Color change was established with a Spectrophotometer. After the initial testing, all specimens were submitted to disinfection procedure 3 times a week for 60 days. Measurements were repeated and data were statistically analyzed using one-way ANOVA followed by Fisher's LSD or Games-Howell test . Results: Spectrophotometer results showed non-significant decrease in the light absorbance of all experimental groups after disinfection, indicating a strong integration between the nano filler and the polymeric chains, which was not broken during the disinfection procedure. Highly-significant increase in Shore A hardness was recorded, while the decrease in surface roughness was highly significant in all experimental groups. Tear strength reduced significantly after disinfection in all experimental groups. Conclusion: Disinfection seemed to cause different amount of alteration in all of the tested properties of silicone. High color stability is expected in this type of maxillofacial silicone after disinfection.Although microwave exposure had increased the hardness of the material, it is considered a satisfactory disinfection procedure since it caused the least effect on the tear strength and surface roughness of the material. Therefore, microwave exposure is recommended for the disinfection of maxillofacial silicone prostheses


Article
The Effect of Silver-Zinc Zeolite Incorporation on Some Properties of Condensation Silicone Impression Material

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Background: elastomeric impression materials are indicated when a high degree of accuracy is required, due to their excellent properties like details reproduction, dimensional stability and tear strength but with main two disadvantages those are their hydrophilicity as well as the absence of antibacterial activity. This study aimed to evaluate the effect of incorporation of 0.5% wt Ag-Zn zeolite into condensation silicone through the following tests; setting time, dimensional stability, reproduction of details, wettability, and hardness . Materials and methods: one hundred specimens were constructed of condensation silicone, divided into two groups for the first 50 specimens one0.5% by wt Ag -Zn zeolite was added, keeping the other fifty specimens without addition. Then each group further subdivided into five subgroups according to the conducted test. The tests performed were; setting time, dimensional stability, reproduction of details, hardness and wettability. Results: A statistically non-significant effect on the setting time and reproduction of details tests was observed, combined with a highly significant increase of wettability of condensation silicone after incorporation of 0.5% wt Ag-Zn zeolite with non-significant increase of dimensional change of condensation silicone following incorporation of 0.5% wt Ag-Zn zeolite. Hardness test results shoed statistically significant increase following the addition of Ag-Zn zeolite. Conclusion: Ag-Zn zeolite incorporated into condensation silicone, improved wettability which determine the extent to which an impression material replicates the structures of the oral cavity and production of bubble-free gypsum die. It also showed a statistically significant increase in the hardness of condensation silicone impression material, and had no effect on setting time, reproduction of details and dimensional stability.


Article
Comparison of the Marginal Fitness of the Ceramic Crowns Fabricated with Different CAD/CAM Systems (An In Vitro Study)

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Background: The marginal fit is the most characteristic that closely related to the longevity or success of a restoration, which is absolutely affected by the fabrication technique. The objective of present in vitro study was to evaluate the effect of four different CAD/CAM systems on the marginal fit of lithiμm disilicate all ceramic crowns. Materials and Methods: Adentoform tooth of a right mandibular first molar was prepared to receive all ceramic crown restoration with deep chamfer finishing line (1mm) and axial reduction convergence angle of 6 degree, dentoform model duplicated to have Nickel-Chromiμm master die. Thirty two stone dies produce from master die and distributed randomly in to four groups (8 dies for each group) according to the type of CAD/CAM system that used: Group A: fabricated with CERAMILL motion2 (Amann Girrbach); Group B:fabricated with CEREC in lab MCXL (Sirona);Group C: fabricated with CORiTEC 250i (imes-icore); Group D: fabricated with ZIRKONZAHN M5 (Zirkonzahn). Marginal discrepancy was measured at four points at each tooth surface. Sixteen points per tooth were measured using digital stereomicroscope at (140X) magnification. Results: ANOVA and LSD post Hoc tests were used to identify and localize the source of difference among the groups. It was found that there is a highly significant difference in the marginal gap mean values between group C and group D, and highly significant differences between group A and group D. Conclusions: From the above result we can conclude that better marginal fit values were may be exhibited by CORiTEC 250i CAD/CAM system.


Article
Comparative Evaluation of the Effect of Different Universal Adhesives and Bonding Techniques on the Marginal Gap of Class I Composite Restoration (A SEM Study)

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Background: With the increase in composite material use in posterior teeth, the concerns about the polymerization shrinkage has increased with the concerns about the formation of marginal gaps in the oral cavity environment. New generation of adhesives called universal adhesive have been introduced to the market in order to reduce the technique sensitive bonding procedures to give the advantage of using the bonding system in any etching protocol without compromising the bonding strength. The aim of the study was to study marginal adaptation of two universal adhesives (Single bond™ Universal and Prime and Bond elect) using 3 etching techniques under thermal cycling aging. Materials and Methods: Forty-eight sound maxillary first premolar teeth were included in the study. Teeth were divided into two groups according to the universal adhesive used then each group was subdivided into 3 subgroups according to the etching protocol used. Standardized class I cavities were prepared in the teeth followed by the restoration of teeth using Filtek™ Bulk Fill Posterior Restorative composite material. After finishing and polishing, teeth were subjected to 500 thermal cycles in 55º-5ºC bath with dwell time of 30 seconds. Teeth then were examined using SEM to measure the marginal gap at 12 points. Data obtained were analyzed using one-way ANOVA and LSD test for each group and with student t-test to compare the two adhesives. Results: The result of this study the showed that etch and rinse technique showed significantly the least marginal gap width for both adhesive types. The selective etch technique showed lower gaps compared to the self-etch technique with no significant difference. The result showed that single bond universal showed significantly the least marginal gap for the all etching techniques compared to Prime and bond elect. Conclusion: The etch and rinse technique remains the most suitable technique for adhesive restoration. The type of adhesive plays an important role in adhesion


Article
Gingival Marginal Leakage of Different Tooth Colored Materials Combination as an Intermediate Layer in Class II Composite Restoration (A Comparative In Vitro Study)

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Background: The aim of this in vitro study was to evaluate and compare the microleakage between Vertise Flow T M composite material and other conventional (Filtek Z250, riva light cure and SDR) composite materials when restoring CII mesial box only cavity at gingival margin through die penetration test Materials and methods: Forty maxillary first premolars were prepared with class II box design only cavities. Samples were divided into four groups of ten teeth according to material used: group I (FiltekZ250 only). Group II (SDR+FiltekZ250). Group III (Vertise Flow +FiltekZ250). Group IV (Riva light cure+ FiltekZ250). After 24 hrs. immersion in 2% in methylene blue, samples were sectioned and micro leakage was estimated. Results: None of the materials showed zero score for dye penetration. Micro leakage percentage in group III had lowest value; followed by group IV then group I while in group II had highest value of micro leakage Conclusion: All the materials show micro leakage at variable degrees and that the microleakage degree depend on materials type Vertise flow is a promising material to be used in clinic as it saves both time and effort and gives high degree of performance from the microleakage point of view


Article
In Vitro Comparative Assessment of Composite Nanoleakage Using Various Dentine Surface Treatments

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Background: The treatment of dental tissues proceeding to adhesive procedures is a crucial step in the bonding protocol and decides the clinical success ofrestorations. This study was conducted in vitro, with the aim of evaluating thenanoleakage on the interface between the adhesive system and the dentine treated by five surface modalities using scanning electron microscopy and energydispersiveX-ray spectrometry. Materials and methods: Twenty five extracted premolars teeth were selected in the study. Standardized class V cavities were prepared on the buccal and lingual surfaces then the teeth divided into five main groups of (5 teeth in each group n=10) according to the type of dentine surface treatment that was used: Group (A): dentine was conditioning with Er, Cr: YSGG laser. Group (B): dentine was conditioning with (Er, Cr: YSGG laser + acid). Group (C): dentine was conditioning with (acid + Er, Cr: YSGG laser). Group (D): dentine was conditioning with acid etch. Group (E): dentine was conditioning with acid + 10% sodium hypochlorite. For All the teeth SBMP adhesive were used and restored with Z250 composite restoration then all specimens were subjected to thermocycling 500 cycles, at 5° to 55 °C. The teeth were soaked in silver nitrate suspension. Then the teeth sectioned bucco-lingually across the centre of the restorations. The specimens were characterized using scanning electron microscopy and the amount of nanoleakage was measured by EDX spectro-analysis to identify the existence of metallic silver particles. Results: Data were analysed statistically by one way ANOVA test and (LSD) Tests. The results showed that there were statistically highly significant differences among all groups of the present study.The resultshowed that the acid and laser (group III) exhibited the lowest mean value of nanoleakage at around (6.14 %), whereas the highest mean value of nanoleakage (12.83 %) was determined by the only acid (group IV). Conclusions: Treating the acid etched dentine with Er: Cr: YSGG laser showed promising results as it exhibits lowest amount of nanoleakage of the adhesive bonding system


Article
Cell Surface Expression of 70 KDa Heat Shock Proteins and P21 in Normal Oral Mucosa, Oral Epithelial Dysplasia and Squamous Cell Carcinoma (An Immunohistochemical Study)

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Background: Oral SCC is a complex malignancy where environmental factors, viral infections and genetic alterations most likely interact, and thus give rise to the malignant condition. The HSP70 play a direct role in apoptosis inhibition by aligning the improved integrity of a cell’s proteins with the improved chances of that particular cell’s survival.P21 gene produces p21 protein which is a potent cyclin-dependent kinase inhibitor that plays a significant role in carcinogenesis. The aims of the study were to evaluate and compare the immun-histochemical expression of the HSP70 and cell cycle protein p21in NOM, OED, and OSCC. Correlate both marker expressions with each other. Materials and methods: Forty six formalin-fixed, paraffin embedded tissue blocks(10 cases of normal oral mucosa,16 cases of oral epithelial dysplasia, and 20 cases of oral squamous cell carcinoma) were included in this study, an immunohistochemical staining was performed using antiHSP70monoclonalantibody, and anti p21 monoclonal antibody. Results: Positive IHC expression ofHSP70 was found in 2 cases (20%) of NOM, 13 cases (81.3%) of OED and in 16 cases (85%) of OSCC. Positive IHC expression of P21 was detected In NOM in 2 cases (20%), while it was found in 9 cases (56.2%) of OED, and in 14 cases (70%) of OSCC .The difference between the expressions of both markers was statistically significant in NOM, highly significant in OED, and OSCC. Conclusions: This study signify the important role of HSP70 and p21in oral carcinogenesis and in the evolution of the mucosa from normal to dysplastic to invasive carcinoma

Keywords

NOM --- OED --- OSCC --- HSP70 --- p21


Article
Comparison of Immunohistochemical Expression of DNMT3B among Oral, Laryngeal and Skin SCC

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Background: Recently epigenetic alterations have received increased attention because of theirimportant role in the process of tumerigenesis. It has been found that more than half of genetic changes were epigenetic. Epigenetic alterations are catalyzed by DNMTs enzymes. Increased knowledge about this molecular event may achieve progress in the war against cancer. The aim of this study was to evaluate and compare the expression of DNMT3B among oral, laryngeal and skin SCC. Materials and Methods: This study was performed on (120) formalin-fixed, paraffin-embedded blocks, histopathologically diagnosed as oral, laryngeal and skin SCC). Immunohistochemical staining of DNMT3B antibody was performed on each case of this study. Results: The immunohistochemical analysis showed that the DNMT3b is over expressed in oral, laryngeal and skin squamous cell carcinoma as (77.5%), (77.5%) and (72.5%) respectively, withsignificant difference in expression among them (P=0.009), The expression in all the three types is correlated positively with the degree of differentiation (P<0.001), (P<0.001) and (P=0.015) respectively. Conclusion: According to the results of this study, epigenetic alterations are believed to play a crucial role inthe development of oral, laryngeal and skin SCC.The results also, conclude that DNMT3B may act as a promising prognostic marker in cancer of epithelial in origin.


Article
Immunohistochemical Expression of Endocan in Ameloblastoma

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Background: Ameloblastoma is the most common clinically significant odontogenic tumor, known for its locally invasive potential and frequent recurrences unless treated radically. Endocan is a soluble proteoglycan which is reported to have prognostic implications in multiple human diseases and tumors. This study aims to describe the expression of endocan in ameloblastoma. Materials and methods: With immunoperoxidase method; tissue sections of formalin fixed- paraffin embedded blocks for ameloblastomas were stained with monoclonal antibodies to endocan, the localization of the endocan expression was examined and the resulting scores of the tissue sections were analyzed according to age, sex, site and tumor subtype. Results: endocan was found to be expressed in peripheral and central epithelial cells of ameloblastoma tumor islands and stroma to different extents; a selectively increased expression was noted in epithelial cells with acanthomatous differentiation. Tumor epithelial cells of plexiform subtype tend to have higher expression levels of endocan. However, the associations did not reach statistically significant levels. Conclusions: Endocan is expressed specifically in various populations of tumor epithelial cells and stromal elements of ameloblastoma. The prognostic significance of the expression needs to be clarified in further studies

Keywords

Ameloblastoma --- Endocan


Article
Prevalence of Dental Anomalies among Iraqi Dental Students

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Background: Dental anomalies are abnormal tooth condition occurs due to certain genes or environmental factor disturb tooth development during morphodifferentiation stages, affecting group of teeth or entire dentition. The aim of the study is to evaluate the frequency of occurrence of dental anomalies among dental student. Materials and Methods: Three hundred dental students with age ranged (18-23 years) were examined clinically and radiographically searching for dental anomalies in shape, number and position. Results: Only 25 students (8.3 %) from the total sample (300) had dental anomalies, female form the higher percentage of anomalies (about 68%) compared to male (32%). The age group (22 years) which was the larger group had a higher percentage of dental anomalies (about 40%). Regarding the type of anomalies found, disturbance in number of teeth represent the higher percentage (48%); but impacted third molar represent the most common subtype of positional anomalies found in the study (20%). Conclusion: Higher percentage of dental anomalies detected in female and larger age group, study of dental anomalies was of great importance especially prior to orthodontic and surgical intervention


Article
Assessment of Cysts and Cystic-Like Lesions of the Jaws and Their Effect on Adjacent Structures by Using Cone Beam Computed Tomography (CBCT)

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Background: Preoperative radiographical assessment of the maxillofacial lesions is of a great importance in guiding the surgeon during surgical procedure in reducing post-operative complications. This study highlighted the application of CBCT scan in the assessment of maxillofacial cystic and cystic like lesions as a part of advanced radiology Materials and methods: A total of 20 patients (15 males and 5 females) participated in this prospective study. CBCT scan (Kodak 9500 CBCT) with (DICOM) software utilized to perform scanning to all patients in order to assess lesion extension, morphological features and it’s relation to the adjacent vital structures. Results: In this study, the total cystic and cystic like lesions involving the maxilla and mandible were (20) lesions. Statistical analysis of the collected data showed no significant differences between the radiographical records and surgical findings regarding diagnostic accuracy of the lesions. Conclusion: The validity of the CBCT in the assessment of maxillofacial cystic and cystic like lesions was similar to the surgical findings regarding lesion extension, expansion, perforation of buccal/or lingual plates, and relation to the adjacent vital structures.

Keywords

CBCT --- Jaw --- cystic lesion


Article
Sex Variations by Linear Measurements of Palatal Bones and Skull Base Using 3D Reconstructed Computed Tomographic Scan among Iraqi Sample

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Background: The skull base and the hard palate contain many anatomical features that make them rich in information which are useful in sex differentiation; in addition to that they have the ability to resist the hardest environmental conditions that support them in making sex differentiation. Three dimensional computed tomographic techniques has important role in differentiation between sex since it offers images with very accurate data and details of all anatomical structures with high resolution. This study was made to study sex variations among Iraqi sample by craniometric linear measurements of the hard palate and the skull base using 3D reconstructed Computed Tomographic scan. Materials and methods: This study composed of 100 Iraqi subjects (50 male and 50 female) aged between 20-59 years. The sample collected from patients attending Al-Shaheed Ghazi hospital in Baghdad city to for spiral CT scanner. The craniometrical linear measurements of the hard palate and the skull base in this study were including: Maxillo-Alveolar Breadth, Maxillo-Alveolar Length, the distance between incisive foramen and greater palatine foramen (right and left), the distance between the incisor foramen and B point (the median point located at the anterior area of the magnum foramen), the distance between the incisor foramen and the anterior root of the mastoid notch on both sides (right and left), Maxillo-Alveolar Index and size of Palate. All these measurements were done by (mm) unit. Results: The statistical analysis of linear measurements of the hard palate and the skull base showed that the mean values of all measurements were significantly higher in males than females except for Maxillo-Alveolar Index was not significant and also showed that the size of the palate was the best indicator for sex variation and making the diagnosis of male with accuracy 93.3%. The age had none significant effect on these measurements. Conclusion: Three dimensional Computed Tomographic scanners is the best diagnostic tool for sex variation by the craniometrical linear measurements for the anatomical landmarks points of the hard palate and the skull base


Article
Physical and Histological Evaluation of Coated Implant with Nano ZrO2 after Creation Titania Nanotubes

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Background: Contact between implant material and bones must be strong and fast creation, to fulfill these properties appropriate surface modifications must apply on used implants. In this contribution; double surface modifications are applied on Ti-6Al-4V alloy to accelerate osseointegration. Materials and methods: Anodic process is utilized to create titania nanotubes (TNTs) on the screws made from Ti-6Al-4V alloy. These implants were coated with nano ZrO2 particles. Second modification was annealing anodized screws at 8000C, and implanted in tibiae of nine adult New Zealand white rabbits. Results: Physical and histological consequences of two surface modifications on Ti-6Al-4V alloy screws were studied. Scanning electron microscope (SEM) images shows inhomogeneous distribution of TNTs on screws surfaces. X-ray diffraction (XRD) patterns illustrate the covering of first group samples with ZrO2 and transformation of Ti to its oxide (Rutile phase) for second group. These pattern shows that TiO2 had higher crystallinity and larger grain size than ZrO2. Atomic Force Microscopy images (AFM) shows the increasing of roughness, grain size and internal diameter of TNTs after annealing process. Coated implant with ZrO2 at 4 month duration shows threads with newly Haversian canal feature. Annealed implant at same duration shows well developed threads, base of implant illustrates bone trabeculae filled the base of implant bed with active osteoblast cells. Conclusion: Modification of implant's surface produced an improvement of osseointegration in comparison to untreated one.


Article
Clinical and Sonographic Changes of Parotid Gland in Patients with Type I and Type II Diabetes Mellitus and ItsEffect on Physical Properties of Saliva

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Background:Sialosis is described as a specific consequence of diabetes. In diabetic sialosis, the increased volume of the glands is due to the infiltration of adipose in the parenchyma. The B-scan ultrasonography is a generally accepted tool for determining parotid gland enlargement. Oral health is, to a greater extent, dependent on quality and quantity of saliva, both of which may be altered in diabetics. This study was conducted to detect the enlargement of parotid gland in diabetic patient and study the changes in physical properties of saliva and its relation with the salivary gland enlargement. Subjects, Materials and Methods: This cross-sectional study included subjects of both sexes attending Al-Yarmouk teaching hospital (Al-Yarmouk center for Diabetes), their ages ranged from20 to 65 years. Parotid gland was measured by using B-mode ultrasonography with a high frequency (6-9MHz). The Physical properties of saliva that were measured were flow rate, pH, and viscosity. Results: The statistical analysis showed that: The right-left mean difference in length, width, depth and volume ultrasonography measurements of parotid gland among diabetic study group, revealed statistically non-significant difference, similar result was obtained among control group. The effect of Diabetes mellitus is marked on the parotid gland measurements as the disease progresses and the HbA1c increase. Physical properties of saliva give obvious decrease in flow rate and pH in diabetic patient while the viscosity was increased in diabetic rather than normal. Conclusion:This study concludes that there is positive correlation between the progressions of disease and salivary gland measurements. On the other hand, the present article shows that there is negative association between flow rate, pH, and viscosity in comparison with salivary gland measurements


Article
Immediate Implant Placement in Fresh Extraction Socket

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Background: In the traditional protocol, the patient should wait after extraction up to six months to place the dental implant in healed bone, this waiting time accompanied by varying degrees of alveolar bone changes. In order to overcome these problems, immediate implant placement in the fresh extraction socket was introduced. The Aim of this study was to evaluate the outcome of the immediate implant placement utilizing Resonance Frequency Analysis (RFA) to quantify implant stability and osseointegration. Materials and Methods: A total of (23) patients participated in the study, receiving (44) implants placed in the sockets of teeth indicated for extraction. Clinical and radiographic preoperative assessment was accomplished for each patient, β-TCP (combined with collagen membrane) was used to fill gaps ≥ (2 mm) and to repair bone defects. Implant stability quotient (ISQ) values were measured for the implants at baseline and at 16 weeks. Postoperative clinical and radiographic evaluation was applied for each patient. Results: A total of (22) patients received (41) implants completed the follow-up period, all these implants survived (100% survival rate) with no signs and symptoms of failure. The mean of ISQ value at baseline was (65.32±9.50), the mean of ISQ value at 16 weeks was (69.78±7.15), paired samples statistic showed high significant increase in the implant stability (P<0.01). Application of guided bone regeneration (GBR) showed no significant difference on ISQ value at baseline and at (16 weeks), but ISQ values increased significantly in GBR cases during the healing period. Conclusions: Immediate implant placement is a predictable treatment approach; it has the benefit of reducing treatment time and the numbers of surgical procedures when careful preoperative examination and appropriate intraoperative protocol is applied.


Article
Surgical Biopsy in Cervical Lymphadenopathy

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Background: Cervical lymph nodes are the most frequently enlarged and biopsied of all the peripheral lymph nodes and in most of the cases the enlargement results from benign infectious causes, however, the presence of cervical lymphadenopathy (LAP) requires accurate diagnosis to exclude more serious causes. The aim of this study was to analyze cases of Iraqi patients presenting with cervical LAP who underwent surgical lymph node biopsy to establish accurate diagnosis. Materials and Methods: This retrospective study included 25 patients who presented with cervical LAP for whom surgical biopsy was performed to establish a definitive diagnosis. The investigated data included the demographic and clinical parameters in addition to the final histopathological diagnosis. Results: Twenty five patients were included in this study with a mean age of 33.8 years and female predominance; benign diseases were diagnosed in 56% of the cases whereas the remaining 44% were diagnosed with malignant diseases. Tuberculous lymphadenitis was the most common cause. Conclusion: This study emphasizes the importance of surgical lymph node biopsy in establishing a definitive diagnosis in patients presenting with cervical LAP


Article
Assessment of Salivary α-amylase and Flow Rate Levels and Their Correlation with Gingivitis and Severity of Chronic Periodontitis (Part: 1)

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Background: Periodontal diseases are bacterial infections of the gingiva, bone and attachment fibers that support the teeth and hold them in the jaw. α-amylase is an enzyme, produced mainly by parotid gland and it seems to play a role in maintaining mucosal immunity. Aims of the study: Determine the salivary levels of α-Amylase and flow rate and their correlations with clinical periodontal parameters(Plaque Index , Gingival Index , Bleeding on Probing , Probing Pocket Depth , and Clinical Attachment Level ) and the correlation between α-Amylase with flow rate of study groups that consist of ( patients had gingivitis and patients had chronic periodontitis with different severities(mild ,moderate ,severe) and control group . Materials and Methods: Salivary α-Amylase and flow rate levels with clinical periodontal parameters(Plaque Index , Gingival Index , Bleeding on Probing , Probing Pocket Depth , and Clinical Attachment Level ) were measured from 75 males , age ranged (30-45) years old, that divided into study groups(group of 45chronic periodontitis patients with different severities which sub-grouped into (Mild=15, Moderate=15 and Severe=15), group of 15 patients with gingivitis) and control group comprised 15 subjects had clinically healthy periodontium. Results: The levels of salivary α-amylase in patients had chronic periodontitis were the highest followed by patients had gingivitis .Highly significant differences were demonstrated between each pairs of chronic periodontitis subgroups hence, the highest level at severe chronic periodontitis subgroup patients. Flow rate decreased in gingivitis group and chronic periodontitis with its different severities. Highly significant strong positive correlations were found between α-amylase with clinical periodontal parameters at all groups and subgroups. Conclusions: The findings of the present study suggest that salivary α-Amylase can help to monitor the progression of the periodontal disease.


Article
Detection of Granulocyte Chemotactic Protein 2 in Serum of Periodontitis Patients

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Background: Chronic periodontitis defined as “an infectious inflammatory disease within supporting tissues of the teeth, progressive attachment loss and bone loss". Aggressive periodontitis is rare which in most cases manifest themselves clinically during youth. It characterized by rapid rate of disease progression .Pro-inflammatory chemokines organized inflammatory responses. Granulocyte chemotactic protein 2 is involved in neutrophil gathering and movement. The purpose of the study is to detect serum of Granulocyte Chemotactic Protein 2 and correlate to periodontal condition in patients with chronic periodontitis, Aggressive periodontitis and Healthy Control subjects and measurement the count of neutrophils for the studied groups. Subjects and methods: Eighty four male and female were enrolled in this study .They were divided into three groups (18) patients with Aggressive periodontitis with age range (20-45) years, (33) chronic periodontitis patients and (33) Healthy control with an age range (30-50). Clinical periodontal parameters were recorded for each group. The concentration of granulocyte chemotactic protein- 2 in serum was quantified by a high-sensitivity enzyme linked immunosorbent assay. Blood neutrophils count were detect for five subjects from each group using light microscope Result: ANOVA analysis revealed high significant differences in Granulocyte chemotactic protein 2 means between aggressive, chronic and controls. Neutrophils count in aggressive periodontitis is higher than chronic and controls .No significant difference in neutrophils count between aggressive and chronic periodontitis, while significant difference when correlate them with controls Conclusion The concentration of granulocyte chemotactic protein 2 increased with the increase in severity of periodontitis. Higher neutrophils count was found in aggressive periodontitis than chronic and controls. As higher granulocyte chemotactic protein 2 that chemoattract more neutrophils recruitment to the site of inflammation


Article
Correlation between Periodontal Health Status and Salivary Matrix Metalloproteinase-9 Levels in Smoker and Non-Smoker Chronic Periodontitis Patients (A Comparative Study)

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Background: Periodontal diseases are inflammatory diseases affecting the supporting tissues of the teeth. One of the leading environmental factors that are closely related not only to the risk but also to the prognosis of periodontitis is smoking. This study aimed to evaluate the influence of smoking on periodontal health status and to measure the levels of matrix metalloproteinase-9 in smokers and nonsmokers chronic periodontitis patients, also it aimed to test the correlation between the levels of matrix metalloproteinase-9 and the clinical periodontal parameters. Materials and Methods: Five milliliters samples of un-stimulated whole saliva and full-mouth clinical periodontal recordings (plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment level) were obtained from forty patients of two groups (non smokers with chronic periodontitis and smokers with chronic periodontitis). All subjects were systemically healthy males, with age range (35-50) years. Salivary matrix metalloproteinase-9 levels were analyzed by using Enzyme-linked Immunosorbent Assays. Results: Statistical analysis revealed that probing pocket depth and clinical attachment level were higher in smokers than non smokers, while there were decreases in the numbers of bleeding sites in smoker when compared with non smoker subjects. Salivary matrix metalloproteinase-9 levels were significantly higher in smoker with chronic periodontitis patients than their non smoker counterparts. Conclusion: Salivary matrix metalloproteinase-9, as a biomarker, could reflect the increased periodontal tissue destruction due to the smoking


Article
Time of Emergence of Permanent Teeth and Impact of Nutritional Status among 4-15 Years Old Children and Teenagers in Basrah City /Iraq

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Background: The timing of eruption of permanent teeth is of considerable importance to the dental health planning for diagnostic, preventive and therapeutic measures for children and teenagers. The purposes of this study were to determine timing of maxillary and mandibular permanent teeth emergence (except third molars) and to evaluate the effect nutritional status by anthropometric measures on the eruption time of permanent teeth, investigations had been done according to jaw and gender variations. Materials and Methods: This study was conducted among four to fifteen years old children and teenagers from kindergarten and schools in Basrah city in the south region of Iraq. The total sample composed of 1807 children and teenagers that were collected randomly from kindergartens, primary and secondary schools in Basrah city. The data were statistically analyzed by using probit model in order to compute the median 5th and 95th percentile range of emergence. Athropmetric measures of height and weight were used for the purpose of assessment of nutritional status. The indices include: Weight for age, Height for age and Weight for height; each was considered as in term of standard deviation score (Z – score) as primary indicator of underweight, stunting and wasting respectively. The statistical significance of differences in mean of a normally distributed variable (nutritional indices z score) between 2 groups was assessed by independent samples t-test. Results: The results showed significant differences (p<0.05) between the timing of maxillary and mandibular teeth emergence in girls and boys, with earlier emergence in girls , also the mandibular teeth emerge before their maxillary opposing teeth in both sexes except for premolars . The prevalence of malnutrition according to height for age, weight for age, and weight for height nutritional status indicators were found to be 7.4 %, 3.7 % and 1.5% respectively. The results showed that among well-nourished children and teenagers described by height for age nutritional status indicator, most teeth were significantly erupted earlier than stunted except the lateral incisor which erupted earlier in stunted boys than well-nourished boys but the difference was not significantly accepted. The greatest difference of median eruption age of permanent teeth between well -nourished and stunted found in girls in the second molar tooth. Conclusions: Records indicated that the Iraqi children exhibit variation in their times of permanent teeth emergence when compared with other studies, and among well-nourished children and teenaged described by height for age nutritional status indicator, most teeth were significantly erupted earlier than stunted children and teenagers


Article
Efficacy of Papacarie in Reduction Total Bacterial Count in Comparison with the Conventional Rotary Method

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Background: The change in the concepts of cavity preparation and the development of reliable adhesive materials lead to the development of alternative methods of caries removal. Chemo-mechanical caries removal (CMCR) involves the chemical softening of carious dentin, followed by its removal with manual excavation. The present study was conducted to evaluate clinically the efficiency of caries removal using a new chemo-mechanical agent (Papacarie) compared to the conventional drilling method in reduction of total bacterial count. Material and methods: The study is a split mouth design. The sample composes from sixty mandibular deciduous molars teeth in thirty children, between six to nine years of age with bilateral class I deep occlusal carious lesions without pulp involvement. Samples of this study were classified into group A and B with thirteen teeth for each. In groupAtreatment by Papacárie while group B were treated by the conventional drilling method Results: The results showed significant different in total bacterial count in period after treatment with Papacarie as comparative with drill method for caries remove. Conclusions: It was concluded that Papacarie could be an effective caries removal method to treat children, particularly those who present with early childhood caries or management problems


Article
Personality Types in Relation to the Periodontal Health Status and Salivary Dehydroepiandrosterone among Teachers in Baghdad City

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Background: The individual differences in emotional and behavioral style can be examined through personality instruments. These differences may explain the health status of the individuals. The purpose of the present study was to assess the influence of Personality Types on gingival and periodontal health status among teachers in Baghdad city in relation to selected salivary hormone (Dehydroepiandrosterone). Materials and methods: Females teachers 534 of randomly selected schools were subjected to personality questionnaire using The Riso-Hudson Enneagram Type Indicator. Teachers were examined to estimate the periodontal status according to the Community Periodontal Index (CPI). A group of teachers were selected for salivary analysis of Dehydroepiandrosterone (DHEA). Results: Data analysis showed that the higher mean of scores was reported for the Helper personality Type among the sample. According to the maximum (CPI) code, significant difference was found in the mean values of Individualist Personality Type scores between the healthy periodontium (code 0) and calculus (code 2) of Community periodontal index. No significant correlation was found between salivary DHEA concentration (pg /ml) and the scores of the Nine Personality Types. No significant correlation was found between salivary DHEA concentration(pg/ml) and number of sextants for CPI codes. Conclusions: Personality Types could influence gingival and periodontal health status of the subjectsso that psychological interventions may be carried out to improve the oral hygiene condition of the population


Article
Dental Caries and Treatment Needs among Kindergarten Children in Al-Basrah Governorate/Iraq

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Background: Dental caries is a disease occurs in the world in both developed and developing countries, it is still widespread among children and it can be controlled but not eliminated , most of tooth loss occurs due to dental caries and its complications. The aim of this study was to estimate the occurrence, and severity of dental caries and treatment needs among kindergarten children in Al-Basrah governorate. Materials and methods: The sample consisted of 1000 kindergarten children at age of 4-5 years old (445 boys and 555 girls) from urban areas in Al-Basrah city. Diagnosis and recording of dental caries and treatment needs were done according to the criteria of WHO (1987). Results: The percentage of dental caries was (80.8%) of the total sample. The dmfs value was higher among boys compared to girls with no statistically significant difference (P>0.05).The dmfs value among 5 years old children were found to be higher than children aged 4 years with statistically highly significant difference (P< 0.01). The higher percentage of examined children was in need of one surface filling (71.6%) followed by those in need of preventive or fissure sealant (61.3%). Conclusions: A study revealed a high prevalence of dental caries was found among Kindergarten children in Al-Basrah governorate, thus there is a need for preventive programs among those children


Article
Effect of Black Cardamom Extracts on Mutans Streptococci in Comparison to Chlorhexidine Gluconate and De-ionized Water (In Vitro Study)

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Background: Spices and herbs have been used by many cultures to enhance the flavor and aroma of food and for their medicinal value. Black cardamom is one of these spices widely used in cooking because of its unique taste and powerful flavor. The aim of study was to test the effect of black cardamom on Mutans Streptococci in comparison to chlorhexidine gluconate (0.2%) and de-ionized water. Materials and methods: Dried fruits of black cardamom were extracted by using alcohol (70% ethanol). Saliva was collected from seven volunteers. Agar well technique with different concentrations of black cardamom extracts was used to test the sensitivities of Mutans Streptococci, as well black cardamom extracts effect on viable counts of Mutans Streptococci. Results: Mutans Streptococci was sensitive to different concentrations of alcohol extracts of black cardamom in vitro starting with (5%) to (40%) using agar well diffusion technique. Black cardamom was effective in inhibition of Mutans Streptococci but still weaker than chlorhexidine gluconate 0.2%. Highly significant reduction in the counts of bacteria was reported with cardamom extracts and CHX in comparison to neutral control after 2 hrs. Conclusions: Black cardamom showed an effect on Mutans Streptococci but still less than CHX


Article
Oral Health Status among Group of Patients with Juvenile Idiopathic Arthritis According to Duration of Illness and Age Group in Iraq

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Background: Juvenile idiopathic arthritis (JIA) is a chronic disease of childhood. Increased prevalence of periodontal disease and dental caries in juvenile idiopathic arthritis is due to difficulties in executing good oral hygiene. This study was conducted to assess oral health status in patients with Juvenile idiopathic arthritis according to age and duration of illness. Materials and methods: A research was conducted among Juvenile idiopathic arthritis patients attending Baghdad Teaching Hospital with different age and both gender, underwent a clinical evaluation of their dental and oral condition. Diagnosis of dental caries was done according to the criteria of WHO (1997). Dental plaque, gingival condition, calculus were assessed by PI/ GI/Cal I following the criteria of Silness and Loe (1964), Loe and Silness (1963), Ramfjord (1959) respectively . Results: The study showed the percentage of caries-free patients was 6.17%. Mean value of caries experience of primary teeth decreased with increasing age while caries experience of permanent teeth increased with increasing age, Pl and Cal indices mean values increased with increase age and difference was found significant. Mean value of dmft decreased with the disease advance and significant difference was found. Caries experience of permanent teeth increase with increase disease duration and difference was significant. Conclusion: The systemic effect of disease may impact on oral health


Article
Assessment of Enamel Surface after Debonding of Different Types of Esthetic Brackets (An In Vitro Study)

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Background: Debonding orthodontic brackets and removal of residual bonding material from the enamel surface include critical steps that may cause enamel damage. The aim of the present study was to evaluate and compare the site of bond failure and enamel surface damage after debonding of three types of esthetic brackets (composite, ceramic, sapphire) bonded with light cure composite and resin-modified glass ionomer adhesive. Materials and methods: Seventy two maxillary premolars teeth were divided into three groups each group consisted of 24 teeth according to the type of brackets. Each group was subdivided into two subgroups (12 teeth for each) according to the bonding material that was used. After 7 days of bonding procedure, the brackets were debonded using specifically designed debonding device in which the brackets were debonded by a debonding pliers to simulate the actual clinical debonding procedure. Instron Universal testing was used to apply the debonding force on the debonding pliers which transferred to the bracket. The teeth and the brackets were examined with a 10X magnifying lens to evaluate the site of failure. After the removal of residual adhesive, stereomicroscope was used to evaluate enamel surface damage. Results: The most common type of bond failure was cohesive failure (Score II) in all esthetic brackets. While enamel cracks (scale I) were found to be the most type of enamel damage. Chi- square showed non-significant differences among different types of esthetic bracket bonded with same type of adhesive and between the same types of brackets (ceramic, sapphire) bonded with the two types of adhesive. On the other hand, there was significant difference between composite brackets subgroups bonded with the two adhesives. Conclusion: The bond failure mostly within the adhesive itself and higher enamel damage was resulted from mechanical debonding of these esthetic brackets.


Article
Evaluation of Mandibular Third Molar Position by Using Space-Width Ratio Method

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Background: The prediction of changes in the mandibular third molar position and eruption is an important clinical concern because third molar retention may be beneficial for orthodontic anchorage. The aims of this study were to assess the mandibular third molar position by using medical CT scan and lateral reconstructed radiograph and evaluate gender differences. Materials and Methods: The sample of present study consisted of 39 patients (18 males and 21 females) with age range 11-15 years who were attending at Al-Suwayra General Hospital/ the Computerized Tomography department. The distance from anterior edge of ramus to distal surface of permanent mandibular second molar and mesio-distal width of developing mandibular third molar were measured in both three dimensional volumetric and two dimensional CT derived lateral images. The statistical analyses included: means, standard deviations. Paired t-test was used to compare between the two methods and independent t-test was used in verifying the genders difference. Results: The results showed that there was high significant method difference between 3D CT and 2D image and gender differences were observed in values of linear measurements of present study, as males showed higher mean values than females. Conclusion: There is high accuracy of measurement on CT images, so C.T. scan is advisable during the diagnosis and treatment plan of orthodontic cases


Article
Comparison of Bolton’s Ratios in a Sample of Iraqi and Egyptian Populations

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Background: The objective of this study was to investigate the possibility of standardizing the Bolton ratio analysis as a diagnostic measure for both Iraqi and Egyptian orthodontic populations within three Angle' classification groups. Materials and methods: Two hundred forty pretreatment study casts (one hundred twenty of each population) were included in this study and divided into three Angle' classification groups. The mesiodistal crown diameters of all teeth were measured for computing the anterior and total Bolton ratios. Analysis of variance was performed to compare the mean ratios of Bolton analysis as a function of the Angle classification.HSD test was used to specify the classes of malocclusion that have significant differences. Results: No statistically significant differences were determined in the mean values of the anterior ratio among the angle classification groups in both Iraqi and Egyptian populations. No statistically significant differences were determined in the mean values of the overall ratio among the angle classification groups in Iraqi population. While there were statistically significant differences in the mean values of overall ratio among the angle classification groups in Egyptian population. This difference is specified with in class II malocclusion of Egyptian population. Conclusion: Anterior Bolton ratio can be standardized for both Iraqi and Egyptian orthodontic populations. While the overall ratio can be standardized only in class I and III malocclusions of both populations

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