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:1

Article
Teeth Displacement and Palatal Adaptation of Autoclave Cured acrylic resin with Various Palates and Investments

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Background: The denture base inaccuracies during processing negatively influence the retention and stability of finished complete denture. The aims of this study were to evaluate teeth movement and palatal adaptation of autoclave cured denture bases and their relationship with palatal depths and investments. Materials and methods: A nightly maxillary complete dentures prepared, processed and organized to be tested as follows: 1. Processing methods: water bath and autoclave with both fast and slow cycles. 2. Palatal depth: shallow, medium and deep. 3. Investing medium: stone and silicone. For every finished denture, two measurements were done: first: teeth movement by attaching metallic reference screws on the right and left centrals, first premolars and second molars. Second: palatal adaptation by sectioning the posterior part of the denture and measuring the distances between five selected points which were on the right and left: ridge crest, center of the vestibule and middle of the palate. Then two measurements were done before and after curing by using travelling microscope of 0.001% of accuracy. The collected data organized statistically by three ways analysis of variance for curing methods, investments and palatal depth. Also, least significant test and t test for detection of difference. Results: High significant improvements in dimensional stability shows when autoclave was used compared with the water bath. Results show that autoclave curing reduces the amount of teeth movements and improves palatal adaptation with silicone investment compared with stone. Conclusions: resin curing by autoclave is a better alternative to water bath. The dimensional stability were improved especially when silicone were used instead of stone


Article
An Evaluation of Antimicrobial Efficacy of Steralium, co+steralium, and 5% Sodium Hypochlorite against Enterococcus Faecalis Biofilm Formed on Tooth Substrate: (An in Vitro Study)

Authors: Ayad M. Al-Kadhi
Pages: 11-16
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Background: Enterococcus faecalis is emerging as an important endodontic pathogen, which can persist in the environment for extended periods after treatment and may cause endodontic failure. It is known to produce biofilms, a community of bacteria enclosed within a protective polymeric matrix. This study aimed to establish whether the biofilm formation by Enterococcus faecalis can be inhibited with steralium, co+steralium, and 5% sodium hypochlorite in the root surface environment. Materials and Methods: Extracted human teeth were biomechanically prepared, vertically sectioned, placed in the tissue culture wells exposing the root canal surface to E. faecalis to form a biofilm. At the end of the 3rd and 6th weeks, all groups were treated for 10 minutes with the previously mentioned tested solutions and control and were analyzed qualitatively and quantitatively. Results: Qualitative assay with 3-weeks biofilm showed a complete inhibition of bacterial growth with co+steralium and NaOCl, except steralium and saline, which showed presence of bacterial growth. In quantitative analysis, steralium and saline- treated tooth samples have 57.74 ± 5.39* CFU/ml., 140.71 ± 8.49 CFU/ml. respectively. Qualitative assay with 6-week biofilm showed growth when treated with steralium and saline treated tooth samples have 346.0 ± 78.88* CFU/ml., 127.18 ± 17.84 CFU/ml. respectively whereas co+steralium and NaOCl has shown complete inhibition. Conclusions: co+steralium and 5% sodium hypochlorite showed maximum antibacterial activity against E. Faecalis biofilm formed on tooth substrate. co+steralium showed statistically significant antibacterial activity. The use of co+steralium as a root canal irrigant might prove to be advantageous considering the several undesirable characteristics of NaOCl


Article
The Effect of Pores in Dual Nano Hydroxyapatite Coating on Thermally Oxidized Commercial Pure Titanium: Mechanical and Histological Evaluation

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Background:In this study,TiO2 layer was thermally grown as a diffusion barrier on CP Ti substrate prior to electrophoretic deposition of HA coatings, to improve the coating’s compatibility also macro and micro pores in nano Hydroxyapatite dual coatings were created and their effect on the bond strength between the bone and implant was evaluated. Materials and methods: Electrophoretic Deposition technique (EPD) was used to obtain coatings for each one of four types of Hydroxyapatite(HA)on CP Ti screws (micro HA, nano HA, dual nano HA with micro pores, dual nano HA with macro pores) where carbon particles used as fugitive material to be removed by thermal treatment to create porosity.For examination of the changes occurred on the substrate, SEM, SPM and XRD used, coatings characterized by XRD, SEM and interfacial shear strength measurements. Results:The results mentioned the formation of rutilenano TiO2 with, SEM showed that the size of pores in HA coatings corresponded to the size of carbon particles. Statistical analysis of the removal torque tests showed highest means of the single nano HA coating at 2 and 4 weeks implantation intervals. Histological analysisrevealed a faster reaction of bone and higher osteoblasts activity towards thermally oxidized CP Ti implants coated with single nano HA coating. Conclusion:Carbon particles as a fugitive material within nano HA coat produced porosity.Presence of pores 1μ in nano HA coats did not achieve highest removal torque values nor highest osteoblasts activity in 2 and 4 weeks implantation intervals


Article
A Comparison between the Horizontal Condylar and Bennett Angles of Iraqi Full Mouth Rehabilitation Patients by Using Two Different Articulator Systems (An In-Vivo Study)

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Background: Errors of horizontal condylar inclinations and Bennett angles had largely affected the articulation of teeth and the pathways of cusps. The aim of this study was to estimate and compare between the horizontal condylar (protrusive) angles and Bennett angles of full mouth rehabilitation patients using two different articulator systems. Materials and Methods: Protrusive angles and Bennett angles of 50 adult males and females Iraqi TMD-free full mouth rehabilitation patients were estimated by using two different articulator systems. Arbitrary hinge axis location followed by protrusive angles and Bennett angles, estimation was done by a semiadjustable articulator system. A fully adjustable articulator system was utilized to locate the terminal hinge axis using a kinematic face bow followed by protrusive angles location by the aid of two square shaped transparent hard plastic protractors attached close to the condylar stylus of the articulator followed by Bennett angles calculation according to the Hanau formula. All results were subjected to statistical analyses. Results: The two articulator systems scored protrusive angles for male patients greater than female patients which were non-significant for the fully adjustable articulator but they were significant for the semiadjustable articulator. Non-significance existed between females of the fully adjustable articulator and males of the semiadjustable articulator while high significance was located between males of the fully adjustable articulator and females of the semiadjustable articulator. Concerning Bennett angles, the highest mean value belonged to the male group of the fully adjustable articulator, while the lowest scored by the female group of the semiadjustable articulator. Highly significant differences were located between the Bennett angle mean values of the groups. Conclusion: Using both articulators, the total mean values of the males were greater than the females regarding both horizontal condylar angles and Bennett angles with the total means scored by the fully adjustable articulator being larger than those of the semi-adjustable type. Using both articulators, the males' right and left condyles exhibited greater Bennett angles than their female equivalents. The precision estimation of the horizontal condylar angles and Bennett angles provided by the condylar axis protractors of the fully adjustable articulator render such type of articulators most suitable for treating full mouth rehabilitation cases


Article
The Effect of LED Light on Depth of Cure and Microhardness of Three Types of Bulkfill Composite

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Background: To evaluate the ISO depth of cure of bulkfill composites and depth of cure which determined by Vickers microhardness test. Materials and Methods: Bulkfill resin composite specimens (n=150) were prepared of three bulkfill composite materials (TetricEvo Ceram, Quixfil and SDR) and light cured by Flash max p3 for 3, 10, 20 seconds and by wood pecker for 10, 20 seconds respectively, a mold was filled with one of the three bulkfill composites and light cured. The specimens removed from the mold and scraped by plastic spatula and the remaining length (absolute length) was measured which represent the ISO depth of cure. After that the specimens were returned into the mold and a microhardness indentation device applied on the specimen and hardness measurements (Vickers hardness, VHN) were made at defined distance, beginning at the resin composite that had been closest to the light curing unit (i.e. at the top) and proceeding toward the uncured resin composite (i.e. toward the bottom) on the basis of the VHN measurement, Vickers hardness test generated for each group. Results and Conclusion: ISO depth of cure of bulkfill composite materials is time and type of light curing protocol dependent rather than type of material of bulkfill composite while the depth of cure determined by Vickers hardness number is material dependent in addition to the light curing protocol


Article
The Electrophoretic Deposition of Nano Al2O3 and AgNO3 on CpTi Dental Implant (An in vitro and in vivo study)

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Background: Even the wide use of dental implants, still there is a proportion of implants are failed due to infection. Much considerable attention has been paid to modify the implant surface. Coating of dental implant with a biocomposite material of suitable properties can improve osseointegration. And this is the main concern of this study. The aim of present study was to evaluate the use of a biocomposite coating of dental implant with (ceramic nano Al2O3 and metalic AgNo3) on the bond strength at bone – implant interface and tissue reaction. Materials and methods: A total number of forty-eight screws, CpTi dental implant used in this study. Half of these screws were coated with a biocomposite material of nano (Al2O3and AgNo3), this was done by using electrophoretic deposition method (EFD). In invitro part of the study, analysis of the coated surface was done using: X ray diffraction (XRD), atomic force microscope (AFM), Energy Dispersive X-ray spectroscopy (EDX), Optical microscopy and Scanning electron microscope (SEM). In invivo part of study, 10 white male New Zealand rabbits were used, and a screw type of dental implant [uncoated and coated with nano (Al2O3and AgNo3)] were implanted in each tibia of rabbit. Then biomechanical and Histological test were performed after 2 and 4 weeks healing intervals. Results: The results of biomechanical test showed a higher torque mean values of (M+SD):(14.91N.cm+2.7)and (22.5 N.cm +5.31) after 2 and 4 weeks respectively. In histological examination of coated screws at 2 weeks, there isa bone trabeculae occupies a base of implant bed with osteoblast andosteocyte. At 4 weeks, there is a progress in the healing process around dental implant, and this includes: -new bone with haversian canals, osteoblast and osteocyte. Conclusion: Biocomposite coating of dental implant with Alumina and silver nitrate can be made by electrophoretic deposition method (EPD), and a multifunctional surface has been created


Article
A Comparative Evaluation of the Centering Ability and Canal Transportation of Simulated S-Shaped Canals Instrumented with Different Nickel –Titanium Rotary Systems

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Background: The purpose of this study was to evaluate and compare centering ability and canal transportation of simulated S-shaped canals instrumented with four different types of rotary nickel-titanium systems. Materials and Methods: Forty simulated S-shaped canals in resin blocks were divided into four groups of ten each and were instrumented to an apical size 25 by different instrumentation technique using ProTaper Universal files (group A), ProTaperNext (group B), Reciproc (group C) and WaveOne (group D).Centering ability and canal transportation was measured at (11) measuring points from D0 to D10 bysuperimposion of the pre- and postoperative images obtained by using digital camera in standardized manner. An assessment of the canals shape was determined using Photoshop CS2 and AutoCAD software. The data were analyzed statistically using ANOVA and LSD test. Results: In terms of centering ratio values, there was no statistically significant difference among the four groups at the coronal portion of the canals, with ProTaper system showing the least centering ability at all levels except at apical foramen. At the apical curvature, the Reciproc and WaveOne groups showed better centering ability than ProTaperNext and the difference was statistically highly significant among them at these points, while at the coronal curvature the ProTaperNext showed better centering ability than Reciproc and WaveOne. Canal transportation was seen in all groups but the ProTaper systems showed more transportation values at almost levels when compared with the other groups with the least values by ProTaperNext at the coronal curvature and the least values by Reciproc and WaveOne at the apical curvature. Conclusions: Under the conditions of this study, ProtaperNext ,WaveOne and Reciproc instruments maintained the original curvature significantly better than ProTaperUniversal at almost levels. ProtaperNext showed a better shaping ability than Reciproc and WaveOne at the coronal curved section while at apical curved section Reciproc and WaveOne showed a better shaping ability than ProtaperNext


Article
A Comparison of the Effectiveness of Reciprocating System with Continuous Rotary Systems in Non-Surgical Endodontic Retreatment (An In vitro study)

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Background: Optimal root canal retreatment was required safe and efficient removal of filling material from root canal. The aim of this in vitro study was to compare the efficacy of reciprocating and continuous motion of four retreatment systems in removal of root canal filling material. Materials and Methods: Forty distal roots of the mandibular first molars teeth were used in this study, these roots were embedded in cold clear acrylic,roots were instrumented using crown down technique and rotary ProTaper systemize Sx to size F2 ,instrumentation were done with copiousirrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilledwater, roots were obturated with AH26 sealer and Protaper gutta-percha point F2 and medium fine accessory gutta-percha using lateral condensation technique,roots were left for 7 days with 100% humidity at 37ºC in an incubator. Roots were randomly divided into four groups according to technique used for removing the root filling material (ten teeth for each group): group I: reciprocating technique and Wave One system, group II: continuous technique and ProTaper retreatment system, group III: continuous technique and R-Endo system, group IV: continuous technique and D–RaCere treatment system. All the roots were radiographed before and after removal of gutta-percha from both bucco-lingual and mesiodistal directions using custom made platform and digital radiograph system RVG to havea digitized images. The total surface area of all root canals was measured before removal ofthe gutta-percha and the area of the remaining gutta-percha filling in the canals after retreatment procedure from both directions. These measurements were analyzed with Adobe Photoshop CS6 software, the percentage of removed gutta-percha calculated. Results: Statistical analysis was performed and the result showed group Ihad the highest mean values in removal of root canal filling material in both bucco-lingual and mesiodistal direction of dental radiograph and there were significant difference between group I and most of the other groups ,there were non significant difference between group II,group III and group IV. Conclusion: This study was showed all the used retreatment systems did notcompletely remove the root canal filling material. The reciprocating technique was most effective method for removing gutta-percha and sealer than continuous rotary technique


Article
Risk Factors of Oral Cancer and Potentially malignant disorders (PMDs) – Developing a High / Low Risk Profiling System

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Background: Oral squamous cell carcinoma (OSCC) remains a lethal and deforming disease, with a significant mortality and a rising incidence in younger and female patients. It is thus imperative to identify potential risk factors for OSCC and oral PMDs and to design an accurate data collection tool to try to identify patients at high risk of OSCC development. 14 factors consistently found to be associated with the pathogenesis of OSCC and oral PMDs. Eight of themwere identified as high risk (including tobacco, alcohol, betel quid, marijuana, genetic factors, age, diet and immunodeficiency) and 6 low risk (such as oral health, socioeconomic status, HPV, candida infection, alcoholic mouth wash and diabetes) were stratified according to severity of risk, associated carcinogenicity and clinicopathological effects, using evidence obtained from the International Agency for Research on Cancer (IARC). This review provides understanding of the significance of various risk factors in oral carcinogenesis to help to stratify patients, especially those with potentially malignant disorders, into high and low risk groups


Article
The Prevalence of Impacted Maxillary Canine among Iraqi Patients of Al-Basrah City

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Background: Impacted teeth are frequent problem and one of the most affected teeth is the maxillary canine. The early diagnosis of impacted canines by radiographic evaluation is imperative. The aim of this study was to determine the prevalence of impacted maxillary canines in patients attending the Oral diagnosis and Radiology clinic in College of Dentistry, University of Al-Basrah. Materials and Methods: 1280 patients attending the Oral Diagnosis and Radiology clinic in College of Dentistry University of Al-Basrah, between October 2013 and March 2015 were examined for the study. The age of the patients ranged from 15 to 55 years, with a mean age of 22.2 years. Results: The prevalence for maxillary impacted canines in all the cases was found to be 2.7%.The prevalence of impacted canines in males was 2.3% and in females was 3.2%. A higher number of impaction was seen on the left side of the maxillary arch; 57.1% compared to 37.2% on the right side. Unilateral impaction was seen in 94.3% whereas the bilateral impaction occurs in only (5.7%) of the patients. Conclusions: The prevalence of impacted maxillary canine in people attending the College of Dentistry, University of Al-Basrah is 2.7%.

Keywords

Canine --- impaction --- prevalence


Article
A Comparative Study of Clinicopathological and Immunohistochemical Expression of CD1a, RANK and RANKL in Langerhans Cell Histiocytosis of Jaw and Skull Lesions

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Background: Langerhans' cell histiocytosis (LCH) is a group of conditions affecting the reticuloendothelial system. It includes Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma and most often presents in childhood. Materials and methods: Twenty-five cases of LCH were diagnosed histologically and confirmed by CD1a antibody and assessed immunohistochemically using anti-RANKL and anti-RANK antibodies to evaluate osteoclastogenic mechanism. Results: Regarding jaw cases, there was a significant correlation between CD1a and RANK (P=0.016). While in the skull, highly significant correlation existed between RANK and RANKL (p=0.001). Among the sites, there was no statistically significant difference found for each the immunohistochemical markers used. Conclusion: LCH of jaws and skull bear similar osteoclastogenic mechanism when quantified with RANK and RANKL immunostaining respectively. With a significant correlation between CD1a and RANK for jaw cases, while in the skull lesions, there was a high significant correlation between RANK and RANKL.


Article
Cephalometric Study of Iraqi Adult Subjects with Cl I and Cl III Skeletal Relationships and Their Effects on Masseter Muscle Thickness by Using Ultrasonography

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Background: Masseter muscle is one of the most obvious muscles of mastication and considered as one indicator of jaw muscle activity. It has a major influence on the transverse growth of the midface and the vertical growth of the mandible. This study undertaken to determine the role of cephalometric analysis for discrimination between Cl I and Cl III skeletal relationships, determine the role of ultrasonography in determination of masseter muscle thickness, compare masseter muscle thickness between Cl I and Cl III skeletal relationships, and determine the effect of gender on masseter muscle thickness. Material and Method: The sample of the current study consisted of 70 Iraqi subjects 40 males and 30 females with age ranging 18-25 years. They were divided into 2 groups depending on ANB angle: class I skeletal relationship 20 males and 15 females and class III skeletal relationship 20 males and 15 females. The collected sample included patients attended for different diagnostic purposes to the Dental Radiology Department at College of Dentistry/Babylon University, standardized lateral cephalogram was taken to determine facial morphology, six angular and eight linear measurements were assessed. Masseter muscle thickness measured ultrasonography in Al-Hilla General Teaching Hospital/Ultrasonorgaphic Department, in relaxation and contraction conditions for both sides. Results: Various parameters measured for males and females in each class and the comparison shown statistically significant differences between them (P<0.05). No difference in muscle thickness between right and left sides in the same class (P>0.05). Gender variation showed significant difference in masseter muscle thickness during rest and occlusion conditions (P<0.001). Conclusion: Cephalometric analysis served to demonstrate the skeletal morphologies and provide a base for discrimination between class I and class III skeletal relationships. Ultrasonographic scanning is an important imaging procedure. It is reproducible and simple method for accurately measuring masseter muscle thickness. The ultrasonorgaphic study has revealed variations in masseter muscle thickness among individuals with different skeletal morphologies in each gender on one hand and between males and females in each skeletal class on the other hand.


Article
A Comparative Immunohistochemical Expression of Cyclin D1 in Keratocystic Odontogenic Tumor, Dentigerous and Radicular Cysts

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Background: Odontogenic cysts include a group of osseodestructive lesions that frequently affect the jaws. Those cysts could derive from odontogenic epithelium and occur in the tooth-bearing regions of the jaws. The aims of this study were to evaluate the immunohistochemical expression of Cyclin D1 in Keratocystic Odontogenic Tumor, Dentigerous cyst and Radicular cyst in epithelium and connective tissue capsule. Materials and Methods: In this study, thirty formalin fixed paraffin embedded tissue blocks of Odontogenic cysts and Tumor, consist of 14 Keratocystic Odontogenic Tumor, 8 dentigerous cysts and 8 radicular cysts were analyzed immunohistochemically for the presence of Cyclin D1 proteins. Results: Strong to moderate expression of Cyclin D1 in epithelium was found in Keratocystic Odontogenic Tumor cases with positive cases percentage was (85.7%). Statistical significant differences (P<0.001) observed when comparing the three lesions. Immunoreactivity of Cyclin D1 in stroma of Keratocystic Odontogenic Tumor was higher than in dentigerous cysts and radicular cysts cases. However, the difference was not statistically significant (P<0.067). Conclusion: The results of this study propose that high expression rate of Cyclin D1 might be one of the reasons for aggressive behavior of Keratocystic Odontogenic Tumor and high recurrence rate


Article
Cone Beam Computed Tomography in an Evaluation and Diagnosis of Anatomical Variations and Pathological Lesions in Maxillary Sinus Prior to Maxillary Sinus Lift Surgery

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Abstract: Thorough assessment of the maxillary sinus is very important. Recently 3-dimensional image with Cone Beam Computed Tomography (CBCT) is very dependable in Maxillary Sinus diagnosis. The aim of this study is to: shade light on the role of (CBCT) diagnosis of the maxillary sinus anatomical variation and pathological finding among smokers and nonsmokers prior to maxillary sinus lift techniques. Materials and Method: In this study 60 males with age ranged between 20-50 years old, referred for (CBCT) assessment of maxillary sinus in the Specialist Health Center of Al-Sadder city. The scanning were performed using Kodak 9500 (CBCT), the KV was 90, mA10 and scanning time 10 s. Voxel size 0.3mm with( DICOM ) software on a multiplaner reconstruction window in which the axial, coronal and sagittal plane could be visualized in 0.3 mm interval, 40 were smokers and 20 nonsmokers, both sides were evaluated to assess the presence of septa, maxillary sinus membrane (Schneiderian membrane)thickening, complete opacification and adenoid polyp. Result:The maxillary for nonsmoker patients (20) patients were clean and have no any pathological or anatomical changes, among smoker patients, it was found that 7 (17.5%) of them had a clean maxillary sinus, 25 (62.5%) patient from smokers, the mucosal thickening was clear and measured more than 4 mm, 20 (80%) of them bilateral maxillary sinus were involved and 5 (20%) of them have a unilateral thickening, 6 (15%) of the smoker patient have bilateral involved adenoid with max sinus, and 2(5%) of them have full opacification., no septa was found in this study. Conclusion:Cone Beam Computed Tomography(CBCT)was themost useful technique to diagnose maxillary sinusbefore maxillary sinus augmentation, an evaluation ofCone Beam Computed Tomography(CBCT)scans before implant surgery or sinus augmentation procedures has extreme clinical importance in evaluation of anatomic structures, such as thickening of the Schneiderian membrane and presence of pathological lesion such as adenoid polyp.


Article
Interleukine-6 Level in Saliva of Patients with Chronic Periodontitis: A Case-Control Study

Authors: Haween T. Nanakaly
Pages: 103-108
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Background:Periodontal diseases are infectious diseases in which periodontalpathogens trigger chronic inflammatory and immune responses. Interleukine-6 is a multifunctional cytokine playing a central role in inflammation and tissue injury.The aim of the study IS to determine the level of Interleukin-6(IL-6) in saliva of patients with chronic periodontitis compared to healthy subjects. Materials and Methods:The total subjects of the present study is 60, divided into 3 groups; 20 patients with chronic periodontitis with pocket depth(PD ≥4 mm)(group I), 20 patients with pocket depth(PD <4 mm) with clinical attachment loss (group II), and 20 healthy controls with pocket probing depth (PPD ≤ 3 mm) without clinical attachment loss (group III). Un-stimulated salivary sample was taken from each subject and was investigated for the presence of Interleukine-6by using Enzyme‑linked Immunosorbent Assay (ELISA) technology. Results:Mean IL-6 levels in saliva in patients with chronic periodontitis (98.40 ± 18.44 ng/L)was significantly higher than in controls (11.67 ± 3.32; p=0.001). Also a significant difference in IL-6 levels in saliva was observed between the PPD ≥ 4 mm and PPD < 4 mm groups and between PPD ≥ 4 mm and control groups, as well as statistically significant differences were observed between PPD < 4 mm and control groups (P < 0.001). Conclusion:The Interleukine-6 level in saliva can be considered as one of inflammatory biomarker indicators of severity of periodontitis


Article
An Assessment of the Efficacy of Sinus Balloon Technique on Transcrestal Maxillary Sinus Floor Elevation Surgery

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the invasiveness of modified Caldwell-Luc (lateral approach) and the drawbacks of the osteotome (summers' technique) in maxillary sinus floor elevation surgery. Materials and methods: A total of 13 adult Iraqi patients aged 28-55 years, 4 males and 9 females underwent sinus floor elevation surgery via crestal approach by using sinus balloon technique. A panoramic radiograph and (Cone beam computed tomography (CBCT)/or medical CT scan) were obtained before and after surgery. Postoperative gained bone was assessed and the patient reactions including pain, nasal bleeding, and ecchymosis were recorded. The whole follow up period was 1year following the sinus lift surgery. Results:The total performed sinus floor elevation cases were 17 with a total of 27 sinus floor elevation sites. The maximum gained bone with sinus balloon technique was 10.6 mm. Twenty three dental implants placed in augmented maxillary sinuses, two implants early failed 8.70 % and the survival rate of the dental implants was (91.30 %). Schneider's membrane perforation didn’t occur in any case of this study 0%. Conclusion: Sinus floor elevation via crestal approach using the balloon technique solve the limitations for original osteotome technique (summers' technique) for cases even when the subantral bone height is less than 3 mm. The utilization of hydraulic pressure in combination with balloon technique also shows a great role in both sinus membrane elevation and as a diagnostic aid of Schneider's membrane perforation


Article
Salivary α-Amylase and Albumin Levels in Patients with Chronic Periodontitis and Poorly or Well Controlled Type II Diabetes Mellitus

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Background: Recent studies suggest that chronic periodontitis (CP) and type2 diabetes mellitus (T2DM) are bidirectionally associated. Analysis of saliva as a mirror of oral and systemic health could allow identification of α amylase (α-Am) and albumin (A1) antioxidant system markers to assist in the diagnosis and monitoring of both diseases. The present study aims at comparing the clinical periodontal parameters in chronic periodontitis patients with poorly or well controlled Type 2Diabetes Mellitus, salivary α-Am, A1, flow rate (FR) and pH then correlate between biochemical, physical and clinical periodontal parameters of each study and control groups. Materials and Methods: 80 males, with an age range of (35-50) years were divided into four groups, (20 subjects each): two groups had well or poorly controlled Type 2Diabetes Mellitus both of them with chronic periodontitis, group of patients with only chronic periodontitis and control group with healthy periodontium and systemically healthy. From all subjects unstimulated whole salivary samples were collected to measure FR, pH, Al and α – Am, then clinical periodontal parameters (plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment level)were recorded. Results: Patients had chronic periodontitis with poorly controlled Type 2Diabetes Mellitus demonstrated the highest median values of all clinical periodontal parameters and highest increase in levels of salivary α-Am and Al with lowest median values of FR and pH, in addition to the highly significant differences among the study and control groups regarding biochemical and physical parameters. Positive correlations were revealed between α-Am with Al and both of them with all clinical periodontal parameters but, they were negative with FR and pH. Conclusion: Patients with poor glycemic control had more severe periodontal tissue break down with decrease in FR and pH also obvious increase in levels of A1 and α- Am so, these biochemical markers will provide an objective phenotype to allow practitioners for early diagnosis, which is essential for improved prognosis and effective delay of clinical complications associated with chronic periodontitis and DM and an important strategy to lower the incidence of both diseases world wide


Article
The Uses of Pedicled buccal Pad of Fat Flap in Reconstruction of Intra Oral Defects

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Introduction: Different surgical techniques used for closure of various oral defects. While each one of these techniques has its limitation; the buccal pad of fat used in last quarter of last century as pedicle or free graft in reconstruction of small to medium, congenital and acquired defects showed good potentials for success. The present study used the BPF as pedicled flap to reconstruct intra oral defects. The study aimed to evaluate of the success of buccal pad of fat pedicled flap in the reconstruction of intra oral defects. Outlining its indications, limitations and complications. Materials and Methods: The study included 19 patients (17 males and 2 females) with age range between (1- 70 years), all patients were treated with pedicled BPF for intra oral defects (8 pts. with oro-antral communications, 5pts. with maxillary alveolar bone defects, 4 pts. with cleft palate, and 2 pts. with carcinoma of buccal mucosa), under general or local anesthesia. Follow-up period was for 3 months post-operatively, Results:The results showed that 94.7% of patients had complete epithelization of flap and complete closure of the defect within 4-6 weeks. Only 1 pt. 5.3% had total flap loss with very small size of the BPF. In postoperative period, 5.3% of pts. complained from pain, trismus, vestibular obliteration, partial flap loss, all disappeared gradually within 1 month from the reconstruction. Conclusion:The BPF is reliable, easy, safe method to reconstruct small and medium size intra oral defects of maximum size 5x4x3 cm, in maxilla from upper canine region to the soft palate, and in buccal mucosa from retro molar area to the commissure of the mouth


Article
An Evaluation of the Effectiveness of Coenzyme Q10 Gel in Management of Patients with Chronic Periodontitis (II inter group comparison)

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Background: Anti-oxidants are used as supplements to counteract the over production of free radicals in periodontal disease.Co-Q10 functions as an intercellular antioxidant by acting as a primary scavenger of free radicals (FRs) and reactive oxygen species (ROS), this study aimed to evaluate the effect of intra pocket application of perio Q gel (coenzyme Q10) alone and as adjunct to scaling and root planing on the periodontal clinical parameters in the treatment of patients with chronic periodontitis and compare the better improvement on the clinical periodontal parameters among different treatment modalities at 3 and 6 weeks. Materials and methods: A total of 323 sites with pocket depth (5-8) mm in patients with chronic periodontitis were randomly divided into three groups. The Gel group, 111 sites were treated with intra-pocket application of Perio Q gel alone. In the Combination group, 106 sites were treated with scaling and root planning (SRP) plus intra- pocket application of Perio Q gel, in Scaling and root planing group, 106 sites were treated with scaling and root planing alone. Clinical periodontal parameters such as Plaque index (PI), Gingival index (GI), Bleeding on probing (BOP), Probing pocket depth (PPD), Relative attachment level (RAL) were assessed at first visit, 3weeks and 6weeks. Results: Inter-group analysis, showed significant reduction in the clinical parameters PPD and RAL of combination group in comparison to SRP group. Conclusion: Better improvement of the clinical periodontal parameters had been achieved by using the gel in combination with scaling and root planing instead of using scaling and root planing only


Article
The Soft Tissue Changes Following Orthodontic Treatment of Bimaxillary Protrusion (A Clinical and Photographical Study)

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Background: Bimaxillary protrusion is considered as one of the most important causes to seek the orthodontic treatment to get better esthetics. This study aimed to test the effect of orthodontic treatment in improvement the facial esthetics. Materials and Methods: Ten Iraqi Arab females having bimaxillary protrusion based on Class I malocclusions treated with fixed orthodontic appliance and extraction of the maxillary and mandibular 1st permanent premolars. Pre and post-treatment facial profile photographs were taken for each patients and the effect of treatment was tested in comparison with the pre-treatment photographs by using seven angular measurements. Results: After treatment, the upper and lower lip projections were decreased significantly, the naso-labial and mento-labial angles were increased significantly. Conclusion: Treatment of bimaxillary protrusion with fixed orthodontic appliances and extraction of four premolars improve the facial esthetics of the patients by decreasing the lip projection and increasing the naso-labial and mento-labial angles


Article
The Salivary Inflammatory Biomarkers (Interleukin-6, C - reactive protein) in Relation with Caries-Experience among a Group of 12 Year Old Obese Boys

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Background: Obesity and dental caries are multifactorial diseases related to poor eating habits and show a close relationship with the sociodemographic characteristics of individuals presenting these diseases. This research aimed to investigate the severity of dental caries among group of obese boys aged 12 year in relation to salivary interleukin- 6 (IL-6) and C-reactive protein (CRP) of unstimulated whole saliva in comparison with normal weighted boys of the same age. Materials and Methods: The study group included 40 obese boys, with an age of 12 year. The control group included 40 normal weighted boys of the same age. The total sample involved for nutritional status assessment using Body Mass Index specific for age and gender according to CDC growth chart (2000). The diagnosis and recording of dental caries conducted by using (D1-4MFS and d1-4mfs) index according to the criteria of Muhlemann (1976). The collection of unstimulated whole saliva was performed under standardized condition. Salivary samples were chemically analyzed for measuring IL-6 and CRP. Results: The caries experience among study group was lower than that among control group for both dentitions, with significant differences for D2, ds and dmfs and highly significant difference for d4. Salivary inflammatory biomarkers (IL-6, hs-CRP) were slightly higher among study group compared with control group with no significant difference between them. Salivary IL-6 and hs-CRP were negatively correlated with dental caries of both dentitions among study group with significant correlation between IL-6 and D2, while they were correlated positively with dental caries of both dentitions among control group with highly significant correlation between IL-6 and D3 and significant correlation between IL-6 and d4. Conclusion: Obesity and dental caries are associated with increased levels of salivary interleukine-6 and C-reactive protein, this making both obesity and dental caries as a state of inflammation that exacerbating immune responses in the body


Article
The Fluoride Concentration of Bottled Drinking Water in Al-Basra City, Iraq

Authors: Baha'a A. Jeri
Pages: 143-146
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Abstract

Background: This study aimed to determine the amount of fluoride in commercially available bottled drinking water in Al-Basra city, Iraq Materials and Methods: Eleven brands of bottled drinking water were obtained from supermarkets in Al-Basra city, Iraq. Five samples of 10 ml. were taking from each one of brands and the fluoride was determined by using fluoride ion selective electrode. Results: The highest fluoride concentration was present in BADIOT brand (1.174 mg/L) while the lowest was in Barakat brand (0.038 mg/L). One way ANOVA test showed a highley significant difference among different commercially branded types. Coclusions: Bottled water available in Al-Basra city contains less concentration of fluoride ion than normal values because there is no adding of fluoride to the water.

Keywords

Bottled water --- fluoride --- Al-Basra --- Iraq


Article
Nutritional Status among a Group of Preschool Children in Relation to Concentration of Selected Elements in Saliva and Caries Severity (A Comparative Study)

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Background: Nutritional status during childhood is very important for individual development and growth. Nutrition has local and systemic effect on the oral health by affecting dental health and salivary composition. This study was aimed to determine effect of iron, sodium and potassium ions in saliva on the nutritional status and to determine the effect of nutritional status on caries severity among preschool children. Material and Methods: The sample consists of 90 children aged 4 and 5 years of both genders, selected from 6 kindergartens in Al-Resafa aspect of Baghdad province. Children classified according to their nutritional status into three groups (normalweight, underweight and overweight). Nutritional status was determined by using body mass index BMI that achieved from height and weight (weight (Kg)/height (m)2). Assessment and recording of caries experience was done by the application of decayed, missing, filled index (dmfs for primary teeth). The diagnosis of dental caries was done according to (d1-4 mfs) criteria for primary teeth. Stimulated saliva was collected from children between 9-11 AM under standardized conditions and chemically analyzed to determine the concentration of iron, sodium and potassium calorimetrically by using ready-made kits and spectrophotometer machine. Data were analyzed using SPSS version 19. Results: Concentration of sodium, potassium and iron ions were (46.64 mg/dl ± 18.00, 31.22 mg/dl ± 9.84, 17.76μg/dl ± 3.17) respectively. From the elements measured in saliva only sodium ions recorded statistically significant difference among the three groups of nutritional status. By application of LSD, the significant difference was found to be between normal weight and overweight groups (46.33 mg/dl ± 17.18, 40.64 mg/dl ± 14.79) respectively (P<0.05). Furthermore, positive and statistically significant correlations were recorded between sodium ions with BMI mean of overweight group on one hand (r=- 0.125, P<0.05) and iron ions and normal weight group on other hand (r=0.362, P<0.05). Recording and diagnosis of dental caries showed that means of ds, ms, dmfs, d2s and d4s were significantly higher among children aged 5 years than those aged 4 years. In addition to that means of ds, ms, dmfs and d2s were significantly differ among the three groups of nutrition. Application of LSD test showed that those means were higher among underweight group than others. Conclusion: Concentration of sodium ions in saliva changed according to nutritional status. On the other hand nutritional status may affect caries severity, where underweight children suffering from dental caries more than normalweight and overweight children.


Article
An Evaluation of Corrosion Pits in Esthetic Coated Stainless Steel Orthodontic Archwires in Dry and Wet Environment at Different Intervals (An In Vitro Study)

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Background: The demand for esthetic orthodontic appliances is increasing; so the esthetic orthodontic archwires were introduced. Among them, Teflon and Epoxy coated stainless steel archwires. The amount of force available from the archwire depends on the structural properties and susceptibility to corrosion. All metallic alloys are changed during immersion in artificial saliva, chlorhexidine mouthwash andtoothpaste, but their behaviors differ from one type to another. They corrode at different rates, which lead to decrease the amount of force applied to the teeth. This in vitro study was designed to evaluate the corrosion pits in stainless steel archwires coated with Teflon and with Epoxy in dry and after immersion in artificial saliva, chlorhexidine(0.2%) (Parodontax) and toothpaste media (Sensodyne) for (1, 7 and 28) days intervals. Moreover, this study is intended to compare the corrosion pits for each type of archwires at these different media among all intervals. Materials and Methods: In this study, two hundred forty pieces of orthodontic wires of Teflon (Hubit) coated Stainless steel (120 pieces) and epoxy (Orthotechnology) coated Stainless steel (120 pieces), rectangular in cross section, size (0.019 x 0.025) inch and 15mm in length divided into four groups according to immersion media: (dry environment group, artificial saliva group, chlorhexidine group and toothpaste group). The atomic force microscope was used to measure the corrosion pits for all samples at dry and wet conditions and after different immersion periods. Results: Statistical analysis showed that there was a highly significant increase in the corrosion pits of Teflon coated stainless steel archwires (P ≤ 0.05) in wet environment at 28 days immersion period.The highest corrosion pits were found in the toothpaste medium for the two archwire types at 28 days immersion period. Conclusion: We can conclude that Epoxy coatedstainless steel archwires are indicated to be used above Teflon coated stainless steel archwires in terms of corrosion resistance. IfTeflon coated stainless steel archwires should to be used, they should be change in shorter periods than Epoxy coated stainless steel archwires type


Article
In Vitro Evaluation of Shear Bond Strength of Sapphire Brackets after Dental Bleaching

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Background: The present study was conducted to evaluate the effects of different bleaching methods on the shear bond strength of orthodontic Sapphire brackets bonded to human premolars teeth using light cured composite resin and to determine the predominant site of bond failure. Materials and Methods: Thirty freshly extracted human premolars were selected and randomly divided into three groups (10 per group). These groups are: control (unbleached) group, hydrogen peroxide group (HP) 37.5% ; which is the in- office bleaching method group, carbamide peroxide group (CP) 16%; which is the at- home bleaching method group. After bleaching process was performed, all the teeth stored in distilled water in a sealed container at room temperature for 24 hours before bonding was initiated, then orthodontic brackets were bonded with a light cure composite resin, stored in distilled water at room temperature for another 24 hours before debonding then the brackets de-bonded and tested for shear bond strength using an Instron universal testing machine. For adhesive remnant index (ARI) the enamel surface and bracket base of each tooth were inspected under magnifying lens (20X) of a stereomicroscope. Results and Conclusions: Non-statistically significant differences of shear bond strengths were found between the control group and the bleached groups, the dental bleaching in both methods did not affect the SBS of Sapphire brackets. The mode of failure was mostly between the adhesive and the enamel and the bond failure between the bracket base and the adhesive were also observed


Article
Color Stability of Different Aesthetic Archwires (An In vitro study)

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Background: Coated aesthetic archwires are currently the existing solutions for the esthetic problem, but the color of these archwires tends to change overtime. This study was aimed to evaluate the color stability of different types of esthetic archwires from four different companies at different time periods after immersion of two different staining drinks which are tea and Pepsi cola. Materials and methods: 48 specimens were prepared, each specimen contains 10 aesthetic archwires; and were divided according to type of solution into two groups: A (tea) &B (Pepsi cola); each group contained 24 specimens (12 specimens were immersed in the staining solution as 4 specimens for each time intervals and 12 specimens were immersed in distilled water as control group). Each subgroup contains one specimen from each company. Color measurements were performed by means of a computed spectrophotometer according to the Commission Internationale de I’Eclairage L*a*b* system, and color changes (ΔE*) and National Bureau of Standards units. Results: Both staining solution caused color change in variable degree and the higher amount of color instability was found for the archwires from the Hubit Company while the least amount of color change was for the archwires from the Orthotechnology Company. Conclusion: The tea caused highly significant change on the aesthetic archwires which is higher than the effect of the Pepsi cola


Article
The Effect of Multi-Wall Carbon Nanotubes on the Microhardness of the Tooth Enamel

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Background: The objectives of this study are to evaluate the effect of addition of Multi-Wall Carbon Nano Tubes (MWCNTs) of different concentrations (0.05 mg.mL-1,0.25 mg.mL-1,0.5 mg.mL-1and1 mg.mL-1) on dimethyl sulphoxide DMSO and distilled water (DW) on tooth enamel. It intends to evaluate enamel microhardness in (Kg. m-2) pre and post the application of Multi-Wall Carbon Nano Tubes (MWCNTs). Materials and Methods: Thirty specimens prepared for the present study to measure the hardness of the enamel. Results: The results showed that a significant increase in the enamel microhardness for groups 0.05 mg/mL (group B), 0.25 mg/mL (group C), 0.5 mg/mL (group D) and 1 mg/mL (group E) compared with control group (group A) in dimethyl sulphoxide media. Also, the results showed a significant increase in the enamel microhardness for polished samples compared with unpolished samples in DMSO media. Conclusion: The final conclusion highest mean value obtained was 1 mg/mL (group E) in the enamel microhardness suspension in and dimethyl sulphoxide media.


Article
An In Vitro Evaluation of the Effectiveness of Gotu Kola (Centella asiatica) on Inhibiting the Growth of Selected Microorganisms in Human Saliva

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Background: Gotu Kola (Centella asiatica) has been used as a traditional medicine for many years to cure different kinds of diseases. Studies have been reported that Gotu Kola extracts might be used as a cure for oral diseases such as periodontal disease. In the present study, Gotu Kola leaves extracted with water will be used to evaluate its effect on some microorganisms living in the human saliva using minimum inhibitory concentration (MIC) method. Material and Method:Gotu Kola fresh leaves extract have been used with water as a solvent, a rotary evaporator was used to separate the solvent from the extract. The following microorganisms: Streptococci, Lactobacilli, and Staphylococcus aureus have been isolated fromthe Saliva of ten volunteers participated in the present study. Nutrient broth tubes have been prepared for MIC test, where various concentrations of the Gotu Kola extracts (0.5mg/ml, 1 mg/ml, 2 mg/ml, 3 mg/ml, 4 mg/ml, and 5 mg/ml) were added, respectively. The tubes incubated at 370C for 48h. Results:The MIC test shows that a concentration of 4 mg/ml have the ability to inhibit the growth of oral Lactobacilli and 8 mg/ml has the ability to inhibit the growth of S. aureuswhich may be due to asiaticoside and asiatic acid which are active ingredients that the leaves extracts consists of. There was no MIC for Streptococci. Conclusion:The Gotu Kola leaves extract can be used to inhibit the growth of some oral microorganisms at certain concentration.


Article
The Prevalence of Oral Protozoa Trichomona Stenax in some Patients with Gingivitis

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Background:As arelationshipbetween gingivitis disease and the presence of the oral protozoa Trichomonastenax has been represented byconsiderable differences among various study population.The purpose of present study is determining the prevalence of T.tenax in patients with gingivitis and healthy subjects. Subjects,Materials and Methods:The presence of the parasite has been diagnosed with 58 patients withgingivitisand 58 healthy persons during the period of the study(April and May 2015) by taken two swabs for each one,microscopic examination was done using saline wet mount method and stained method. Age, sex and brushing teeth habit were in a count. Statistical analysis was done by SPSS program. Results:Gingivitis disease was observed in 58patients among the total 163 examined subjects(35.58%)with a highly significant differences P<0.01 recorded between males and females(40.22%,30.26% respectively).The prevalence of T.tenax in gingivitis patients was higher than healthy(56.89%,6.89%)respectively. According to gender and age the highly prevalence rate was demonstrated in males (62.85%)and in the age category 51-60 years old (92.8%). Data analysis showed that a highly significant differences P<0.01was demonstrated in the prevalence rate between brushing teeth users 29.1% and non-brushing teeth users 11.9%. Conclusion:The study confirmed the existence of a relationship between parasite infection and gingivitis disease where the higher prevalence of T.tenaxwas found in gingivitis patients compared with healthy controls. People should receive dental care togain high hygiene oral cavity and have low infection to T.tenax


Article
An Antimicrobial Activity of Moringa Oleifera Extract in Comparison to Chlorhexidine Gluconate (In vitro study)

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Background: Oral diseases persist to be a major health problem all over the world. Various bacteria and fungi are found to be the possible pathogensresponsible for the oral diseases. Moringa oleifera it is an extraordinary nutritious vegetable tree with many different uses. These leaves have high medicinal value. In the present study, antibacterial and antifungal activities of aqueous extracts of plant Moringa oleifera in comparison to chlorohexidene gluconate and deionized water were determined. Materials and methods: The leaves of plant of Moringa oleifera were collected from College of Pharmacy; Baghdad, Iraq. Tested microorganism (bacterial and fungal) was isolated from different clinical specimens. In-vitroantimicrobial activity was performed by agar well diffusion method on Muller Hinton agar medium. Results: The water extract of Moringa oleiferashowed antibacterial effect on the tested organisms: Staphylococcus aureus, Streptococcus spp. and Enterococcus faecalis. Aqueous extract showed maximum zone of inhibition against S.aureus. Conclusion: Moringa olifera can be used as safe and cheap plant antimicrobial agent

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