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: 2015 volume:27 issue:2

Article
The antibacterial effect of herbal alternative, green tea and Salvadora Persica (Siwak) extracts on Entercoccus faecalis

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Background: Disinfection and shaping of the canal with a combination of chemical agents and endodontic instruments play an important role in the success of endodontic therapy. Eliminating the microorganisms within the pulp space is a critical and important objective in treating a tooth with apical periodontitis. This study was conducted to evaluate the antibacterial properties of herbal alternatives (Green tea and siwak extracts) as possible irrigants during endodontic treatment compared with the conventional irrigation solutions. Materials and methods: Salvadora Persica (siwak) and Green Tea solutions were prepared.An agar diffusion test was performed on Mueller-Hinton agar using the well diffusion method. The tested solutions (5.25% NaOCl, 2% Chlorhexidine gluconate, 5% Siwak extract and 5% Green tea extract)were used to fill the wells that were made in the agar media respectively.Plates were left to incubate for 24 hr. at 37°C. Zones of inhibition of the bacterial growth were calculated to measure the antibacterial effect of the tested irrigants. Results: Sodium hypochlorite had the highest mean value (29.88) followed by Chlorhexidine which had a mean value of (26.13), Siwak with mean value of (11.25) and Green tea being the least with mean value of (8.88). ANOVA test showed a highly statistical difference with a P-value of (0.000). Conclusions: NaOCl still the superior irrigant than other irrigants. Herbal alternatives (Siwak and Green tea) can be used as possible irrigants solution to disinfect the root canal system from Enterococcus faecalis during endodontic treatments.


Article
The effect of glass flakes reinforcement on the surface hardness and surface roughness of heat-cured poly (methyl methacrylate) denture base material

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Background: Heat-cured poly (methyl methacrylate) the principal material for the fabrication of denture base have a relatively poor mechanical properties. The aim of this study was to investigate the effect of glass flakes used as reinforcement on the surface hardness and surface roughness of the heat-processed acrylic resin material. Material and method: Glass flakes (product code: GF002) pretreated with silane coupling agent were added to Triplex® denture base powder using different concentrations. A total of 100 specimens of similar dimensions (65 x 10 x 2.5) mm were prepared, subdivided into 2 main groups of 50 specimens for each of the study tests. Ten specimens for the control group and 40 specimens for each of the experimental groups (2%, 3%, 5%, and 7%) glass flakes content. The surface hardness was evaluated using the Shore D hardness test, while the surface roughness was evaluated using a profilometer device that detect the geometry of the specimen unpolished surface. Results were analyzed using the Wilcoxon rank sum test and the 1-way analysis of variance, (P-value< 0.05). Results: The surface hardness tended to increase significantly p 0.05 with the increasing flakes concentration, as an increase of 5.12% was recorded in surface hardness for the highest loading level; while the roughness showed a significant increase that remained within the tolerable range –less than 2μm– (significant bacterial colonization would occur if the surface roughness is more than 2μm). Conclusion: The addition of glass flakes to heat-cured poly(methyl methacrylate) enhanced the hardness of the material, the improvement was statistically significant for the higher glass flakes concentrations (5% and7%), while for the surface roughness there were a constant increase in roughness along with the increasing glass flakes content


Article
A study to compare the cleaning efficiency of different irrigation systems for macro debris removal in instrumented canals (An in vitro study)

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Background: Irrigation of the canal system permits removal of residual tissue in the canal anatomy that cannot be reached by instrumentation of the main canals so the aim of this study was to compare and evaluate the efficiency of conventional irrigation system, endoactivator sonic irrigation system,P5 Newtron Satelec passive ultrasonic irrigation and Endovac irrigation system in removing of dentin debris at three levels of root canals and to compare the percentage of dentin debris among the three levels for each irrigation system. Materials and methods: Forty extracted premolars with approximately straight single root canals were randomly distributed into 4 tested groups of 10 teeth each. All canals were prepared with Protaper Universal hand files to size #F4, and irrigated with 2.5% NaOCI 1 ml between files and 5ml for 60 seconds as a final irrigant by different irrigation devices; group one, by using conventional system; group two, by using Endoactivator sonic irrigation system, group three, by using Satelec Passive Ultrasonic irrigation and group four by using the Endovac system. After the final irrigation, the roots were split longitudinally and photographed with a digital microscope. The roots were magnified to 100X; a percentage of debris was calculated for the apical 0-3, middle 3-6 and coronal 6-9 mm. The debris score was calculated as a percentage of the total area of the canal that contained debris as determined by pixels in Adobe PhotoshopCS5. Data were analyzed statistically by ANOVA and LSD at 5% significant level. Results: when comparing the debris remaining, the Endovac, Endoactivator and Satelec groups showed significantly less debris than the conventional group at all three levels (p < 0.01). The Endovac group showed significantly less debris than the Endoactivator group at middle and coronal levels while no significant difference found between the Endovac system and Endoactivator system at apical level. The apical 0-3 mm showed significantly more debris than both the middle and coronal level for all groups. Conclusion: The EndoVac system showed a higher cleaning capacity of the canal at all levels, followed by the protocols that used Endoactivator sonic irrigation system. The conventional irrigation system with maxi-i-probe needles showed inferior results. The apical three millimeters showed a greater amount of debris than the 3-9 millimetres from the working length, regardless of the irrigation device used


Article
Evaluating the effect of silver nanoparticles incorporation on antifungal activity and some properties of soft denture lining material

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Background: Colonization of soft denture liners by Candida albicans and other microorganisms continued to be a serious problem. The aim of this study was to evaluate the effect of incorporating silver nanoparticles into heat cured acrylic-based soft denture liner on the antifungal activity, and on water sorption, solubility, shear bond strength and color change of the soft lining material. Furthermore, evaluating the amount of silver released. Materials and methods: Silver nanoparticles were incorporated into soft denture liner in different percentages (0.05%, 0.1% and 0.2% by weight). Four hundred and twenty specimens were prepared and divided into five groups according to the test to be performed. The antifungal activity of the soft liner/AgNPs composite was evaluated in three different periods by using (viable count of C. albicans and disk-diffusion test). The amount of silver released in artificial saliva was measured by atomic absorption spectroscopy. The water sorptions, solubility, shear bond strength and color change was measured and the results were statistically analyzed. Results:All experimental groups showed a highly significant decrease in colony forming units of C. albicans in comparison to control group. There was no inhibition zone around any test specimen of any test group. There was no silver detected to be released. The addition of AgNPs resulted in a highly significant decrease in water sorption, while only 0.2% group showed highly significant decrease in solubility. Non significant differences in shear bond strength were found. A highly significant increase in light absorption percentage was observed in all experimental groups. Conclusion: The addition of AgNPs helps to produce soft denture liner with antifungal properties. Silver was not detected to be released. This addition resulted in decrease in water sorption, and did not affect the shear bond strength and it increased the opacity of the material


Article
Early and delayed effect of 2% chlorhexidine on the shear bond strength of composite restorative material to dentin using a total etch adhesive

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Background: Lack of durability of the bond of the dental adhesive systems to tooth structure is one of the most important problems in tooth colored restorative work. This in vitro study was performed to evaluate the effect of 2% chlorhexidine gluconate(CHX) on dentin bond strength by using total etch adhesive system at twenty-four hours and three months of water storage. Material and methods:A flat dentin surface was prepared for forty sound human maxillary premolar teeth which were acid etched with 36% phosphoric acid gel after being divided randomly into four groups of ten teeth each according to storage time and CHX application, theCHX was applied for 60 seconds before adhesive application for groups I and III which were tested after twenty-four hours and three months respectively, while the distal water was applied for 60 seconds before the application of adhesive for group II and IV which were tested after twenty-four hours and three months respectively.The Prime and Bond® NT™ adhesive (Dentsply) was applied and cured, Composite (Ceram X mono, Dentisply) was applied through special mold with 2 mm thickness and light cured, Then all specimens were stored in distilled water 37oC until the time of testing of each group.Shear bond strength test was performed at the end of the storage period (24 hours or 3 months). Results:T-test results showed high statistically significant reduction in shear bond strength (SBS) in non CHX group IV (tested after 3 months) compared to non CHX group II (tested after 24 hours)(P< 0.01). In CHX groups I (tested after 24 hours) and III (tested after 3 months), results showed no statistically significant differences in shear bond strength(p> 0.05).On the other hand result showed statistically no significant differences between groups I and II in 24 hours shear bond strength (P> 0.05). After 3 months water storage, there was statistically high significant differences between the groups III and IV (P< 0.01). Conclusion: the use of 2 % CHX glocounate solution after acid etching and before bonding of dentin have no adverse effect on immediate bond strength (24 hours storage), and was effective in reducing degradation of resindentin bond interface after three months of water storage


Article
Estimation of the linear dimensional changes of autoclave cured acrylic resin with multiple palatal depths and investment materials

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Background: Dimensional changes of acrylic denture bases after polymerization results in need for further adjustments or even ends with technical failure of the finished dentures. The purpose of this study was to estimate the linear dimensional changes for different palatal depths when using multiple investment materials and polymerization techniques. Materials and methods: Ninety upper complete denture bases were constructed for this study. They were divided into two main groups according to the polymerization methods: conventional water bath and experimental autoclave (short and long cycles). Each main group was further subdivided into three subgroups according to the palatal depth (shallow, medium and deep). Furthermore, for each palatal depth; complete denture bases were invested either with dental stone or laboratory silicone. For each upper complete denture, measurements of linear dimensional changes were done by fixation of metallic screws on the tissue surface of the denture base. The distances were measured by using travelling microscope with an accuracy of 0.001 %. The data were statistically analyzed using three way analysis of variance (ANOVA) for three variables, which were (palatal depth, investments and polymerization techniques), LSD test and student T test for comparisons between groups. Results: There were significant improvements in the dimensional accuracy of denture bases cured with autoclave compared with water bath. Also, silicone investments were a successful alternative to stone, study data shows that short autoclave processing with silicone reduces the magnitude of the linear dimensional changes. On the other hand, long autoclave processing and stone investments were better than silicone in reducing dimensional changes. Conclusion: The findings of this study indicates that the use of autoclave processing in acrylic curing is a promising alternative to the conventional water bath and leads to better dimensional stability for the finished dentures in all oral configurations and palatal depths. Also, Silicone is more preferable than stone, although it's not as strong investing materials when compared with stone


Article
Evaluation of the cleaning efficiency of the isthmus using different rotary instrumentation techniques (In vitro study)

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Background: The aims of the study were to evaluate the unclean/clean root canal surface areas with a histopathological cross section view of the root canal and the isthmus and to evaluate the efficiency of instrumentation to the isthmus using different rotary instrumentation techniques. Materials and Methods:The mesial roots of thirty human mandibular molars were divided into six groups, each group was composed of five roots (10 root canals)which prepared and irrigated as: Group one A: Protaper system to size F2 and hypodermic syringe, Group one B: Protaper system to size F2 and endoactivator system, Group two A:Wave One small then primary file and hypodermic syringe, Group two B:Wave One small then primary file and endoactivator system, Group three A: step back technique to size 25 file as MAFand hypodermic syringe, Group three B: step back technique to size 25 file as MAFand endoactivator system . All the roots were sectioned at 2mm, 6mm ,12mm from the apex and studied by histopathological cross section. The degree of cleaning of each section was measured by the use of Autocade 2004 software system. Result :the least uncleaned isthmus surface area at coronal, middle and apical section was found by the Protaper system with endoactivator which represented the mean of the percentage of uncleaned surface area of 16.87%, 14.32% and 9.55% respectively. The system that produced least uncleaned canal wall was by Protaper system with endoactivator at coronal ,middle ,and apical sections of 12.21%, 9.14% and 18.55% respectively . The mean of highest percentage of increased canal diameter which was Protaper system, Wave One system and then step back. The comparison between the groups in the means which showed that the highest percentage of decrease in isthmus area was with the Protaper system, Wave One system and lastly the step back. Conclusions:The Protaper system with endoactivator was the best system in canal and isthmus cleaning


Article
Assessment of the oral findings, salivary oxidative status and IgA level among group of workers exposed to petroleum pollutants in Al-Daura oil refinery

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Background: Oil refinery workers are continuously exposed to numerous hazardous materials. Petroleum contains the heavy metals as a natural constituent or as additives. These metals induce the production of ROS which associated with an oxidative damage to DNA, proteins, and lipids. This study was conducted to assess the salivary levels of heavy metals, salivary oxidative status, oral immunological activity (salivary sIgA) and assessment of the oral findings among the workers of Al-Daura oil refinery in Baghdad city. Subjects, Materials and Methods: This study was done in Al-Daura oil refinery; samples consist of 60 workers involved in refinery processes (study group) and 20 non-workers (control group). Oral examination and saliva collection was done to assess the oral findings and measurement the level of heavy metals (lead and cadmium), oxidative status (MDA and SOD) and secretary IgA. Results: salivary lead and cadmium was higher in study group (6.34 μg/dl and 0.56 μg/l) than that of control group (3.3 μg/dl and 0.34 μg/l) with highly significant difference (p<0.001). A significant increase (p<0.05) was found in salivary MDA (15.3 ng/ml) and salivary sIgA (464.36 μg/ml) and significant decrease in salivary SOD (1895.1 pg/ml) among the study group. Lead has shown significant linear correlation with MDA and IgA. A significant reverse correlation was found between heavy metals (lead and cadmium) and SOD. The oral examination revealed no oral lesions of interest. Conclusion: Workers in Al- Daura oil refinery exposed to pollution with heavy metals (Pb and Cd) which was associated with changes in the biochemical and immunological findings among the oral cavity

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Article
Salivary IgA in chronic kidney disease patients undergoing hemodialysis in Missan governorate

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Background: Chronic kidney disease is a worldwide health problem, with adverse outcomes of cardiovascular disease and premature death, can be divided into five stages, depending on how severe the damage is to the kidneys, or the level of decrease in kidney function, the final stage of chronic kidney disease is called end-stage renal disease, salivary immunoglobulin A is the main immunoglobulin found in mucous secretions, including tears, saliva, colostrum and secretions from the genitourinary tract gastrointestinal tract, prostate and respiratory epithelium. It is also found in small amounts in blood.This study aimedto measuresalivary flow rate and salivaryimmunoglobulin Alevels in chronic kidney disease patients on hemodialysis treatment in comparison with healthy control subjects. Materials and Methods: Ninety (90) subjects were participated in this study; 45 Patients undergoing hemodialysis with chronic kidney diseases; 45 health control subjects. Saliva collected was measured and levels of salivary immunoglobulin A were measured by Enzyme Link Immunosorbent Assay (Elisa). Results:The present studyrevealed that the mean value of salivary flow rate in chronic kidney disease patients was (0.34 ± 0.19) ml/min, while for healthy control subjects was (1.02 ± 0.39) ml/min, there wasstatisticallysignificantly decrease in salivary flow rate ofchronic kidney disease on hemodialysis patients as compared to control healthy subjects.The present study revealed that the (Mean±SD) of the immunoglobulin A in chronic kidney disease patients on hemodialysis (388.81±227.86) μg./ml, while in control group (273.98±155.89) μg./ml, the result revealed statistically significant increase in chronic kidney disease patients on hemodialysis as compared to control subjects. Conclusions: Salivary immunoglobulin (IgA) reflects the functional capacity of the glands. Increased concentration of this component is usually marker of a poor general condition


Article
Clinicopathological analysis of oral squamous cell carcinoma in Iraq During period (2001-2013)

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Background: Oral cancer is a highly lethal and disfiguring disease. Squamous cell carcinoma of the oral cavity constitutes about 90% of all oral malignancies. The aims of the study was to achieve an epidemiological description of the oral squamous cell carcinoma in Iraq in general and in Iraqi governorates except Kurdistan region retrospectively during period 2001-2013 Materials and Methods: Data were collected from department of oral and maxillofacial pathology, college of dentistry, university of Baghdad, Nuclear medicine and radiotherapy hospital, Iraqi cancer registry center, Main hospitals in Baghdad and Iraqi governorates, Private labs. for histopathological examinations. The descriptive and inferential statistical methods were used (frequency distributions, percentages, incidence rate, standardized ratio and relative risk) Results: In Iraq from 2001-2013, there were 1664 cases with overall M:F ratio (1.4 : 1). The most affected age group was (50-69 yrs), tongue was the most common affected site, grade II was the most common, and the highest number of OSCC was reported in Baghdad governorate. A negative time trend was observed in the overall (crude) incidence rate of all registered OSCC in Iraq. Conclusion: The incidence rate (crude rate) of OSCC decreased in Iraq from 2001 to 2013, and the standardized ratio showed that there is a decrease in tumor risk with advancing time


Article
Flattening of the posterior slope of the articular eminence of completely edentulous patients compared to patients with maintained occlusion in relation to age using computed tomography

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Background: The posterior slope of the articular eminence of completely edentulous patients compared to patients with maintained occlusion shows significant flattening. This study aimed to correlate between the flattening of the posterior slope of the articular eminence, with dental status, age, genders, on both sides using computed tomography. Materials and Methods: The sample of the present study was a total of 117 Iraqi subjects, who admitted to the maxillofacial department at Al-Sadr Teaching Hospital in Al-Najaf city. The examination was performed on CT scanner; the eminence inclination was measured in two methods using sagittal section. Results: Clinically, the inclination of articular eminence was higher in edentulous subjects than in dentate subjects. While no statistically significant differences were found in the eminence inclination between the age groups. No statistically significant differences were found between the right and left side measurements or between female and male subjects. Conclusion: There were no statistically significant differences in eminence inclination according to sex, age and between right and left side. The flattening of the articular eminence was significantly higher in completely edentulous patients than in patients with maintained occlusion


Article
Histological and mechanical evaluation of the osseointegration of titanium implants by the modifications of thread design and/or coating with flaxseed (An experimental study on rabbits)

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Background: Dental implant surface technologies have been evolving rapidly to enhance a more rapid bone formation on their surface and improve implant therapy.Implant threads should be designed to increase surface contact areathat induced better stability. In addition, implant surface coating with Flaxseed was used to enhance bone formation at the bone-implant interface. Materials and methods: Ninety-six commercially pure titanium (CpTi) screws were implanted in rabbits' tibiae and divided into three groups as dual-threaded group, flaxseed-coated group and control group. All groups were evaluated mechanically, histologically and radiographically after each healing periods (2, 4, 6 and 8) weeks and the resulting data were statistically analyzed using ANOVA and t-test at 0.05 significance level. Results: Dual threaded implant recorded the highest value in removal torque testand it showed mature bone at 8 weeks period. Coated implant shows enhancement of osteoblast and it is the only modified implant that illustrates proliferating cartilage zone that later on degenerated and replaced by bone. Conclusion: Each modified implants shows different benefits whether a modification of the implant surface mechanically (dual-threaded) or by coating the implants with Flaxseed


Article
Effect of gender, age and tooth loss on the dimensions of incisive canal, and buccal bone anterior to the canal (Computed Tomography study)

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Background: The incisive canal is an anatomical structure with an important location in the anterior maxilla, analyzing this canal and its relation to the bone anterior to the canal is necessary during dental implant. Aim of this study is evaluated effect of gender, age and tooth loss in area of maxillary central incisors teeth on the dimensions of incisive canal and buccal bone anterior to the canal using spiral computed tomography. Materials and Methods: Sample consists of prospective study for 156 subjects for both gender, they divided into two groups, 120 dentate group (60 male and 60 female) with age ranging from (20-70) and 36 edentate group (with missing maxillary central incisors) (18 male and 18 female) with age ranging from (50-70). All subjects attended to Baquba teaching general hospital in Diyala for computed tomography scan investigation for different diagnostic purposes. The following were measured and recorded from sagittal section of CT for analysis 1-diameter and length of incisive canal.2- distance and length of buccal bone anterior to canal. Result: Gender had effect on the dimensions of incisive canal and buccal bones anterior to this canal, the mean values begin higher in male as compared to female. Dental status had effect on incisive canal length and buccal bone dimensions, mean values is higher in dentate than in edentate group, canal diameter remain unchanged with dental status. Age had no effect on all selected measurements in study sample. Duration of maxillary central incisors teeth loss had effect on canal length and buccal bone dimensions mean values begin lower in long duration than that in short duration while it had weak effect on incisive canal diameter. Conclusion: Gender and dental status are important factors that can affect incisive canal and amount of bone anterior to canal.


Article
Assessment of cortisol as salivary psychological stress marker in relation to temporomandibular disorders among a sample of dental students

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Background: University dental students perceived a higher level of stress prior to the final exam associated with raised salivary cortisol levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Using a Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insight about the association of this marker and temporomandibular joint disorders. The aim of this study was to evaluation level of salivary cortisol in stressor students with temporomandibular disorder and the relation between this marker in relation to temporomandibular disorder severity. This might give a better understanding to the role of psychological stress as an etiological factor for developing temporomandibular joint problems. Materials and methods: A total eighty participants age between 20 to 24 were recruited for this study. The participants were University dental students under graduate students at final examination period who were examined and gave saliva samples in final examination period. Salivary assay kits as cortisol was used to measure those variables and a Helkimo anamnestic and clinical dysfunction scoring for TMD. Results: The group of participants with stress and temporomandibular disorder showed significantly higher levels of salivary cortisol than the control group, the salivary cortisol has statistically significant correlation with Helkimo anamnestic categories (Di-I mild, Di-II moderate and Di-III severe. Salivary cortisol levels show significant but weak association with two categories of clinical dysfunction criteria in Helkimo index system, which are Muscle pain and TMJ pain on palpation. Conclusion: This study demonstrated that University students perceived a high level of stress before the final examination. Salivary cortisol is the stress biomarker that is most often used to measure acute stress. Helkimo anamnestic and clinical dysfunction scoring criteria for still the pioneer for measuring a temporomandibular disorder


Article
Oro-facial manifestations, oxidative stress marker and antioxidant in serum and saliva of patients with Beta thalassemia major

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Background: Beta thalassemia is a typically autosomal recessive form of severe anemia which is caused by an imbalance of two types of protein (alpha and beta) subunits of hemoglobin. Oxidative stress imbalance is the equilibrium between pro-oxidantantioxidant statuses in cellular system, which results in damaging the cells. Antioxidant is a chemical that delays the start or slows the rate of lipid oxidation reaction and it play a very important role in the body defense system against reactive oxygen species. The aims of this study were to recorded the orofacial manifestations in beta thalassemic patients and assess the oxidative stress marker malondialdehyde in serum and salivs and their role in the pathogenesis of beta thalassemia and evaluation the antioxidant uric acid in serum and saliva of those patients. Methods: The study included fifty eight beta thalassemic major patients, twenty eight patients with periodontitis and thirty patients without periodontitis and twenty nine healthy subjects that were age matched with the patients. Orofacial manifestations recorded clinically, serum and saliva malondialdehyde and uric acid were measured in all subjects. Results : The main oro-facial manifestations were malocclusion ,rodent face, brown pigmentation of oral mucosa and incompetent lip.The mean serum and saliva malondialdehyde was significantly higher in thalassemic patients with periodontitis (p<0.001). Serum and saliva uric acid was significantly higher in thalassemic patients without periodontitis (p<0.001). Conclusions: Malocclusion was the most prevalent oro-facial manifestations in beta thalassemic patients, increased serum and saliva malondialdehde refer to the role of oxidative stress in the pathogenesis of beta thalassemia. Uric acid increased to counteract the elevation in the oxidative stress process


Article
Assessment of the Immunohistochemical expression of EBV in oral lichen planus

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Background: Oral lichen planus (OLP) is a chronic immunologic disease. The etiology of OLP is unknown, viral antigens (for example EBV) have been proposed as etiologic agents. OLP may get transformation to malignancy so research on the presence of these in OLP lesions seems to be necessary. The aim of this study was to evaluate EBV expression immunohistochemically in OLP. Materials and Methods: Tissue specimens of 30 formalin fixed, paraffin-embedded tissue Blocks histologically diagnosed oral lichen planus was performed to evaluate EBV expression. Results: Expression of EBV was detected in epithelium of (46.6%) in the study samples in (OLP). no statistically significant correlation was found with clinical parameters except for a significantly higher expression in females. Conclusions: Epstein Barr viruses were present in considerable amounts in oral lichen planus. Taking into account the potential of viruses in OLP proving or disapproving or etiological role of viruses in OLP is continuously need to be examined in further studies

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EBV --- lichen planus


Article
Periimplantitis- A review

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This review article concentrates the light about aetiology and treatment of the periimplantitis

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periimplantitis


Article
Efficacy of arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibular joint

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Background: Temporomandibular joint disorders refer to a group of heterogeneous pain and dysfunction conditions involving the masticatory system, reducing life quality of the sufferers. Arthrocentesis is simple and less invasive surgical procedure for the treatment of internal derangement than arthroscopy and better than other conservative procedures such as drugs, occlusal appliances and physiotherapy. The aim of the study was to evaluate the effect of arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibular joint for the restoration of its function, reducing pain and preventing further deterioration of the temporomandibular joint dysfunction. Materials and methods: This study was performed in Al-Sheed Ghazi Al-Hariri Hospital, Department of Oral and Maxillofacial Surgery, from November 2012 to October 2013, included 60 patients, aged 18 to 45 years with symptoms of temporomandibular joint pain, clicking during function and limited mouth opening. Temporomandibular joint internal derangement was assessed with clinical examination and confirmed with computed tomography scan. Arthrocentesis was done with insertion of two 18 gauge needles in the upper joint compartment, lavaged with ringer’s lactate solution and at the end of the procedure 1ml of hyaluronic acid was injected. Intensity of temporomandibular joint pain was assessed using visual analog scale, maximum mouth opening was assessed with ruler scale and joint clicking was assessed clinically by stethoscope and manual palpation. All the parameters were measured before the procedure then 1 and 3 months later. Results: During 4 months follow-up, clinical examination and comparison of the results showed reduction in pain with success rate 95%, improvement in mouth opening with success rate 100% and clicking disappeared in 95% of patients. Conclusion: The technique of arthrocentesis using Sodium Hyaluronate injection, used in patients who presented with internal derangement, showed therapeutic benefits, simplicity, safety, patients acceptance of the technique and lack of significant side effects and complications.


Article
Effects of light smoking on salivary levels of alkaline phosphatase and osteocalcin in chronic periodontitis patients

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Background: Chronic periodontitis is an inflammatory disease that affects the supporting tissues of the teeth and it’s common among adults. Smoking is an important risk factor for periodontitis induces alveolar bone loss. Alkaline phosphatase enzyme is involved in the destruction of the human periodontium. It is produced by many cells such as polymorphonuclear leukocytes, osteoblasts, macrophages and fibroblasts within the area of the periodontium and gingival crevice. Osteocalcin is one of the most abundant matrix proteins found in bones and the only matrix protein synthesized exclusively there. Smaller Osteocalcin fragments are found in areas of bone remodeling and are actually degradation products of the bone matrix.The purpose of this study was to evaluatethe effect of smoking on the salivary alkaline phosphatase and Osteocalcin in subjects with chronic periodontitis compared to control subjects. Materials and Methods: Five ml of unstimulated whole saliva samples and full-mouth clinical periodontal recordings (plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment level) were obtained from study groups (25 light smokers and 33 non-smokerssubjects, both with chronic periodontitis) and control groups (8 light smokers and 13 non-smokers subjects, both with healthy periodontium). All subjects were systemically healthy males, with age range (30-50) years. Salivary Alkaline phosphatase and Osteocalcin levels were determined by Colorimetric and Enzyme-linked Immunosorbent Assays, respectively. Results: Smoker chronic periodontitis patients revealed non-significant differences in clinical periodontal parameters with non-smoker counterparts (P o.o5) in terms of Plaque index, Probing pocket depth and Clinical attachment loss, with slight increase in plaque index value in smoker chronic periodontitis group(1.42±0.46) than non-smoker chronic periodontitis group, while there were highly significant differences in terms of Gingival index and Bleeding on probing(P ≤ 0.01).Osteocalcin levels were lower in smoker chronic periodontitis group (0.13±0.20) than non-smoker chronic periodontitis group (1.09±2.26) with significant difference (0.05 ≥ P > 0.01). Mean of Alkaline phosphatase level was lower in smoker chronic periodontitis (11.14±4.53) than non-smoker chronic periodontitis (11.45±4.17) with a non-significant difference, while there was a significant difference inAlkaline phosphatase concentrations between smoker and non-smoker control groups.There were non-significant differences between smoker chronic periodontitis and smoker control groups in terms of Osteocalcin and Alkaline phosphatase concentrations. There were nonsignificant differences between non-smoker chronic periodontitis and non-smoker control groups in terms of Osteocalcin and Alkaline phosphatase concentrations. Conclusion: Within the limits of this study, it may be suggested that suppression of salivary Osteocalcin levels by smoking and slight increase in alkaline phosphatase in smokers groups, may explain the deleterious effects of smoking on periodontal health status.


Article
Time-related salivary cathepsin B levels and periodontal status in different orthodontic force magnitudes

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Background: Biologically active substances, such as Cathepsin B (CAB) which is a lysosomalcystein protease may be involved in periodontal metabolism in the degradation of organic bone matrix containing collagen fibers in response to mechanical stress from orthodontic appliance. The aims of study were to determine and compare salivary levels of CAB, pH as well as clinical periodontal parameters (Plaque index PLI and gingival index GI) with different orthodontic force magnitudes at different time intervals. Materials and methods: A twenty-four patients (both gender) with age range (17-23) years had Angle's Class II division 1 malocclusion with GI <0.5 enrolled in this study. The level of salivary CAB and pH, in addition to the clinical periodontal parameters (PLI and GI) were measured before (baseline), 1 hour (1H), 1 day (1D), 1week (1W), 2 weeks (2W) and 3 weeks (3W) after fixed orthodontic appliance placement with different forces applied to the teeth (F1 (40 gm), F2 (60 gm) and F3 (80 gm)). Results: The highest mean concentration of salivary CAB was (12.057) at F1 in 1D visit with highly significant differences among the visits as well as among the forces (p≤0.05). Weak correlations were revealed between all pairs of forces as well as between each visit with the baseline visit about salivary CAB except the strong negative correlations between F1 with F3 at 3W and baseline with 3W visits at F3. Maintenance of good oral hygiene during the study period demonstrated that the highest mean values of PLI and GI were (0.2) and (0.25) respectively, in addition to the non-significant differences regarding pH among the visits. Conclusion: The concentration of salivary CAB was increased following fixed orthodontic appliance insertion. The very light continuous orthodontic force could produce significant increase of this enzyme activity and give enough effectiveness to produce tooth movement as compared to the higher forces


Article
Management of facial fistulas and sinuses

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Background: A major difference between the treatment of the skin lesions and the odontogenic and nonodontogenic sinuses. We aimed to analyze a substantial number of consecutive causes in order to clinical suspicion in the differential diagnoses may be correctly weighted. Materials and methods: The material of this research consisted of 40 patients. A complete history is collected from the patients with the duration and the site of the sinus present, the patient was examined for factors of the fistulas and sinuses and its associations, and patient having any concomitant lesions, a medical consultation done for opinion and management. Clinical examination with facial fistulas and sinuses was mandatory to avoid any mistakes that may occur. A treatment plan was contemplated regarding a conservative line will be followed or a surgical intervention was indicated results. Results: The common etiological causes: congenital and acquired causes. Fifteen patients have eighteen facial sinuses and fistulas (40.9%) developed because of non-odontogenic infections, fifteen patients had fifteen facial sinuses (34%) because of odontogenic infections, four congenital sinuses (9%) developed at three patients, two patients with two facial sinuses (4.5%) due to tumor growth, three patients with three facial fistulas (6.8%) due to traumatic causes and one patient with one facial sinus (2.2%) because of Actinomycosis and unknown cause for each. Conclusions: The maxillofacial surgeon should be aware of causes of whether developmental anomalies, deep seated infections, epithelization of the tract, insufficient or inadequate drainage, deep lining foreign bodies and certain types of infections


Article
Evaluation of the effectiveness of coenzyme Q10 gel in management of patients with chronic periodontitis (I intra group comparison)

Authors: Taif M. Salih --- Maha Sh. Mahmood
Pages: 130-135
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Background: Periodontal pathogens can induce free radicals over-formation and thus may cause collagen and periodontal destruction. Anti-oxidants are used as supplements to counteract the over production of free radicals in periodontal disease, that can reduce of collagen destruction. Coenzyme Q10 serves as an endogenous antioxidant, regenerates other antioxidants, stimulates cell growth, and inhibits cell death. Because it is an antioxidant, coenzyme Q10 has received much research attention associated with periodontal diseases. Perio Q gel may possibly be effective as a topical agent and as an adjunct to scaling& root planing in treatment of gingivitis and chronic periodontitis. Aim of study:Determine the periodontal health status in a follow up study for 6 weeks of a group of patients with chronic periodontitis by measuring clinical periodontal parameters, which included (Plaque index, Gingival index, Bleeding on Probing, Probing Pocket Depth and Relative Attachment Level) and to evaluate the effect of intra pocket application of perio Q gel (coenzyme Q10) alone & as adjunct to scaling,& root planing on the periodontal clinical parameters in the management of patients with chronic periodontitis. Materials and methods: A total of 323 sites with pocket depth (5-8) mm in patients with chronic periodontitis were randomly divided in 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: on intra-group analysis, all groups showed highly significant reduction in PI, GI, BOP, PPD and RAL among the three visits .On inter-group analysis, the results showed significant reduction in the clinical parameters PPD and RAL of combination group in comparison to SRP group. Conclusion: The results of the research were encouraging and suggested the possibility to use the gel as a sole agent to support standard treatment procedures in periodontitis. The clinical parameters significantly improved in the phase of periodontal treatment, indicating that CoQ10 opens new treatment options by improving the host response to disease activity.


Article
Effect of different staining materials on color stability of sapphire brackets bonded with different types of light cure orthodontic adhesives (An in vitro study)

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Background: The demand for better esthetic during orthodontic treatment has increased nowadays, so orthodontists starting using esthetic arch wires, brackets and ligatures.Tooth colored brackets were introduced in different types of materials. Sapphire ceramic brackets are one type of esthetic brackets and their color stability remains the main concern for the clinicians and patients at the same time . The present study design to evaluate the effect of three different staining materials (pepsi, black tea and cigarette smoke) on the stainability of sapphire ceramic brackets bonded with three types of light cure orthodontic adhesives which include: Resilience, Enlight and Transbond. Materials and Methods: The sample consisted of three hundred sixty sapphire brackets. The brackets were divided according to bonding materials into three groups each group consist of one hundred twenty brackets, then each subgroup farther subdivided into four groups according to the material they were immersed (distilled water, black tea, Pepsi and cigarette smoke) with thirty brackets each, then Each group with ten brackets farther subdivided according to time interval of immersion in each media into three groups one day, seven days and fourteen days at 37°C in the incubator.A UV-Visible spectrophotometer (Shimadzu, UV -1800) was used to perform a light absorption test. Results: ANOVA and LSD post Hoc tests were used to identify the significant effects of the staining materials at a significance level P ≤ 0.05.It was found that the immersion time gradually influenced the color stability of the adhesive materials with sapphire brackets with the highest activity observed at fourteen days interval. The brackets bonded with Resilience light cure adhesive are the most type affected by staining materials, then followed by the brackets bonded with Transbond and finally the brackets bonded with Enlight light cure adhesive. For the staining materials it was found that the cigarette smoke is the most powerful staining material, followed by tea and finally pepsi. Conclusions: From the above result we can conclude that the type of adhesive must take in consideration when the esthetic brackets have been used


Article
Dental fluorosis, dental caries, and treatment needs in Al-Muthana'a governorate among 12 years old students

Authors: Hiba A. AL-Shuker --- Athraa M. AL-Waheb
Pages: 142-147
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Background: A case-control study design revealeda relationship between the present of fluoride, and the reduction of dental caries and the increase prevalence and severity of dental fluorosis .The aim of this study was to assess the prevalence and severity of dental caries in relation to dental fluorosis among school children in Al-Muthana'a Governorate. Materials and methods: It was conducted among primary school students aged 12 years old, the age was taken according to the criteria of World Health Organization (1997) (1).The number of students was selected in each sector of control group according to number of schools in that sector .Sectors of control group which depend on water of river as source of drinking water. Case group which include AL-Salman sector that depend on underground water as source of drinking water includestudents in all area of Al- Salman sector in 4 schools Results: Results showed that the prevalence of dental fluorosis in case group, is (60.6%) and the mean of maximal fluorosis index (1.15 ±0.12) .In control group, the prevalence of dental fluorosis is (49.0%) and the mean of maximal fluorosis index (0.73±0.4) .The DMFS/DMFT values of dental caries for case sample (3.83± 0.44) (2.31± 0.22), while for control DMFS/DMFT is (5.95±0.26) (3.41±0.13) respectively with significantly difference. The prevalence of caries free in case sample is 23.6% while for control is 8.4% with significantly difference between case and control. Conclusions:A study revealed that a high prevalence of dental fluorosis, dental caries thus there is a need for preventive programs among those children


Article
Congenitally missing and supernumerary teeth among a group of 3-12 years old children with cleft lip and/ or palate in Iraq

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Background: There are many congenital anomalies associated with cleft lip and/or palate. This research is to study the prevalence of congenitally missing teeth and supernumerary teeth in this population group. Materials and Method: One hundred eight cleft lip and/or palate Iraqi patients had participated in this study (57 male, 51 female), 3-12 years of age. 26 of them had orthopantomogram were within (6-12) years of age were inspected for congenitally missing teeth and supernumerary teeth. Patients whom age range 3-5 years were checked for the congenitally missing teeth by clinical examination with strongly insisting the teeth were not missed due to caries or trauma. Results: There were 19(73.076%) patients with 41 congenitally missing teeth for the 26 patients within 6-12 years age group who were with orthopantomogram, while there were 20(37.037%) patients with 32 congenitally missing teeth for the 54 patients within 3-5 years of age who were not indicated for orthopantomogram. There were (22) patient with (27) supernumerary teeth. Conclusion: The most frequently congenitally missing tooth was the permanent upper lateral incisor, on the other hand the tooth most frequently noted as extra tooth was the primary lateral incisor. Majority of them were with cleft lip and palate


Article
Load-deflection characteristics and force levels of coated nickel titanium orthodontic archwires

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Background: Coated archwires have been introduced to improve esthetics during orthodontic treatment. Theaim of the present study was to evaluate and compare the load–deflection characteristics and force levels of six brands of coated nickel titanium orthodontic archwires using palatal and gingival deflection. Materials and methods: Ten round wires (0.016 inch) and ten rectangular wires (0.019x0.025 inch) were obtained from each of six brands (G&H, Opal, Ortho Technology, Dany, Hubit and Astar Companies). The load-deflection properties of these archwires were evaluated by the modified bending test usinga readymade dental arch model in both palatal and gingival directions at 37°C temperature using a universal material testing machine. Forces generated at maximum loading of 2mm and at unloading of 1.5mm were measured. Results: All the wires showed hysteresis and significant differences in their load deflection curves, but these differences were more evident in round wires than in rectangular wires where G&H wires showed the widest loadingunloading deflection curves. The maximum loading force of round wires in gingival deflection were higher than by palatal deflection. The force decline during unloading (plateau gap) ranged between 18 to 34% for round wires and 17 to 37% for rectangular wires. Conclusion: Coated epoxy wires (G&H, Opal, Astar and Ortho Technology) produced lower forces compared to polymer (Dany) and Teflon (Hubit) coated round and rectangular archwire


Article
Depression status in relation to caries experience and salivary physiochemical characteristics among 15 years old students in Al-Swera city – Wassit Governorate-Iraq

Authors: Huda S. Khiala --- Ban S. Diab
Pages: 158-162
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Background: Depression is a common mental disorder that presents with depressed mood;it can become chronic or recurrent and affect dental health .Thus this research aimed to assess the prevalence and severity of dental caries among students with different grade of depression in relation to physicochemical characteristics of stimulated whole saliva. Materials and methods: The total sample involved for depression status assessment is composed of 800 students for both gender aged 15 years old that were selected randomly , This was performed using children depression inventory (CDI) index that divided the students into four groups of depression(low or average grade, high average grade, elevated grade and very elevated grade). The diagnosis and recording of dental caries was by using decay, Missing, Filled surface index (DMFs); and according to the criteria ofManji et al (1989), Salivary samples was collected from 30 student with very elevated grade of depression and 30 from low or average grade under standardized conditions, then analyzed for measuring salivary flow rate and viscosity, in addition to estimation salivary elements that includes total protein, zinc, copper, chromium and Lithium. Results: the data of the present study showed that the percentage of Caries free students was higher among very elevated grade (8.60%) followed by low or average grade (8.52%), the less was among elevated grade of depression (5.04%).Concerning caries experience, the highest result was among elevated grade of depression followed by low or average grade, the lower result was among high average grade. While the sever grade of dental caries (D4) was found to be highly significant differ among different grade of depression, The data analysis of salivary elements found that the protein was higher in very elevated grade than low or average grade while other elements show the opposite result with significant concerning copper and zinc among very elevated grade that show significant difference. DMFs correlated negatively with salivary flow rate among low or average grade and very elevated grade; while concerning salivary viscosity, the correlation was direct with DMFs. With highly significant in very elevated grade, Salivary elements show positive relation with not significant except copper that show negative relation with significant. Conclusion: The results of the current research revealed that depression status had an adverse effect on salivary physicochemical characteristics and dental status including caries experience


Article
Hard palate bone density and thickness determination using CT scan and their relationships with body compositions measured by bioelectrical impedance analysis for Iraqi adult sample

Authors: Zahraa M. Al- Fadily --- Hadeel A. Al- Hashimi
Pages: 163-172
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Background: This study was conducted to evaluate the hard palate bone density and thickness during 3rd and 4th decades and their relationships with body mass index (BMI) and compositions, to allow more accurate mini-implant placement. Materials and method: Computed tomographic (CT) images were obtained for 60 patients (30 males and 30 females) with age range 20-39 years. The hard palate bone density and thickness were measured at 20 sites at the intersection of five anterioposterior and four mediolateral reference lines with 6 and 3 mm intervals from incisive foramen and mid-palatal suture respectively. Diagnostic scale operates according to the bioelectric impedance analysis principle was used to measure body weight; percentages of body fat, water, and muscle; bone mass; and basal and active metabolic rates. Results: No significant difference in overall bone density and thickness of hard palate during 3rd and 4th decades. The gender should be considered in regard to bone thickness. Cortical bone density and thickness showed a tendency to decrease posteriorly, while the cancellous bone density showed a tendency to increase posteriorly. In the mediolateral areas, no specific patterns were observed. With increasing BMI, the cortical bone density was increased. The relationships of bone density and thickness with most scale measurements were not significant. Conclusion: Mini-implants for orthodontic anchorage can be effectively placed in most areas of hard palate regarding the bone density. While regarding bone thickness, care should be taken during the planning of their placement in hard palate. A new classification for bone thickness of hard palate has been developed


Article
The effect of nutritional status on arch width and length of primary teeth among five years old kindergarten children

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Background: In human life, malnutrition may adversely affect various aspects of growth at different stages of life. Teeth are particularly sensitive to malnutrition. Malnutrition may affect odontometeric measurement involving arch width and length of primary dentition. The aim of this study is to estimate the effect of nutrition on arch width and length dimension measurements among children aged 5 years old. Material and methods: This study was conducted among malnourished group in comparison to well-nourished group matching with age and gender. The present study included 158 children aged 5 years (78 malnourished and 80 wellnourished). The assessment of nutritional status was done by using three nutritional indicators, namely Height-for-age, Weight-for-age and Weight-for-height. Odontometeric measurements including two different orientations. For both upper and lower study models, photographs were taken using special photographic apparatus for each child, and the data were then analyzed using special computer software. For primary dentitions, two linear measurements (intercanine distance and inter-molar distance) were utilized, representing arch measurements. Results: As for primary dentitions, all means value of maxillary and mandible arch width and length were lower among malnourished group than well-nourished group with statistically highly significant except for both inter-canine distance of maxillary and mandibular, maxillary anterior arch length and mandibular molar vertical length. Conclusion: Malnutrition effect on minimize the odontometric measurements (dental arch width, dental arch length) among children aged 5 years


Article
Effect of zinc oxide nanoparticles on total salivary peroxidase activity of human saliva (In vitro study)

Authors: Suha T. Abd --- Abbas F. Ali
Pages: 178-182
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Background: The potential use of zinc oxide and other metal oxide nanoparticles in biomedical are gaining interest in the scientific and medical communities, largely due to the physical and chemical properties of these nanomaterials. The present work revealed the effect of zinc oxide nanoparticles (ZnONPs) on the total salivary peroxidase enzyme activity of human saliva in comparison to de-ionized water. Materials and methods: Forty eight unstimulated saliva samples were collected from dental students/University of Baghdad 18-22 years. Then measure the total salivary peroxidase activity first without any addition to human saliva as a control, second with dilution the saliva with de-ionized water, and third with zinc oxide nanoparticles in concentration (5.8 mg/ml). Results: The results showed that there was significant inhibition of the activity of the total salivary peroxidase enzyme in the presence ZnO NPs and non-significant inhibition of enzyme activity in the presence de-ionized as compared with control group. Conclusion: Zinc oxide nanoparticles have inhibition effect on total salivary peroxidase activity

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