Journal of Research in Dental and Maxillofacial Sciences
Volume:1 Issue: 4, Autumn 2016

First permanent molars with poor prognosis may be candidate for timely extraction and replacement by second permanent molars. The presence of third molars should be considered in this treatment plan. The aim of the present study was to evaluate the critical developmental stages of permanent second molar and the status of third molar bud in an Iranian population. Four hundred panoramic radiographs of 7 to 11-year-old children were evaluated in this descriptive study. Data were collected from patients’ files and through phone interview with parents. The stage of tooth development in each age group was determined according to the modified Demirjian method. Statistical analysis was performed using Wilcoxon signed Rank test and Chi-Square test. Stage E (beginning of root formation) in permanent second molars had the highest prevalence among 8 and 9-year-olds in the mandible, and among 9 and 10-year-olds in the maxilla. The predominant stage of development in third molar buds was stage 0 (no evidence of bud formation) in the corresponding age groups. There was no significant difference between boys and girls in terms of developmental stages. Mandibular second and third molars were more advanced than maxillary molars in terms of development, with no gender predilection. The beginning of calcification in the furcation area of permanent second molar (Stage E, between 8 to 10 years of age) is the most proper stage to coincide with first molar extraction. However, during this time period, the signs of third molar bud formation are not detectable in many individuals, especially in the maxillary arch.

Methods of age estimation with the aid of radiography have higher accuracy compared with other methods. Some investigations have been performed in this regard, but the correlation between dental development and Body Mass Index (BMI) has been limitedly researched. In the present study, the correlation between dental development and BMI in the children referring to the dental school of Islamic Azad University of Tehran was evaluated with the use of panoramic radiography. In this cross-sectional analysis, panoramic radiographs of 104 children aged 6 to 13 years were evaluated. The date of radiography minus the birth date was used to determine the chronologic age for each child and then, this age was compared with the dental age estimated by the Demirjian method. Afterwards, the height and weight of the children were measured and the BMI was calculated for each subject. The difference between the estimated dental age and the chronologic age of the subjects was analyzed according to gender and BMI classification. Statistical analyses were performed using the ANOVA test, Pearson correlation coefficient and linear regression. In the 104 samples, the difference between the estimated dental age and the chronologic age was not significant (p=0.516). The dental age in normal weight children was lower than the chronologic age while in obese children, it was higher than the chronologic age (p=0.00001). The correlation coefficient of the estimated dental age using the Demirjian method and the chronologic age in normal weight and obese boys was 0.936 and 0.901, respectively, while in normal weight and obese girls, it equaled 0.916 and 0.942, respectively. The results of the present study showed that dental development is accelerated in obese children.

Toothbrushes cannot reach all interdental areas. Interdental cleaning is an important part of oral hygiene care. The purpose of this study was to compare the supragingival plaque removal efficacy of an interdental cleaning power device (Aquajet) and dental floss. Thirty subjects were enrolled in this single-blind, split mouth clinical trial. All the subjects received both written and verbal instructions and demonstrated proficiency prior to the study. The subjects were asked to abstain from oral hygiene methods for 48 hours prior to the study. The subjects were scored using the Proximal/Marginal Plaque Index (PMI). Then, the four oral quadrants were randomly assigned to one of two treatment groups: One upper and one lower quadrant: Aquajet and the other two quadrants: dental floss. The subjects were observed to ensure that they have covered all areas and have followed the instructions. Afterwards, they were scored again using the PMI. The pre and post-cleaning plaque scores were evaluated using two-way repeated measure ANOVA. Both Aquajet and dental floss showed significant reduction of the baseline PMI in all dental areas (P<0.05), but the difference between the groups was not significant (P>0.05). Aquajet was significantly more effective than dental floss in reducing plaque on the mesial, mid-buccal and distal surfaces of upper first premolar and on the mesial and distal surfaces of upper second premolar and first molar (P<0.05). The results proved that oral irrigation with Aquajet is as effective as that with dental floss in plaque removal, and that Aquajet had significantly higher plaque removal efficacy at hard-to-reach dental surfaces.

Probing is the only reliable method for diagnosing periodontal diseases; however, it is a painful examination. The purpose of this study was evaluation of the effect of EMLA anesthetic gel on the level of pain upon probing in patients with chronic periodontitis referring to the periodontology department of the dental branch of Islamic Azad University of Tehran during 2013-2014. This double-blind split mouth clinical trial involved 20 eligible patients. All the teeth in two quadrants of each patient's mouth were randomly selected to be either treated with the anesthetic gel or the placebo and were probed in six points. Afterwards, the level of pain was measured using the VAS ruler. Thirty seconds after applying the gel and probing, the pain was measured again and registered. The levels of pain before and after using the gel were compared using the statistical tests. The levels of pain before and after using the placebo gel were 5.4±1.8 and 5.1±1.8, respectively and pain variations in this group equaled 0.25±0.9 (P= 0.4). The levels of pain before and after using the anesthetic gel were 5.65±1.7 and 2.1±1.2, respectively. Pain variations in this group equaled 3.55±1.3 and this difference was statistically significant (P<0.001). The results of the present study showed that EMLA anesthetic gel is effective in reducing the pain upon probing.

Clinical and radiographic diagnoses of dental root fractures have always been difficult and require high accuracy in dental care and treatment. The aim of this study was to compare the diagnostic accuracy of intraoral digital radiography (PSP) and CBCT in the detection of horizontal and vertical root fractures (HRF and VRF). For this experimental study, 60 human mandibular teeth (30 anterior and 30 posterior multi-rooted teeth) were selected. Thirty randomly-selected teeth were fractured horizontally while the next 30 randomly-selected teeth were fractured vertically by use of a hammer and then the pieces were glued back together and were placed in a sheep mandible. Radiographic images of all the teeth were taken using intraoral digital radiography (PSP) and CBCT methods. Afterwards, two oral and maxillofacial radiologists assessed the images separately. The data were subjected to diagnostic analytic tests. There were significant differences in specificity, sensitivity, positive predictive value and negative predictive value between digital intraoral radiography (PSP) and CBCT in the detection of HRF and VRF. Kappa value for inter-observer and intra-observer agreement in VRF equaled 73.3% for CBCT and 54.2% for PSP, while in HRF it equaled 63.3% for CBCT and 55.4% for PSP. CBCT method has higher specificity and sensitivity in the detection of HRF and VRF compared with intraoral digital radiography.

Basal Cell Carcinoma (BCC) is the most common skin neoplasm and the most common type of cancer. Since the incidence of injury is taken into consideration in the pathologic diagnosis, the study of clinical and microscopic views of BCC is of particular importance. The present study aimed at determining the frequency of clinical and microscopic views of BCC in a 10-year period in Ilam province. This study is descriptive. The study population consisted of all the subjects with BCC in the head and neck area referring to the pathology department of Imam Khomeini hospital in Ilam province in a 10-year period. The data were entered into SPSS 19 software and were analyzed using descriptive statistical methods and Chi-Square test. In the present study, 205 patients were diagnosed with BCC. The maximum and minimum frequency rates of the lesion were detected in the frontal area (9.23%) and neck (8.7%), respectively. The maximum frequency was related to the nodular type (57.1%), while the pigmented variant showed the lowest rate (8.3%). Among the evaluated microscopic variants, maximum views were related to the solid-cystic type (57.1%), while minimum views were related to the pigmented variant (37.3%). There was no significant correlation between the location of the lesion in males and females (p=0.14) or between the location of the lesion and age (p=0.16). The results of this study showed that the nodular type was the most common clinical variant of BCC, while the least common type was the pigmented variant. The most common histological type was the solid-cystic type, while the pigmented variant was the least common type.

Crohn’s disease is an inflammatory bowel disease that can affect any part of the gastrointestinal (GI) tract including the mouth. Bowel symptoms are predominant. Oral involvement may precede the GI symptoms. This case report presents a patient affected by Crohn’s disease with oral onset. We present a 30-year-old pregnant woman complaining of chronic, multiple, yellow-white crusted ulcers predominantly involving the lips. In addition, there were small painless lesions on the palate, buccal and labial attached gingivae, alveolar mucosa and vestibule. The lesions were present since 3 months ago. The patient had not previously experienced any oral lesions or systemic diseases. The laboratory tests were normal. Laboratory investigation showed increase in neutrophil and eosinophil count. Incisional biopsy of the buccal mucosal lesions was performed. In histopathological examination, acanthotic and parakeratotic epithelium with intraepithelial clefts was observed. Inflammatory cells such as eosinophil and polymorphonuclear (PMN) leukocytes were profoundly present in the clefts and diffusely in the epithelium. Blood vessels, collagen fibers and in-depth muscle and fat tissues were also observed. Based on these characteristics, the diagnosis of pyostomatitis vegetans was made. Considering the biopsy results and the presence of GI symptoms such as abdominal pain and diarrhea after postpartum, Crohn’s disease was suspected and therefore, the patient was referred to a gastroenterologist for definitive diagnosis and treatment. The patient showed the diagnostic signs of Crohn’s disease. This report emphasizes the important role of oral lesions as the first sign in the diagnosis of systemic diseases.