علیرضا عمرانی

The placement of orthodontic separator induces pain and discomfort in patient. Use of Nsaid for its analgesic effect is with side effects. The aim of study evaluation of the effect of low level laser therapy on pain reduction and NO level in GCF induced by separator force in orthodontic treatment.

This experimental laboratory study was performed on 30 patients in the age range of 15-35 who required placement of the separator on the right maxillary molars. Patients were randomly divided into two groups of laser and placebo. Gingival groove fluid sampling was performed on 0-3-0 days in both groups. Laser irradiation was performed on days 2 and 4, in the placebo group, the device was used off. The amount of pain was recorded by patients with a VAS questionnaire on a daily basis. Data were analyzed by t-test and ANOVA (α = 0.05).

VAS score in laser group was more than placebo group but it wasn’t statistically different (p value = 0.067), NO level further decrease in laser group compared with placebo group but it wasn’t statistically different (p value = 0.286).

the effect of low level laser therapy on pain reduction was very low and it wasn’t statistically different.

Temporomandibular joint disorders (TMDs) are one of the most common causes of the patientchr('39')s referral to dental clinics. Considering the role of related factors in its creation, the purpose of this study was to investigate the relative frequency of factors related to temporomandibular disorders in patients aged 20 to 50 years referred to dental clinics in Isfahan in 1397.

In this descriptive and analytical study, 324 patients referred to Isfahan dental clinics in 1397 were randomly included. Factors related to TMD and demographic factors of patients were recorded with clinical examination by a trained dentist and self-declaration of patients in the data collection form. The frequency and relevance were analysed by SPSS 22 software and chi-square, fisher and logistic regression statistic tests.

At least one of the TMD related factors was present in 40.7% of the subjects, which the most common factors related to TMD was posterior edentulousness (49.7%). History of jaw dislocation was more common in men (P=0.014) and the frequency of posterior edentulousness was more common in in women (P=0.003). As the age increased, the frequency of posterior edentulousness (P=0.000) and earache (P=0.009) increased. The frequency of posterior edentulousness was higher in housekeepers (P=0.000), the frequency of earache was higher in employees (P=0.005) and the history of jaw dislocation was higher in self-employed persons (P=0.047).

The high prevalence of TMD and related factors, such as a history of jaw dislocation, posterior edentulousness, earache, and clenching, requires attention to be identified and treat these problems.

One of the most common complications in the treatment of fixed orthodontics during treatment is periodontal problems. Different therapies such as mouthwashes, antibiotics and today laser therapy are used to treat periodontal problems in orthodontic patients. The aim of  this study, is that we evaluated the effect of the Diode laser on the number of four periopathogen microorganisms.

In this experimental study, 12 patients with fixed orthodontic appliance without gingivitis and periodontitis were selected. The left and right second premolar teeth were considered as case and control groups. After periodontal examinations, before and after the laser, were taken GCF sample and After 2 weeks and 6 weeks after laser irradiation, samples were re-sampled and transferred to the laboratory. Data were analyzed by Wilcoxon and Mann-Whitney statistical tests

The mean of the four kind of preopatogen immediately after laser radiation decreased significantly. (P<0.001)And this decrease continued after two weeks, but after six weeks only the mean of the number of Prevotella intermedia  (P=0.008) and porphyrpmonas gingivali (P=0.002) decreased significantly.

lasertherapy is effective in the reduction of the number of preopatogenic microorganisms in gingival crevicular fluid of fixed orthodontics patients without inflammation which this effect last for a shorter period in cases of Actinomyces comitans,Actinomyces odontolyticus

Frankel functional appliance is considered to be a very valuable device in the treatment of Cl II malocclusion, with the greatest skeletal effects. The aim of this study was to evaluate the dental and skeletal changes after treatment with Frankel appliance in patients with Class II malocclusion. This clinical trial was carried out on 8 patients, 9–12 years of age, with Class II skeletal and dental malocclusion. Lateral cephalometric radiographs were prepared before and after treatment. Tracings were carried out on cephalograms and the necessary measurements were made. Data were analyzed with t-test (α = 0.05). Of all the variables on the base of the skull, comparison between the group treated with Frankel appliance and control group showed that SN height increased significantly (p value = 0.006). Comparison between the two groups showed that in the maxillary complex, the decrease in SNA angle (p value = 0.04) and the increase in maxillary height (p value = 0.01) were significantly different between the two groups. In the mandible, gonial angle (p value = 0.03), SNB angle (p value = 0.001), SNBpog (p value = 0.0005), height of the ramus (p value = 0.01), base of the mandible (p value = 0.007) and length of the mandible (p value = 0.01) were significantly different between the two groups. Of all the variables created in the upper and lower jaws, the ANB angle (p value = 0.0005) was significantly different between the two groups. Of all the variables, height and relationships of facial variables, S-GO (p value = 0.01) and N-Me (p value = 0.001) were significantly different; and of all the dental relationship variables the mean changes were significantly different between the two groups (p value = 0.01). Frankel skeletal effects included prevention of maxillary forward growth and mandibular anterior movement, eliminating the mandibular deficiency and correction of the discrepancy between the two jaws. Frankel dental effects were minimum, decreasing the overjet and improving dental status in patients with class II malocclusion.

In order to achieve the most effective treatment outcome with the least cost, awareness of the appropriate timing of orthodontic interventions is important, especially for general dental practitioners as the first ring of the therapeutic chain. Orthodontic treatments should be carried out at the right time to achieve a favorable outcome and save time and expenses for patients. The main objective of this study was to assess the knowledge of general dentists of the favorable time for orthodontic treatments.
In this descriptive-analytical study, data were collected from 100 dental practitioners in Isfahan through a randomized questionnaire containing 24 questions. The questions were classified into four categories: primary dentition, early mixed dentition, late mixed dentition and permanent dentition. The mean of the collected data was analyzed using LSD tests (α = 0.05) in terms of university and different graduation times. The normal distribution of data was assessed using Kolmogorov-Smirnov and Kruskal-Wallis tests (α = 0.05).
The mean knowledge score of the dentists was 14.77 (out of 24 score). Graduates of the 2000s gained the highest scores (with a mean score of 15.26), followed by those of the 1990s (mean score = 14.46) and before the 1980s (mean score = 13.40). Moreover, the knowledge of graduates from the governmental universities was higher than others with an average score of 15. 63, followed by the graduates of Isfahan University (a mean score of 15.27), Azad University (a mean score of 14.75) and universities abroad (a mean score of 11.83), which were significantly different from each other.
The knowledge of dentists was moderate; therefore, it is necessary to promote their knowledge.

Insurance companies ýusually use the chain-ladder method in their financial statements to predict loss reservesý. ý The chain-ladder method is based on aggregated data and development years of claims in run-off trianglesý. ýThis triangle is a summary of an underlying data-set related to the development of individual claimsý. This paper used ýthe framework of Position Dependent Marked Poisson Processes and statistical tools for recurrent events in individual claims for a method of reserve as a micro-level stochastic loss reserveý. Detailed information concerning damage occurrence timeýs,ý loss reporting delay timesý, intervals between payments, the values of their paymentsý, ýand the final settlement times of claims are used to calculate the micro-level reservesý. To validate the new model, ýthe data-set from an Iranian insurance company is considered. Using this data-set and the simulation of micro-level stochastic loss reserving model, it was shown that the use of micro-level stochastic loss reserving model is a close estimate to the real value of the required loss reserve in the future years.

Contamination with saliva is an important factor in reducing the shear bond strength of orthodontic brackets to tooth surfaces. One of the most important disadvantages of bonding techniques is their sensitivity to contamination with saliva. The aim of this study was to evaluate the effect of duration of contamination of tooth surfaces covered with unfilled resin with saliva on shear bond strength orthodontic brackets.
In this experimental study, 110 extracted human intact premolar teeth were divided into 5 main groups and 11 subgroups. In the control group the brackets were bonded to tooth surfaces with no saliva contamination. In other groups, after applying the unfilled resin, the samples underwent saliva contamination as follows: group B, 1, 5 and 15 seconds of contamination; group C, 1, 5 and 15 seconds of contamination and drying with air current; and group D, 1, 5 and 15 seconds of contamination and washing and drying with air current, followed by bonding of the brackets. In group E, according to the manufacturer's instructions, after contamination, washing and drying, unfilled resin was applied again and then the brackets were bonded. The shear bond strength of brackets to tooth surfaces was measured by an Instron machine. Data were analyzed with ANOVA (α = 0.05).
The highest bond strength was recorded in the control group (4.21 MPa) and the lowest in the fourth subgroup (15 seconds of contamination without washing) (3.8 MPa). There were significant differences in the mean bond strengths of brackets bonded to enamel surfaces between the main groups (p value = 0.001).
Contamination with saliva reduces bond strength. Proper isolation is necessary to achieve a stronger bond between orthodontic brackets and tooth surfaces.

One of the techniques to treat skeletal Cl II malocclusion is growth modification. bionator functional appliance brings about skeletal changes to resolve Cl II malocclusion caused by mandibular deficiency by protruding the mandible and accelerating growth. The aim of this study was to evaluate skeletal and dental changes in patients with Cl II malocclusion following treatment with Bionator and to compare the results with the control group.
The present clinical trial was carried out on 17 patients (8 girls and 7 boys) aged 9-11, with Cl II malocclusion. To properly register the mandible, a wax rim was used and the bionator appliance was fabricated based on the recorded relationship in an arrticulator and delivered to the patients. Lateral cephalometric radiographs were taken before and after treatment. Tracing was carried out and the necessary measurements were made. Data were analyzed was paired t-test (α Comparison of mean changes in the antero-posterior cranial length, maxilla, and maxilla and mandible relative to each other between the bionator and control groups showed no significant differences between the two groups. The means of upper and lower gonial angles (p value = 0.001), SNB angle, SN-pog angle, Y axis and pog-NP in the lower jaw showed significant differences between the control and bionator groups (p value = 0.01. The mean of Pal-OCC angle, SNB angle, articular angle and Jarabak index (JI) (p value = 0.01) of the facial relationship variables exhibited significant differences between the control and bionator groups.
Bionator can be used to correct antero-posterior mandibular deficiency and Cl II skeletal and dental malocclusion during the growth period.

Airway obstruction in the upper respiratory system for a long duration during the critical growth period of the face and jaws results in morphological changes in the head and face, the final outcome of which in some severe cases might be adenoid facies. The aim of this study was to compare mouth breathing among 6‒12-year-old children with large and normal adenoid.
In this observational-analytical study, 52 patients aged 6‒12 years were selected; 25 subjects had large adenoid, representing the case group, and 27 had normal adenoid, representing the control group. The subjects were asked to seat calm and breathe normally. The rate of air passing through the nose and mouth was recorded by a device separately. Data were analyzed with independent t-test (α = 0.05).
The mean breathing through the nose and mouth in the control (p value Children with adenoid hypertrophy exhibited more mouth breathing and less nasal breathing compared with children without adenoid hypertrophy.

Non-pathological facial asymmetries are usually due to differences in sizes of the right and left sides. This study investigated normal facial asymmetry in individuals with Cl II and III malocclusion to clarify facial laterality and its relationship with the right-handedness or left-handedness.
In this cross-sectional descriptive-analytical study, frontal-view digital photographs were taken of 66 subjects (43 Cl II and 23 Cl III) referring to the Department of Orthodontics, Faculty of Dentistry, Khorasgan University. The patients were questioned about the main chewing function side and their right- or left-handedness. On the photographs, the facial midline and menton point on the chin were drawn; the distance between the midline and the left and right sides were measured on the photographs using Photoshop software program. In addition, the distance between the menton point and the midline was measured. Data were analyzed with independent t-test (α = 0.05).
In 51.2% of Cl II and 47.8% of Cl III subjects the right side of the face (p value = 0.85) was wider than the left side and in 48.8% of Cl II and 52.2% of Cl III subjects the left side of the face (p value = 0.79) was wider than the right side, with no significant relationship between dental occlusion and face width. In addition, 62.1% subjects exhibited deviation of the chin to the left side (p value Cl II and Cl III malocclusion exhibited no effect on face laterality and the facial half width; however, right-handedness and left-handedness affected face laterality.

Currently the vast use of fixed orthodontic treatment in order to resolve dentoalveolar irregularities has led to oral mucosal lesions. The aim of this study was to evaluate the prevalence of oral mucosal lesions due to fixed orthodontic treatments in order to adopt proper strategies to decrease these lesions during orthodontic treatment.
In this cross-sectional study, 56 patients referring for fixed orthodontic treatment to the Faculty of Dentistry, Islamic Azad University Isfahan (Khorasgan) Branch, completed a questionnaire in relation to the absence of systemic diseases and any drug consumption. The patients were examined to assess the oral mucosa and any lesion and pain caused by lesions before treatment and two and four weeks after treatment were recorded in each patient's record. Data were analyzed with the Cochrane statistical methods; pain was determined and analyzed with repeated measures ANOVA (α = 0.05).
The results showed that two and four weeks after treatment, the frequencies of different lesions were as follows, respectively: recurrent aphthous lesions (p value = 0.002, p value = 1), allergic ulcers (p value = 0.06, p value = 0.95), lichenoid reactions (p value = 0.92, p­ value = 1), exophitic lesions (irritation fibroma and pyogenic granuloma, p value Based on the results of this study, it appears some oral mucosal lesions increase following fixed orthodontic treatment. Thus, it is necessary to evaluate the oral mucosa of patients undergoing fixed orthodontic treatment for diagnosis and treatment of these lesions.

The aim of this study was to compare the specific activity of alkaline- phosphatase (ALP) in GCF during two techniques of canine retraction (sliding and frictionless) to find whether this parameter has the potential as a diagnostic biomarker of tissue response in orthodontic tooth movement.
Subjects and In a clinical trial 5 subjects (aged 12-20 yr) with bimaxillary dentoalveolar protrusion were selected. After the extraction of four first premolars, the sliding and frictionless techniques were used cross-sectionally to retract canines in each subject. GCF samples were collected from mesial aspect of each canine by using strile paper points (#15) at four time intervals (immediately after the appliances were fitted, at the time of initial activation, 15 and 30 days afterwards). ALP and microprotein levels were assayed by means of quantitative colorimetric technique and tooth movement at each sampling interval was measured by using a digital caliper.
After the activation of the appliances, average specific activity of ALP in GCF at tension sites was significantly increased using either techniques (P= 0.014). In addition, the specific activity of ALP at sampling intervals in both techniques, showed significant differences. Change in specific activity of APL in sampling intervals, in frictionless technique was significantly higher than sliding technique only in 15-day sampling interval, but not in others.
This study shows that alveolar bone formation can be measured via ALP activity in GCF samples. Therefore this will be a reliable diagnostic tool for monitoring orthodontic tooth movement in clinical practice.

Background and Digital radiography has led to many improvements in radiology. Despite many advantages there are different ideas in determining anatomical landmarks which results in some errors in cephalometric analyses. The aim of this study was to determine the degree of identification differences of anatomical landmarks by conventional and digital lateral cephalometric techniques using manual tracing of human skulls. This descriptive-analytical study was conducted in 17 cases of human skulls in which metal radiopaque markers were attached to 9 landmarks as follows: N, S, ANS, PNS, A, B, Pog, the most inferior point of lower mandibular border, and Go. Conventional and digital lateral cephalograms were obtained from each skull with and without markers. The two cephalograms without markers were traced for landmarks by three orthodontists. Any difference between these landmarks and those of cephalograms with markers, were recorded and analyzed by student t-test. The level of differences in S point was not statistically significant along both x and y coordinates. The measurement differences for the ANS and PNS points obtained by both radiographic methods were significant along the x coordinate but not significant along the y coordinate. Also, the measurement differences for the most inferior point of lower mandibular border, A, B, and Go points along both x and y coordinates were observed to be statistically significant. The measurement difference obtained for the Pog point was significant along the y coordinate and non-significant along the x coordinate. The difference in landmark identification between the two digital and conventional lateral cephalometric techniques was statistically significant for some points on both dimensions, however, the difference was not clinically significant.

The most important function of speech is communication and any disorder in speech undoubtedly affects communication with other people. Speech disorders have a significant effect on social development of human beings. This study was undertaken to evaluate the relative incidence of speech disorders in sagittal dento-alveolar disorders. In this descriptive analytical study 95 patients referring to the Orthodontics Department of Khorasgan Dental School in spring 2008، who met the inclusion criteria (subjects with one of the Angle’s 3 classes of malocclusion based on preliminary evaluations، no history of orthodontic treatment and with no other problems such as mental retardation or cleft palate) were randomly selected and underwent dentofacial examinations. A speech therapist evaluated the subjects’ speech disorders via phonetic test and colloquial speech. Data were analyzed with chi-squared test using SPSS 16 (α=0. 05). Chi-squared test did not reveal any significant relationship between speech disorders and Angle’s malocclusion (p value = 0. 07). The group with dentofacial disorder and the group without it were matched in relation to sex (p value = 0. 092) and age (p value = 0. 543). In addition، of all the consonants the most common disorder was related to abrasive consonants and the speech disorders were not evenly distributed among all the consonants (p value < 0. 001). The results showed no significant relationship between speech disorders Angle’s malocclusion. The most frequent disorder was related to abrasive consonants.

It is useful to determine facial proportions in different communities to find an index for assessment of esthetics. The aim of this study was to determine several facial indices in females and males and compare them with the golden ratio and finally to compare anthropometry and digital photography techniques. In this cross-sectional analytical study, 20 female and 20 male subjects with no history of orthodontic treatment and facial esthetic surgery were selected. The subjects all had Cl I occlusion. Digital photographs were taken from all the subjects in the natural head position. Independent t-test, one-sample t-test and paired t-test were used for statistical analysis (α = 0.05). There were no significant differences between the two anthropometry and digital photography techniques in relation to measurements (p value < 0.05). The average ratios of oral width to nasal width, the distance between the nasal base and the chin to the distance between underneath the nose to the chin, the inter-zygomatic width to the nasal width in females, and the distance between the underneath of the nose and the chin to the distance between the nasal base and the chin in males were higher. Other ratios were not statistically significant in females and males. The majority of variables in males and females were different from the golden ratio (p value < 0.05), except for the ratios of oral width to the distance between the inner canthi of the eyes in females and males and the distance between the nasal base and the chin to the distance between the underneath of the nose to the chin in males (p value < 0.05). Based on the results of this study both methods can be used for facial ratio analysis but computed technique is reproducible and can be carried out in less time with greater accuracy. Due to differences of most of ratios of the present study from the golden ratio, it can be concluded that this ratio cannot always be used as a standard for treatment planning for dentists and surgeons in Iran.

Analysis of gingival crevicular fluid (GCF) may be a good means of examining the biochemical processes associated with bone turnover. The aim of this study was to evaluate the specific activity of acid phosphatase (ACP) in GCF during canine retraction with sliding technique. In this clinical trial 5 subjects (aged 12–20 years) with bimaxillary dentoalveolar protrusion were selected. After extraction of four first premolars, the sliding technique was used to retract canines in each subject. GCF samples were collected from the distal aspect of each canine by using sterile paper points (#15) at four time intervals: immediately after the appliances were fitted, at the time of initial activation, and 15 and 30 days afterwards. Acid phosphatase and microprotein levels were assayed by means of quantitative colorimetric technique. Tooth movement at each sampling interval was measured. Data was analyzed with non-parametric tests of Freeman, Mann-Whitney, and Pearson’s correlation coefficient (α=0.05). After activation of the appliances, average specific activity of acid phosphatase in GCF significantly increased (p value < 0.001). In addition, the specific activity of ACP at sampling intervals showed significant differences (p value < 0.001). No significant relation was noted between changes in specific activity of ACP and tooth movement (p value = 0.215). It is possible to measure specific activity of acid phosphatase in the GCF during orthodontic tooth movements. It is elevated in the pressure side during orthodontic tooth movement.

14-18 year-old female students of Isfahan public schools in 2009-2010 based on Index of Orthodontic Treatment Need (IOTN). In this descriptive study, 370 14-18 year-old female students were selected by random clustering method. The subjects were examined clinically based on two components of IOTN: Dental Health Component (DHC) and Aesthetic Component (AC). Data was analyzed with descriptive statistical methods, including Spearman’s correlation coefficient (α = 0.05). Regarding DHC, 10.8% of samples showed grade 5, 13.5% showed grade 4, 23.8% had grade 3, and 51.8% demonstrated grades 1 and 2. In those showing grade 5, the most common malocclusion was unerupted (i) teeth. The most common malocclusion in grade 4 was contact displasments (d) for more than 4 mm and in grade 3, contact displasment was less than 4 mm and more than 2 mm. The most common malocclusion in grade 2 was contact displasment (d) less than 2 and more than 1 mm. In addition, regarding AC, 98.8% of the subjects were classified as “no need”, 1% as “borderline need” and 0.0% as “definite need” for treatment. No statistically significant differences were noted between AC and DHC (p value = 0.294). It was concluded that 24.3% of 14-18 year-old female students in Isfahan need orthodontic treatment (IOTN grades 4 and 5) and common malocclusions are contact point displacements, unerupted teeth and increased overjet.

Shape and size of upper anterior teeth are important in dental and facial beauty. The aim of this study was to determine the correlation between dental and facial indexes and to evaluate whether there is a golden ratio and its relationship with the proportions measured. In this cross-sectional study, digital images of 34 female and 30 male dental students were taken at maximum smile in a similar manner. Then the images were assessed with Photoshop CS5 and ACDSee computer programs and measurements were made with AutoCAD 2011 software. Data was analyzed with independent t-test and means were compared with a constant. The entire variable means did not demonstrate any significant differences between males and females (p value > 0.05). The inter-pupillary to inter-canine distance ratio did not reveal any significant differences with the golden proportion of 1.618 between males and females (p value > 0.05). Only the ratios of inter-pupillary, inter-canthus and inter-zygomatic distances to maxillary central widths in females, and the ratios of inter-zygomatic and inter-alar distances to maxillary central widths in males were not significant. Under the limitations of the present study, it was concluded that dento-facial proportions are not significantly different between males and females and the golden ratio applies in the inter-pupillary to apparent width of anterior maxillary teeth proportion. Facial indices are appropriate measures to measure the apparent width of anterior maxillary teeth and can be used as a standard for Iranian dentists and surgeons.

Salivary contamination of etched surfaces is an important cause of resin and composites bond strength reduction. The aim of this study was to evaluate the relationship between the duration of saliva exposure on the etched surface and the shear bond strength of braces and the enamel of the tooth.Method and materials: This was an experimental study which included 50 premolar intact teeth. After mounting the specimens, they were randomly divided into 5 groups of 10 teeth. In the first group used as our control, the braces were bonded without any saliva contamination. In the remaining four groups, samples were contaminated with saliva prior to resin application and the etched surfaces were cleaned after 1, 5, 10 and 15 seconds and then the resin was applied. After thermocycling, samples were subjected to shear force and the loads were recorded. The collected data were analyzed through ANOVA and Duncan post hoc tests using SPSS.(α = 0.05) The groups showed significant differences (P < 0.001).Pair wise comparison showed that there was no statistically significant difference only between groups IV and V. Contamination of etched surface with saliva reduces the bonding strength of braces. However, there was no significant difference between the contamination durations of 10 and 15 seconds.