saranaz azari-marhabi

The prevalence of asthma indicates the importance of studying oral manifestations of inhalers as one of the indications of asthma. This study compares two methods of using inhalers, Metered Dose Inhaler (MDI) and Dry Powder Inhaler (DPI) in asthmatic patients.

100 asthmatic patients (50 MDI-treated, 50 DPI-treated) and 50 healthy individuals were selected by convincing sampling. The three sampled groups were gender- and age-matched. We performed a clinical examination, recorded the information, and analyzed the data by SPSS21 software using a t-test and one-way ANOVA for quantitative and Pearson’s chi-square test for qualitative indicators.

DMFT index (p-value 0.001), fissured tongue (p-value 0.005), xerostomia (p-value 0.001), and dental erosion (p-value: 0.011) in MDI-treated patients were significantly higher than the other two groups, while the geographic tongue (p-value 0.008) was significantly higher in DPI-treated patients than in the other two groups. It showed that periodontal disease and median rhomboid glossitis had no significant difference between the three groups.

Due to the higher incidence of manifestations in MDI, it is expected that physicians give more attention to prescribing inhalers and give them the necessary training to maintain oral and dental hygiene.

Using lasers in melanin depigmentation is one of the main fields of interest for dental practitioners and patients. However, it is important to know what would happen inside the tissue and how the cells would interact inside the tissue with a laser.

In this study, we used both wavelengths of 445 nm and 808 nm on sheep gingiva to find out the effects and side effects of these diode lasers while using them for gingival depigmentation.

After microscopic evaluation, we concluded that 808 nm and 445 nm lasers with a power of 1 W are safe enough to use in the depigmentation of gingiva, and both lasers are highly effective in melanin pigments which are located in basal membrane.

The 445 nm blue laser produced a less thermal effect, which means it is safer to be used in gingival hyperpigmentation than a diode laser.

Enterococcus faecalis is a gram-positive, facultative anaerobic bacterium associated with persistent endodontic infections. Conventional disinfection methods may not completely eradicate the bacteria within the root canal system. Therefore, novel modalities have been suggested to optimize root canal disinfection. The aim of this study was to evaluate and compare the antibacterial effect of photodynamic therapy (PDT), passive ultrasonic irrigation (PUI) and their combination in addition to conventional endodontic irrigation against E. faecalis biofilms in root canals.

Root canals of 50 single-rooted extracted human teeth were prepared and incubated with E. faecalis for 21 days. They were then divided into 4 treatment groups and a control group as follows: (1) NaOCl—Syringe irrigation with 2.5% NaOCl, (2) PUI—Passive ultrasonic irrigation with NaOCl, (3) NaOCl+PDT—Photodynamic therapy following syringe irrigation with NaOCl, (4) PUI+PDT, (5) Control—Syringe irrigation with saline. Colony-forming units were counted and bacterial reduction was calculated for each treatment group.

All treatments led to significant reductions in the bacterial load compared to the control group. PUI and PUI+PDT led to the complete elimination of the bacteria from the root canals. NaOCl and NaOCl+PDT treatments reduced the bacteria by 99.9% and 99.5% respectively. NaOCl+PDT was significantly less effective in reducing the bacteria compared to other treatment groups. There were no significant differences between the NaOCl, PUI, and PUI+PDT groups.

Passive ultrasonic irrigation with or without the combination of Photodynamic therapy completely eradicated the bacteria. The use of PDT as an adjunction to NaOCl syringe irrigation and PUI did not enhance their antibacterial effect.

Antimicrobial photodynamic therapy (aPDT) as a supplement to the conventional root canal preparation has shown promising results. Previous studies have adopted various combinations of light sources and photosensitizers, which makes it difficult to compare the disinfection efficacy of different PDT protocols. The aim of the present study was to compare the efficacy of three photosensitizers (toluidine blue, methylene blue, and curcumin) in PDT using LED against Enterococcus faecalis in root canal disinfection.

Root canals of 54 single-rooted extracted teeth were prepared using the ProTaper Gold rotary system and were incubated with E. faecalis for three weeks. They were then randomly divided into five experimental groups and a control group: (1) Irrigation with 2.5% NaOCl for 30 seconds, (2) NaOCl irrigation followed by TB-PDT, (3) NaOCl irrigation followed by MB-PDT, (4) NaOCL irrigation followed by curcumin-PDT, (5) Curcumin solvent (1% ethanol+1% BSA), (6) Control (irrigation with normal saline). Sampling was done by collecting dentin shavings from the root canals, and colony-forming units were determined for each treatment group. The data were analyzed by Kruskal-Wallis and Mann-Whitney U tests. The significance level was set at P˂0.05.

In all treatment groups, the mean values of colony forming unit (CFU) decreased by 99% compared to the control group. The lowest mean values of CFU were observed in groups 2 and 4, followed groups 3, 1, and 5 respectively. The mean CFU count in group 2 was significantly lower than that of group 1 (P value=0.011), while there were no significant differences among groups 1, 3, and 4 (P value >0.05).

The adjunction of toluidine blue-mediated PDT by means of a light-emitting diode to NaOCl irrigation increased its antibacterial efficacy against E. faecalis and could be an effective complementary method in root canal disinfection

Enterococcus faecalis is a resistant bacterium which is the most abundant species in infected root canals. Photodynamic therapy (PDT) is a method for killing the bacteria with active Oxygen radicals generated in a photosensitizer when exposed to centralized light. Furthermore, as a new method of canal disinfection, a variety of irrigation activation systems have been introduced, one of which is GentleFile (GF) with rotary movements and spiral effects for antibacterial action. This study aimed to compare the effectiveness of the two mentioned methods when used with and without Sodium Hypochlorite in eliminating E. faecalis from infected root canals.

Fifty-eight uniradicular teeth were randomly divided into 4 experimental groups of 14. Two specimens were selected for later scanning electron microscopy in order to screen the procedure steps. In each experimental group, 10 samples were selected to be treated with GF or PDT; 3 of them were selected as positive controls and the other one sample was chosen as a negative control. Experimental groups were as follows: (1) Irrigation activation system, (2) Irrigation activation system + sodium hypochlorite, (3) PDT, and (4) PDT+ sodium hypochlorite. The specimens were then cultured for a bacterial colony count.

The decrease in the bacterial count after the treatment with the irrigation activation system was 99.8% (P = 0.011) and when the system was used with sodium hypochlorite, it was 100% (P = 0.001). The antibacterial effect of PDT was 90.08% (P = 0.011) and it was 99.7% when PDT was combined with sodium hypochlorite (P = 0.011).

All four methods can be administered as complementary methods in root canal disinfection. According to the results of disinfection in the experimental groups of current study it is concluded that integration of new technologies such as activation irrigation system or PDT in Combination with NaOCl ameliorates disinfection of root canal and can provide several advantages in the endodontic outcome.

Enhancing students’ pragmatic skills as an enabling means warrants changes in their curricula, which should be reconciled with the students’ educational needs. Thus, this study seeks to examine the viewpoints of last-year dentistry students on the need for the instruction of laser application as an independent credit in general dentistry curricula. The findings of this study can be helpful in determining the educational priorities of students while providing and compiling their curricula.

This descriptive study was done on 91 last-year dentistry students of Shahid Beheshti University in a full census manner. The data collection tool was a fieldwork questionnaire which its validity and reliability evaluation was carried out. To announce the findings, frequency distribution, frequency percentage and average tableaux were utilized.

Amongst the 91 participants, regarding the average figures of value assignment from 1 to 10 to respond to questions, the highest value was assigned to learning the side effects of lasers (7.99 ± 0.01), and the lowest importance of and need for learning was assigned to learning about the history of laser and light physics (4.53 ± 0.47).

The findings indicate that students have a positive attitude toward the incorporation of an independent laser credit in their curricula and, thus, the necessity of incorporating this credit in their curricula can be posed.

Cross-contamination between dental office and prosthetic laboratories is of utmost importance. The dental prosthesis could harbor tones of microorganisms harmful to health staff. It has been estimated that more than 60% of the prostheses delivered to clinics from laboratories or vice versa are contaminated with pathogenic microorganisms. Several disinfection methods and chemicals have been proposed for sanitizing prostheses. Cold plasma, or nonthermal plasma, has been introduced as a new method in medical equipment disinfection. The current study aimed to compare the antimicrobial effect of cold plasma and the routinely used alcohol-based impression disinfectant ASEPTOPRINT® on disinfecting dentures.

In this experimental study, 30 maxillary complete dentures were used as the microbial source. Dentures were randomly divided into 3 groups: (1) cold plasma treatment for 30 seconds, (2) cold plasma for 60 seconds, (3) ASEPTOPRINT® spray. Microbial culturing was taken before and after disinfection in each group on both Blood Agar plates and Soborou Dextrose Agar (SDA) plates. After 48 hours incubation at 37°C, the number of colonies was counted using a digital colony counter and differences between the groups were analyzed.

A significant reduction in microbial colonies was observed after using all disinfection methods. ASEPTOPRINT® spray showed more antimicrobial effects comparing to cold plasma.

The antimicrobial effect of ASEPTOPRINT® spray solution is more than cold plasma application on both microbial and fungal microorganisms. The time of plasma application was not accompanied by any significant differences in the results.

A pivotal issue to achieve success in the treatment of the root canal is root canal disinfection. One of the most important bacteria that infect root canal is enterococcus faecalis. This study seeks to examine the effectiveness of three methods for disinfecting the root canal: photodynamic therapy, modified triple antibiotic paste (MTAP) and calcium hydroxide.Method and material: 62 single-rooted extracted anterior teeth were collectected.After cleaning and disinfection, crowns were cut at the CEJ point. The root canals were shaped to the working length up to file F3 protaper (F1, F2, F3). EDTA 17% and sodium hypochlorite 2.5% were used for 5 minutes to wash and remove the smear layer, and then the apical foramen was sealed using composite. After that, the teeth were sterilized in an autoclave at 121° C for 15 minutes. Then 10 samples were taken randomly as the negative control. The remaining samples were immersed and cultivated in a suspension containing enterococcus faecalis for 21 days. Then samples were divided into 5 groups: two positive control groups, one group treated with the antibiotic paste with the concentration of 1mg/ml, one group treated with calcium hydroxide, and one group treated with photodynamic therapy. Then, to collect the biofilm, the protaper file F4 was used. After that, the microbial suspension was provided and counting the colonies to compare the groups was carried out.

The findings indicated that the amount of CFU/mg of MTAP samples, including clindamycin, metronidazole and ciprofloxacin in the concentration of 1mg/ml and photodynamic therapy and calcium hydroxide was lower than that in the control group. Antibiotic paste, cleansed the root canal up to 99.9%. Photodynamic therapy reduced the amount of CFU/mg to 98.8%, and calcium hydroxide reduced the amount of CFU/mg to 94.13%.

Using photodynamic therapy causes a reduction in biofilm and inhibits the growth of enterococcus faecalis bacterium. In addition, in this study MTAP with the concentration of 1mg/ml was used, which expunged the bacteria completely. Meanwhile, calcium hydroxide had the weakest effect of all on the enterococcus faecalis bacterium

Based on the literature review, the available information regarding late toxicities after intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) is limited to a few countries. This study provides an opportunity to evaluate the delayed toxicities among Iranian patients with NPC that underwent IMRT. Between February 2016 and September 2018, 32 patients were treated with IMRT for NPC at Shohada-e Tajrish Hospital. The majority of them were in the advanced clinical stage and all received platinum-based induction and/or concurrent chemotherapy. Our typical prescription dose was 70.2 Gy to the gross tumor volume (GTV) in 2 Gy per fraction. Uninvolved regional lymph nodes received 59.4 Gy. Considering the minimum follow-up time of 6 months, we aimed mainly at evaluating the rate of delayed toxicities, including xerostomia, hearing loss, and eyeball damages. Toxicities were categorized based on either RTOG/EORTC or LENT/SOMA criteria. The median follow-up time was 12 months (6 - 32 months). The occurrence rates of grade ≥ 2 xerostomia, grade ≥ 2 hearing loss, optic neuropathy, and retinopathy were 28%, 10%, 4%, and 7%, respectively. Based on the dose-volume histogram analysis, averages of mean doses to the parotid glands, submandibular glands, oral cavity, and cochlea were 32.3 Gy, 58.9 Gy, 41.8 Gy, and 44.9 Gy, respectively. Our experience of using IMRT in the treatment of NPC revealed equivalent toxicities (except for hearing loss) in comparison with high-experienced centers.

Gingival hyperpigmentation is excessive deposition of melanin pigments in the epithelium of gingiva which affects facial esthetics. Various surgical methods for gingival depigmentation have been used to treat the darkened color of pigmented gingiva. This study compared the use of 940 nm diode laser and liquid nitrogen cryosurgery in the treatment of gingival physiologic hyperpigmentation in terms of gingival depigmentation, postoperative pain, healing duration, pigmentation recurrence, and patients’ satisfaction. Fifteen systemically healthy patients (11 females and 4 males; 17-35 years of age) with bilateral gingival physiologic hyperpigmentation were enrolled in this split-mouth randomized study. Maxillary anterior labial gingiva of each patient was divided into left and right halves, and each half was randomly depigmented by either laser or cryosurgery. Patients were given questionnaires to evaluate the procedures and were followed up in 3, 7, 10, 17 and 21 days postoperatively for the assessment of gingival healing and 1, 3, 6 and 12 months after the treatments to detect any sign of pigmentation recurrence. The severity of post-op pain measured by visual analogue scale (VAS) was mild to average and showed no significant difference between the 2 modalities (P > 0.05). There was no considerable swelling or hemorrhage after the treatment procedures and the healing duration was significantly shorter in laser (P < 0.05). The degree of pigmentation in all gingival sites treated by laser reached and remained at zero until the last follow up (1 year) and reached zero in 9 out of 15 cryosurgery-treated sites. All patients were completely satisfied with the laser, and 9 out of 15 were completely satisfied with cryosurgery. No pigmentation recurrence was observed during any follow-up periods. Removal of gingival physiologic hyperpigmentation by laser therapy and cryotherapy was effective and safe. The efficiency of the laser was better than cryotherapy.

Sinus tracts (or fistulas) are a common manifestation of pulpal necrosis that requires conventional or rarely surgical- endodontic treatment in order to heal. They are mainly identified intraorally and in rare cases they manifest extraorally which may frequently be misdiagnosed and incorrectly treated. New technologies such as lasers have been developed as adjuncts to standard endodontic antimicrobial procedures in order to increase the success rate of endodontic therapy and complying the desire of saving a natural tooth.
Herein, we present a clinical case of extra oral sinus tract with Periodic pus drainage that was successfully treated by combining conventional endodontic therapy, intra canal PDT and extra oral low level laser therapy.
Results and Treatment of the odontogenic lesion among with the extra oral lesion was an ingenious and successful technique which was achieved by laser technology and winded up to patient’s consent and satisfactory results of treatment.

Pharmacotherapy with analgesics and non-steroidal anti-inflammatory drugs has been traditionally used to relief post-operative pain of endodontic treatments. However, due to the side effects reported for these drugs, some efforts have been made to decrease the post-operative pain of the endodontic treatments through laser irradiation. The present study aimed to evaluate the effects of low level laser therapy (LLLT) on the reduction of pain after root canal retreatment.
In this clinical trial, 61 patients requiring endodontic retreatments in posterior teeth were selected. A single visit endodontic retreatment was performed. After biomechanical preparation, low level laser was irradiated to the buccal and lingual mucosa overlying the apices of the target tooth in the experimental group. In the control group patients received placebo laser to eliminate the probable psychological effects of laser. Laser irradiation was done with a single dose of 808 nm wavelength (Whitening Lase II- Laser DMC, Samsung, Korea) with 100 mW power, and dose of 70 J/cm2 for 80 seconds. Pain severity was recorded before, immediately after and 4, 8, 12, 24 and 48 hours after the treatment by visual analogue scale (VAS). The pain scores were statistically analyzed by chi-square test between 2 groups. The effects of different variables on the post-operative pain experience were also studied by means of Logistic regression.
Pain scores decreased significantly through time until 48 hours after treatment. No significant differences were observed between the 2 modalities regarding pain scores at any time. According to regression analysis, pain severity scores were lower in the laser-irradiated specimens than control groups (OR = 5.69); however, this difference was not statistically significant. Consumption of analgesics after the treatment had significant effect in decreasing post-operative pain experience (OR = 56) while factors of age, gender, laser irradiation, pre-treatment pain scores and education level did not.
Low level laser irradiation had limited effects to decrease pain associated with the endodontic retreatments in the first and second molars; however, more studies are required to assess the effects of different parameters of low level laser in this regard.

Malondialdehyde (MDA) is a useful determinant to show high level of lipid peroxidation which lead to impaired cell function. Previous studies have mentioned there is a relationship between high oxidative stress and low anti-oxidant activity in patients with oral lichen planus. The aim of this study was to evaluate serum level of Malondialdehyde as an indicator of oxidative stress in patients with oral lichen planus which is a chronic inflammatory disease with unknown etiology.
This descriptive-comparative study evaluated the oxidative stress status on twenty patients with oral lichen planus and 20 control healthy individuals based on serum level of Malondialdehyde.
The mean serum Malondialdehyde levels in oral lichen planus patients and control individuals were 2.9 (±2) and 2.4 (±1.3) µg/ml, respectively, indicating no significant difference (P=0.6).
According to the results, role of Malondialdehyde in cellular damage and pathogenesis of oral lichen planus was not proved.

Temporomandibular disorders (TMD) lead to masticatory muscle pain, jaw movement disability and limitation in mouth opening. Pain is the chief complaint in 90% of the TMD patients which leads to disability and severe socioeconomic costs. The purpose of this study was to evaluate the therapeutic effects of low level laser therapy (LLLT) compared to pharmacotherapy with NSAIDs (naproxen) in myofascial pain disorder syndrome (MPDS). In this randomized controlled clinical trial, 40 MPDS patients were divided into two groups. One group received naproxen 500 mg bid for 3 weeks as treatment modality and also had placebo laser sessions. The other group received active laser (diode 810 nm CW) as treatment and placebo drug. Pain intensity was measured by visual analogue scale (VAS) and maximum painless mouth opening was also measured as a functional index every session and at 2 months follow up. Data was collected and analyzed with SPSS software. Independent t test was used to analyze the data. A P < 0.05 was considered significant. Low level laser caused significant reduction in pain intensity (P < 0.05) and a significant increase in mouth opening. In naproxen group neither pain intensity nor maximum mouth opening had significant improvement. Pain relief, in subjective VAS was observed in third session in LLLT group, but did not occur in naproxen group. Maximum mouth opening increased significantly in laser group compared to the naproxen group from the eighth session. Treatment with LLLT caused a significant improvement in mouth opening and pain intensity in patients with MPDS. Similar improvement was not observed in naproxen group.

Pyogenic granuloma (PG) is one of the inflammatory hyperplasia seen in the oral cavity. It is a reactional response to minor trauma or chronic irritation. The most common treatment of PG is surgical excision but alternative approaches such as laser excision have also been proposed especially for pediatric patients.Case report: Herein, we present a case of gingival pyogenic granuloma in a 6-year-old patient. The lesion was excised successfully with diode laser as a conservative and non-stressful method in a pediatric patient.Results and The use of laser as modern medicine offers a new tool for treatment of oral lesions as comfortable as possible in pediatric patients, which results in less stress and fear in children.

Pyogenic granuloma (PG) is one of the inflammatory hyperplasia seen in the oral cavity. It is a reactional response to minor trauma or chronic irritation and also might be related to hormonal changes. Rarely, PG occurs extragingivally.The most common treatment of PG is surgical excision but alternative approaches such as laser excision have also been proposed.Case report: Herein, we present a case of lip pyogenic granuloma in a 15-year-old male whom had been under orthodontic treatment. The lesion was first excised with diode laser as a conservative method, but the lesion had immediately recurred and was excised with surgical blade as the traditional method. No recurrence or scarring was observed in 6 months follow-up.Results and Although the use of laser as modern medicine offers a new tool for treatment of oral lesions, scalpel (blade) surgical excision still seems to be the successful treatment of choice in minimizing the recurrence of lesion especially when exacerbating factors such as hormonal imbalances exist.

Pleomorphic adenoma of the upper lip is a rare entity and its diagnosis requires a high index of suspicion. The aim of this study was to review the reported cases of pleomorphic adenoma (PA) of the upper lip. This study was performed on the basis of the clinical features of 10 well-documented reported cases of the upper lip pleomorphic adenomas from 1990 to 2012 which have been indexed in the PubMed. The search strategy based on MeSH keywords included «salivary gland tumor», «salivary gland cancer», «pleomorphic adenoma», and «mixed tumor». In the clinical records the following data have been considered: Age, sex, clinical view, complaint time, site, size, texture, pathological view, treatment, recurrence rate, symptom and follow-up period. Of the 11 reported cases of PA, 7 (63. 7%) were female and 4 (36. 3%) were male, with age ranging from 12 to 65 years. 50% of the patients were between 35 and 55 years of age. Only 3 (27. 2%) of cases were younger than 20. The main clinical presentation of lesion in all cases was a submucosal nodule. There was a large interval between the first symptoms and diagnosis. The size of the lesions were between 1 and 3 cm. Involvement of the right half of the upper lip was more common than the left side. 63. 6% of the lesions showed a firm consistency and bone formation was seen in one (9. 09%) case. The follow-up period ranged from 5 to 48 months. There was no evidence of recurrence in any of the reported cases. Although rare, pleomorphic adenoma should be considered as a differential diagnosis for the swellings in the upper lip. PA has a potential for malignant transformation