Journal of Islamic Dental Association of IRAN
Volume:31 Issue: 2, Spring 2019

Gingival biotype is a principal component in restorative and implant procedures, especially in the aesthetic region. Immediate determination of the gingival biotype by the clinician could lead to a more successful outcome, especially during implant placement in the aesthetic zone. The aim of this study was to investigate a possible relationship between gingival biotypes and gingival thickness, crown length (CL), crown width (CW), papillary height (PH), and papillary width (PW). In this cross-sectional study, 50 subjects were selected who had all anterior teeth in the upper and lower jaws with a healthy periodontium and no attachment loss. Gingival thickness was recorded based on the transparency of a peri-odontal probe. CL, CW, PH, PW, area of the facial papilla (AP), and facial surface area of anterior teeth (AT) from canine to canine were measured and analyzed using descriptive statistics and t-test in SPSS 16.0 software. When comparing thin and thick gingival biotypes, the mean CL (8.3 mm vs. 8.76 mm; P=0.14), CW (7 mm vs. 7.25 mm; P=0.13), PH (2.86 mm vs. 2.99 mm; P=0.49), and PW (2.86 mm vs. 2.99 mm; P=0.04) were lower in the thin gingival biotype group. The AP and AT were smaller in the thin gingival biotype group but the difference with the thick gingival biotype was not significant (P=0.22 and 0.07, respectively). According to the results, comparable dentopapillary dimensions can be expected in thick and thin gingival biotypes. No association was detected between the dentopapillary complex and gingival biotypes.

Life-threatening medical emergencies might happen at any time to a patient in a dental office. These emergencies should be treated immediately and cannot be avoided or referred. The purpose of this study was to as-sess the knowledge and attitude of dentistry professors, residents, and interns towards medical emergencies at the dental faculty of Hamadan University of Medical Sciences. A cross-sectional study was conducted among 174 dental practitioners practicing as dentistry professors, residents or interns at the dental facul-ty of Hamadan University of Medical Sciences. A questionnaire comprised of three parts, including demographics, knowledge, and attitude, was distributed among the participants. The collected were tabulated and analyzed using SPSS 24. The results were reported in terms of the frequency. Comparisons were made using one-way anal-ysis of variance (ANOVA) with a 95% confidence interval (CI). P<0.05 was considered statistically significant. The residents’ knowledge score was significantly higher than that of the fac-ulty members (P=0.02). The faculty members’ score was higher than that of the interns but the difference was not significant. Less than half of the participants stated that the quality of the provided theoretical educations was satisfactory. The results indicate the lack of proper medical emergency preparedness among the studied dentists. It seems that periodic theoretical and practi-cal medical emergency training courses are necessary for dentists during education and, more importantly, after graduation.

Composite placement poses many challenges, especially in the gingival floor with dentinal margins. Microleakage is one of the factors affecting the longevity of dental restorations. We aimed to compare the microleakage of cavities filled with bulk-fill composite at enamel and dentinal margins. In this experimental study, a total of 102 sound human premolars were randomly divided into six groups. In groups 1, 3, and 5, Class II cavities were prepared with their gingival margins above the cementoenamel junction (CEJ). In groups 2, 4, and 6, standard Class II cavities were prepared with their gingival margins below the CEJ. In groups 1 and 2, cavities were incrementally filled with Filtek Z250. In groups 3 and 4, the gingival 2 mm of the cavity was filled with Fil-tek bulk-fill, and the rest of the cavity was restored with Filtek Z250. In groups 5 and 6, the gingival 4 mm of the cavity was restored with Filtek bulk-fill, and the remaining part was restored with Filtek Z250. The teeth were immersed in 2% basic fuchsine for 24 hours, sectioned mesiodistally, and evaluated under a stereomicroscope at ×40 magnification. Data were analyzed using Kruskal-Wallis test. Wilcoxon signed-rank test was used for intergroup comparisons (α=0.05). No significant difference was noted in the microleakage scores of the gingival margins of the six groups (P=0.168). No microleakage was noted at enamel margins. Neither Filtek bulk-fill nor Filtek Z250 could completely eliminate gingival microleakage. It seems that Filtek bulk-fill flowable composite can be safely and reliably used in 4-mm-thick increments.

Lichen planus is an inflammatory autoimmune mucocutaneous disease. Stimulation of T cells and antigen-presenting cells (APCs), such as dendritic cells, mediates apoptosis of keratinocytes and basement membrane destruction. The aim of this study was to investigate the expression of one of the immune cell markers (CD86) in erosive oral lichen planus. In this paired analytical cross-sectional study, 22 patients with erosive oral lichen planus were included. Biopsies from oral lesions of these pa-tients were obtained. The surrounding normal marginal mucosa around these lesions served as controls. To visualize CD86-expressing cells, immunohistochemistry (IHC) pro-cesses were used. Data were transferred to SPSS 11.0 software and were analyzed us-ing marginal homogeneity test. This study showed an increased number of CD86-expressing cells in erosive lichen planus lesions, while in normal mucosa, no cells were found to express CD86. Marginal homogeneity test revealed that the difference in positivity and negativity between the groups was significant (P<0.001). A high expression of CD86 in erosive lichen planus lesions shows an increased activation of APCs, while these cells are inactive in normal mucosa.

Down syndrome (DS) is a delayed physical and mental development caused by an abnormality in chromosome 21, resulting in the presence of three chromosomes (trisomy 21). Several methods of toothbrushing, such as the Scrub, Bass, Charters, Fone’s, Roll, and Stillman’s methods have been introduced. The aim of this study was to evaluate oral hygiene levels after toothbrushing with the Fone’s and the modified Bass methods in children with DS. This interventional study comprised 15 children (10 boys and 5 girls) aged 7-12 years (purposive sampling). Oral hygiene was assessed using the Simplified Oral Hygiene Index (OHI-S) method introduced by Greene and Vermillion. The results were analyzed using Student’s t-test. Oral hygiene indices were 2.96 and 1.57 before and after using the Fone’s method, respectively (P=0.00), and 2.55 and 2.16 before and after using the modified Bass method, respectively (P=0.00). A significantly increased level of oral hygiene was noted with the Fone’s method (1.39) when compared to the modified Bass method (0.39) of toothbrushing (P=0.00). Both the Fone’s and the modified Bass methods of toothbrushing can improve the oral hygiene of children with DS, with the Fone’s method appearing to be more effective than the modified Bass method.

Fungal infections are the most common opportunistic infections; when accompanied by widespread infections, such as acquired immune de-ficiency syndrome (AIDS), they cause a worldwide health crisis. Therefore, treatment of these infections is seen as one of the health challenges. Medicinal herbs can be used as rich sources of treatment due to their fewer side effects. Currently, Cuminum cyminum (cumin) is considered to have antimicrobial properties. The aim of this study was to compare the efficacy of cumin extract and flu-conazole against Candida species in vitro. In this in-vitro experimental study, aqueous and ethanolic extracts of cumin were prepared through maceration. The minimum inhibitory concentrations (MIC) of aqueous and alcoholic extracts of cumin against Candida albicans and Candida glabrata were determined using the microdilution method. Fluconazole was simultaneously used as an antifungal agent for comparison. Alcoholic and aqueous extracts of cumin were able to prevent the growth of Candida albicans at MICs of 100 mg/ml and 200 mg/ml, respectively. Both aqueous and alcoholic extracts of cumin were able to prevent the growth of Candida glabrata at 200 mg/ml concentration. Fluconazole was able to inhibit the growth of Candida albicans and Candida glabrata at MICs of 0.12 mg/ml and 0.03 mg/ml, respectively. According to the findings of this study, both aqueous and alcoholic extracts of cumin exhibited measurable inhibitory activities against Candida species.

Since fluoride therapy is usually the first step of treatment in pediatric dentistry and it may interfere with other treatments, such as composite fill-ing, this study aimed to evaluate the possible effects of topical pre-fluoride therapy on marginal microleakage of composite restorations in deciduous teeth. In this in-vitro study, 30 deciduous canines were randomly allocated to five groups: 1.23% acidulated phosphate fluoride (APF) gel was used in two groups, while 2% sodium fluoride (NaF) gel was used in the other two groups. Thirty minutes and two weeks after fluoride therapy, Class V cavities were prepared and restored using composite resins. After thermocycling, the teeth were soaked in 0.5% fuchsine solution and were sagittally sectioned in half. The extension of dye penetration into the occlusal and gingival walls was investigated un-der a stereomicroscope at ×30 magnification and scored using a 0-3 scoring system. Data were analyzed using Kruskal-Wallis and Wilcoxon signed-rank tests. Marginal microleakage was neither affected in enamel walls (P=0.213) nor in dentinal walls (P=0.851). The scores of microleakage in enamel walls were lower than that in dentinal walls, and this difference was statistically significant (P<0.05). Topical fluoride therapy using 1.23% APF or 2% NaF gel before the placement of composite resin restorations has no negative effect on marginal microleakage.

Evaluation of the treatment outcome is an important stage in every healthcare system, including orthodontics. This study aimed to assess the atti-tude and practice regarding treatment outcome assessment (TOA) among Iranian orthodontists. In this cross-sectional survey, a questionnaire was developed, which consisted of demographic, attitude, and practice sections. Content validity was evaluated using content validity index (CVI), and reliability of the answers was evaluated using test-retest method and Kappa statistics. The online ques-tionnaire was sent to a Telegram group including 315 Iranian orthodontists and ortho-dontic residents. Only graduated orthodontists with more than two years of experience were included. The average CVI was 0.95, and Kappa value was greater than 0.6. Totally, 66 orthodontists participated in the survey. Almost all orthodontists acknowledged the importance and positive effects of TOA. Seventy seven percent and 87.9% of the par-ticipants stated that treatment duration and stability, respectively, should be consid-ered while evaluating treatment outcome. The most important disadvantage of TOA was its time-consuming nature (56.1%). The best criterion for the evaluation of treatment outcome was “treatment objectives” (89.4%). Photographs (84.8%) were the most common post-treatment document followed by panoramic ra-diographs (72.7%). Also, 23% and 65.2% of the participants “always” or “usually” performed TOA, respectively. TOA was mostly performed subjectively (84.8%) and during the debonding session (48.5%). The results indicated that almost all orthodontists participating in this survey were aware of the importance of assessment of treatment outcome. Most of them usually performed such an assessment using subjective methods.