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MUSTANSIRIA DENTAL JOURNAL

مجلة المستنصرية لطب الاسنان

ISSN: 18138500
Publisher: Al-Mustansyriah University
Faculty: Dentistry
Language: English

This journal is Open Access

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SCIENTIFIC AND REFERRED DENTAL JOURNAL

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Table of content: 2008 volume:5 issue:4

Article
Evaluation of permanent premolars intended for endodontic treatment in term of root number & form, condition of periapical area and state of lamina dura (Radiographic survey).

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Abstract

radiographic film serves an extremely important need in detecting disease process that affects the tooth and its surrounding structures. The aim of the present study is to take a radiographic view to determine root number and form, condition of the periapical area and state of the lamina dura for permanent premolar teeth intended for root canal therapy. One hundred ninety radiographs representing the step of working length determination for permanent premolars intended for root canal therapy were selected from a number of private clinics in Baghdad. Results of this study shows that 52.1 % of the endodontically treated teeth having curvature free roots, while 47.9 % of them were presented with curved roots, most of teeth 94.2% were free of periapical lesions and lamina dura was absent in 65.8 % of the teeth.


Article
The effect of dowel space preparation on the apical seal of Resilon & Gutta-percha obturation materials. (An in vitro comparative study)

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Abstract

Aim: The aim of this in vitro study was to compare the effect of immediate versus delayed dowel space preparation using peeso reamers on the apical seal of roots filled by Gutta-percha with two types of resin based-sealers (AH26 and AH Plus) and by Epiphany obturation system. Methodology: Sixty freshly extracted human teeth with single and straight canals were used in this study. The roots were instrumented using the step-back technique, instrumentation was accomplished by using the Gates-Glidden drills with copious irrigation of 2.5% sodium hypochlorite and 17% solution of aqueous EDTA to remove smear layer. The roots were randomly divided into 3 main groups according to the type of obturation materials using lateral condensation technique (20 teeth for each group): Group A: Gutta-percha + AH26 root canal sealer. Group B: Gutta-percha + AH Plus sealer. Group C: Resilon+ Epiphany sealer+ prime. (Epiphany obturation system) Then each group divided into two subgroups according to the time of dowel space preparation either immediately after obturation or after one week. The external surfaces of all roots were coated by two layers of sticky wax except for the apical 2 mm and were then submerged in 2% methylene blue dye for 3 days at 37ºC. After that, all roots were longitudinally sectioned for linear measurement of dye penetration through the apical foramen using a stereomicroscope. The data obtained were analyzed statistically using ANOVA and Student t-tests. Results: Significantly less apical leakage in roots filled by gutta-percha with AH Plus than those filled by gutta-percha with AH26 and those filled by Epiphany obturation system for delayed dowel space preparation (P< 0.05) and there was a significantly less apical leakage in roots filled by Epiphany obturation system that prepared immediately after obturation than those received delayed preparation (P< 0.05). Conclusion: All the groups had apical leakage what ever the type of obturation material or time of dowel space preparation.


Article
The effect of immediate versus delayed dowel space preparation on the apical seal of Resilon/Epiphany obturation system

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Abstract

Aim: The aim of this in vitro study was to compare the effect of immediate versus delayed dowel space preparation using two techniques (peeso reamers and hot pluggers) on the apical seal of Resilon/ Epiphany obturation system. Methodology: Fifty freshly extracted human teeth with single and straight canals were used in this study. The roots were instrumented using the step-back technique, K-files with circumferential filing action and copious irrigation of 2.5% sodium hypochlorite and 17% solution of aqueous EDTA to remove smear layer. The canal obturation of all roots was performed with lateral condensation technique using Resilon/Epiphany Obturation system. Then the obturated roots were randomly distributed into 5 experimental groups (10 teeth for each group); one control group, and 4 experimental groups according to the technique of dowel space preparation (peeso reamers and hot pluggers) either immediately after obturation or after one week later. After this period, the external surfaces of all roots were coated by two layers of sticky wax except for the apical 2 mm and were submerged in 2% methylene blue dye for 3 days at 37ºC. Then all roots were longitudinally sectioned for linear measurement of dye penetration through the apical foramen using a stereomicroscope. The data obtained were analyzed statistically using ANOVA and Student t-tests. Results: Significantly more apical leakage (P<0.05) in groups that received delayed dowel space preparation using either peeso reamers or hot pluggers compared with control group and no significant differences (P>0.05) between immediate and delayed dowel space preparation using either technique. Conclusion: Resilon/ Epiphany obturation system can received immediate and delayed preparation using conventional methods of dowel space preparation, however immediate preparation was preferred according to the results of this experiment.


Article
An evaluation of the Effect of Surface Treatment On Amalgam Repair

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The purpose of this in vitro study was to evaluate the effect of different surface treatments on shear bond strength of repaired amalgam using two types of amalgam. 120 acrylic blocks (2.7cm diameter by 2.0cm high) were constructed from cold cure resin, each one contained cylindrical hole (7mm diameter by 2mm high) on its circular face that filled with amalgam. The samples were divided into immediate repair group and delayed repair group, which was stored and incubated at 37C0 for one month. After aging the amalgam surface of delayed repair was finished with carbide bur and polished with abrasive rubber cup then divided into three groups according to the surface treatment that include group with out surface treatment, group roughened with diamond bur and the last group was abraded with aluminum oxide (50m) particles size, both immediate and delayed repair were further subdivided according to the type of amalgam used into three subgroups. The repair procedure was done by using a Teflon split mold which containing an opening (3mm diameter by 5mm high) then all the samples were storage and incubated at 37C0 for one week prior to testing. Testing was done by applying shear force at the interface between the initial and repair amalgam with special designed chisel shape rod by using Zwick testing machine at across head speed of 5mm/min. Analysis of the results showed that the shear bond strength in immediate repair were significant higher than of delayed repair and the group roughened with diamond bur is higher than group treated with aluminum oxide and untreated group. The shear bond strength of delayed repair of amalgam is less than that of immediate repair, the surface produced by roughening the samples with a diamond bur will give best strength than the surface treated by aluminum oxide and untreated surface (smooth surface) and the same types of amalgam restorations used in amalgam repair gave better result than different type of amalgam.


Article
Postoperative pain and flare-up in one- and multiple-visits endodontic treatment for pulpally vital molars

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Abstract

In recent years, one appointment endodontics has gained increased acceptance as the best treatment for most cases. The aim of this study was to analyze the incidence of post-operative pain and flare up following single-visit and multiple-visits root canal treatment in pulpally vital molars using two different instrumentation techniques. One hundred seventy seven (177) vital molars teeth from 160 patients were selected and randomly divided into two groups; first group (89) teeth were endodontically treated with multiple visits while the second group (88) teeth were endodontically treated with one visit. Each group further subdivided into two subgroups; first subgroup, canals were prepared by conventional step-back technique using hand-held stainless steel k-files and obturated with laterally condensed gutta-perch cones while the second subgroup were the canals prepared by ProTaper rotary system and obturated with laterally condensed gutta-perch cones. No significant differences in post operative pain and flare-ups between teeth that were treated in one visit and multiple visits. Also the use of the ProTaper rotary system in preparing the canals contributed to lower the incidence of post-operative pain.


Article
Effect of water Clove Extract on Streptococci and Mutans Streptococci, in Comparison to Chlorhexidine Gluconate (A Comparative In Vitro and In Vivo Study)

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Recently, in many parts of the world there is a rich tradition in the use of natural products for the treatments of many infectious diseases; many herbal remedies have been used because of their antibacterial, anti- inflammatory, cytostatic, antifungal and antiviral. Stimulated saliva was collected from four healthy looking females aged (20-21) from which mutans streptococci were isolated. Sensitivities of mutans streptococci according to Agar Well Technique showed that water clove extract was effective in the inhibition of these bacteria, mutans streptococci were more sensitive to chlorhexidine compared to water extract as indicated by the wider zones of inhibition on the Mueller Hinton Agar. An in vitro experiment was conducted to evaluate the effect of these agents on acid formation by mutans streptococci, the result showed that chlorhexidine gluconate and water clove extract were effective in retardation of acid formation. The study involved one in vivo experiment to test the effect of water clove extract (10%) against salivary streptococci and mutans streptococci in comparison to 0.2% chlorhexidine and deionized water. Stimulated saliva was collected from 18 volunteers aged (24-27 years) they were divided into three groups each group rinsed once with either chlorhexidine, deionized water or clove water extract for one minute. The counts of bacteria were recorded at different time points (one minute prior to the rinse, 30 minutes after rinsing, one hour and two hours). No significant difference in the counts of streptococci was found between deionized water and water clove extract for all time points, rinsing with any one of these agents resulted in a slight decreased in the counts of these bacteria, chlorhexidine showed a sharp reduction in the counts of bacteria which was highly significant (P<0.001). For mutans streptococci, a highly significant differences were found between the three mouth rinses (P<0.001) in the counts of bacteria in the following time points (after thirty minute, after one hour). Within these times chlorhexidine was shown to be the most effective in reducing the counts of these bacteria followed by water clove extract. The result of the present study showed the effectiveness of clove especially against mutans streptococci, although it was less than chlorhexidine, but it can be use as effective anticaries agent. This study aimed to evaluate the effect of different concentrations of water clove extract in comparison to chlorhexidine gluconate 0.2% and deionized water on growth, acidogenicity of mutans streptococci in vitro and viability counts of streptococci and mutans streptococci among a number of volunteers.


Article
Effect of Siwak Extract on the Microhardness and Microscopic Feature of Initial Caries-Like Lesion of Permanent Teeth, Compared to Fluoridated Agents

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Siwak is a chewing stick used to clean the teeth and message the gum. Their routine use was shown to be associated with the reduction in severity of dental caries. This study aimed to test the effect of water Siwak extract on the microhardness and microscopic features of artificially initiated carious lesion of the outer enamel surface, in comparison to stannous fluoride and sodium fluoride. Upper first premolars were extracted and subjected to pH cycling procedure. Teeth immerged individually in 20 ml of selected agents for four minutes then rinsed by de ionized water. Agents involved were 5% and 10% water Siwak extract, 8% stannous fluoride and 0.05% sodium fluoride. Samples were subjected to Vickers microhardness test and microscopic examination before and after the pH cycling and following insertion in the agents. Water Siwak extract, stannous fluoride and sodium fluoride were found to increase the microhardness values of de mineralized enamel surfaces, this were statistically highly significant for Siwak extract and stannous fluoride (P< 0.01) and significant for sodium fluoride. However none of the mentioned agents was able to increase the micro hardness to approximate the original values of the sound enamel. Under polarized light results revealed that water Siwak extracts and stannous fluoride produce the best remineralization surface zone. Water Siwak extracts is very effective in remineralization of initial carious lesion.


Article
The Use of Computer Technology in Dental Arch Crowding Assessment

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Background: Correct alignment of teeth is a fundamental goal of Orthodontic treatment. The accurate assessment of dental crowding and the space required to alleviate it, is critical for correct orthodontic diagnosis and treatment planning. Objectives: To assess dental crowding by using two different methods, which are manual and computerized in order to compare the advantages and disadvantages of both methods. Methods: In this cross –sectional study, we studied a convenient sample of 100 individuals (50 male and 50 female) with different degrees of crowding. Upper and lower dental casts were obtained for each subject and these casts were analyzed by using two methods, manual and computerized. Results: It was found that there is a significant difference between the manual and the computerized method in all measurements (crowding, space available and space required). Also, it was found that the computerized method is a quick method and more practical for the storage of a large number of dental casts and more reliable for the measurement of the space available than the manual method. But, there was some difficulty in the assessment of severely crowded groups (>4mm). Conclusions: The degree of dental crowding increased when the teeth size increased and arch perimeter decreased. The degree of crowding in the upper arch is more affected by the size of the teeth rather than the size of the arch, while the degree of crowding in the lower arch is more affected by the arch size rather than teeth size.


Article
Evaluation of color alteration of heat-polymerized acrylic resin

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The present study investigated the color alteration of heat-polymerized acrylic resin specimens exposed to 7 staining solutions (black tea, green tea, coffee, Pepsi, tomato paste, cigarette and diet Pepsi) for two weeks and compared with that exposed to distilled water. Five specimens were used for each group. The specimens were of rectangular shape measuring 5mm width, 40mmlength and 2mm thickness. After the two weeks the light transmission percent values for each specimen were determined by a spectrophotometric device. The result of this study revealed that the distilled water specimen group had the highest mean value of light transmission followed by diet Pepsi and Pepsi groups, coffee group had the lowest one. Further, coffee had a staining effect on resin specimens more than tea, cigarette and tomato paste group. In addition this study showed that resin specimens discolored by black tea more than green tea.


Article
Influence of Heating Rates and Residual Monomer on Dimensional Changes of Acrylic Resin Denture Base

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Background: Most of spaces between the denture base and master cast produced by shrinkage of the base material during polymerization and by the difference in coefficient of thermal expansion of the cast and acrylic resin. The aim of this study is to evaluate the effect of the different heating rates and the presence of residual monomer on the accuracy different curing denture base by recording the gap space between the cast and the denture Materials and methods: 18 maxillary edentulous stone cast were prepared then divided into three main groups, denture bases were constructed. In Group A, using Biostar plates (free of monomer) in the pressure champers. In group B, using short curing cycle while group C, using long curing cycle . The gap space between the cast and denture base was recorded using traveling microscope measuring device. Results: Biostar curing resin (group A) showed significantly the highest dimensional changes among groups (short and long curing resins). There was no significant difference between group B ( short curing resin) and group C (long curing resin). The lowest gap space values were obtained in long curing resin. All samples showed maximum discrepancy in mid palatal reign and minimum dimensional changes at the crest of ridge. Minimum gap space values were shown in the canine reign for record bases cured with short and long curing cycles, while minimum gap space values were shown in the posterior palatal seal for record base cured with Biostar machine. Conclusion: The dimensional changes of record bases mainly depend on the amount of heat applied during processing rather than the amount of residual monomer. Greater distortion was shown in record base processed by Biostar machine (Free of monomer), while the least distortion in record base processed by long curing cycle. All samples showed maximum discrepancy in the mid palatal region and minimum dimensional changes at the crest of ridge.


Article
The visible portion of upper anterior teeth at rest

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Back ground: Esthetics has become a respectable concept in dentistry. In the past, the importance of esthetics was discounted in favor of concepts such as function, structure and biology. In today's, treatment planning must begin with well defined esthetic objectives. The visibility of upper anterior tooth surface with lip at rest is an important factor in determining prosthodontic outcome. A study was therefore, undertaken to investigate the degree of visibility of maxillary anterior teeth surfaces when the lip at rest. Materials and method: 140 patients were examined. All the subject had maxillary anterior teeth present with no caries, restorations, sever attrition, mobility, or obvious deformities. The portions of upper anterior teeth that were visible were measured vertically using millimeter ruler. Results: females showed more of the maxillary central and lateral incisors than males, while the difference in canine was not significant. With increasing age, the amount of maxillary anterior teeth that was visible at rest decreased. Most subjects with shorter upper lips displayed more maxillary anterior teeth than those with longer upper lips. Conclusion: The degree of visibility of maxillary anterior teeth is determined by muscle position that varies from one person to another. These results provide practical guidelines for vertical positioning of the maxillary teeth.


Article
Impacted mandibular third molar and the inferior alveolar canal in Iraqis (A radiographical study)

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Aim of the study: To evaluate the position of impacted mandibular third molars and its relation to the inferior alveolar canals by the aid of panoramic radiographs. Materials and method: The study includes (246) panoramic radiographs with (444) impacted mandibular third molar teeth that are collected from different oral and maxillofacial surgery units belong to patients with the age between (20-35) years who seeks for help to remove their impacted mandibular third molar teeth in order to evaluate the relationship between the position of impacted mandibular third molars and its relation to the inferior alveolar canals by the aid of panoramic radiographs. Impacted mandibular third molar teeth position were classified as vertical, horizontal, mesioangular, and distoangular (Winter’s classification)and the radiographic relationship of the root apex of impacted mandibular third molar to the inferior alveolar canal was categorized as :below,superimpose,grooving and none of them(none). Result and discussion: The majority of impacted mandibular third molar teeth was of mesioangular position (35%), then the vertical position (29%), distoangular (20%), and the horizontal position (16%) in both gender and males has a higher percentage than females.Ingeneral,superimposition relationship between impacted mandibular third molar teeth and inferior alveolar canal is the highest (39%) in most of the cases among the other types of relation, then to a lesser extent was below the roots (31%), grooving (25%), and lastly, none (5%).The alveolar canal is mostly below the vertical and horizontal type of impaction. The alveolar canal is mostly superimposed on the roots of mesioangular and distoangular type of impaction. Grooving relation ship is most common with mesioangular impacted mandibular third molar.


Article
A Comparison between primary and secondary wound closure after surgical removal of lower third molars according to pain and swelling

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The aim of this study was to compare between Primary and secondary closure techniques after removal of impacted third molars. This comparison was carried out according to the pain and swelling parameter. One hundred patients with impacted third molars were randomly divided into two groups (50 patients in each group). Periapical radiographs were taken for each patient to determine the degree of eruption and angulations of third molars. After surgical extraction in Group I, the socket was closed by hermetical suturing of the flap while in Group II; a 5–6 mm wedge of mucosa adjacent to the second molar was removed to obtain secondary healing. Swelling and pain were evaluated for 7 days after surgery with the VAS scale. The statistical analysis (analysis of variance for repeated measures, P < 0.05) showed that pain was greater in GI, although it decreased over time similarly in the two groups (P=0.003, F=2.6613). Swelling was significantly worse in Group I (P < 0.0001, F=38.395). In Group I, dehiscence of the mucosa was present in 15% of patients at day 7, and 1% showed signs of re-infection with suppurative alveolitis at 30 days. Pain and swelling were less severe with secondary healing than with primary healing.


Article
Salivary gland mucoceles: A clinical study of 103 cases

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Mucocele is a tissue swelling composed of pooled mucus that escaped into the connective tissue from a severed salivary excretory duct (extravasated). In the present study 103 cases of mucoceles reviewed from the records of patients at the Department of the Oral Pathology, faculty of Dentistry , Baghdad University over 11 years period ( 1982-1992). Mucoceles were statically analyzed according to age, gender , site of occurrence and type. It was found that a greater number of mucoceles cases 37(36%) occur in patients at 2nd decade of age followed by 29(28.2) of cases occurred in 3rd decade of age. Mucoceles were occurred more in males than females 57(55.2%) ,46 (44.8%),respectively. Lower lip was the predominant site for occurrence of mucocele 84(81.6%) followed by the floor of the mouth 12(11.7%).The most frequent type of mucocele was of extravasated type100(97.1%) whereas it was only 3(2.9%)for mucous retention type.


Article
Identification and Antimicrobial Susceptibility of Bacterial Isolates from Odontogenic Abscesses

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Objective: The purpose of the study was to identify the bacterial composition of the microbiota from odontogenic abscesses and their antimicrobial susceptibilities. Study Design: An aspirate of pus from 37 patients with odontogenic abscesses was obtained by needle aspiration and processed aerobically and under anaerobic conditions. Bacteria were isolated and identified by standard Laboratory methods. Then antimicrobial susceptibility of isolated bacteria was determined by using disc diffusion method. Results: Out of 37 aspirates, 100% yielded positive culture, 34 aspirates contained a mix of microorganisms. A total of 90 strains of bacteria were isolated.Out of 90 strains, 63 strains were anaerobes and 27 strains were aerobes and facultative anaerobes. The mean number of strains per sample was 2.4, two samples were purely anaerobes, 9 samples were mixed anaerobes, 2 samples were purely facultative anaerobes, no purely aerobic, 17 had mixed growth of anaerobes and facultative anaerobes, and 7 samples had mixed growth of aerobes and facultative anaerobic bacteria. Out of 90 isolates, 42 (46.67%) were Gram-positive cocci, 25 (27.78%) were Gram-positive bacilli, 21 (23.33%) were Gram-negative bacilli, and 2 (2.22%) were Candida albicans. The genera of bacteria most frequently isolated were viridans group streptococci, Peptostreptococcus spp., Eubacterium spp., and Prevotella spp. Invitro antibiotic sensitivity of isolated microorganisms were tested for Penicillin, Amoxillin, Ampicillin, Amoxicillin/Clavulanic acid, Erythromycin, and Metronidazole by disc diffusion method. All isolates were sensitive to Amoxillin+ clavulanic acid: 27/27(100%), followed by Ampicillin: 24/27(88.89%), Amoxillin: 23/27(85.19%), Penicillin: 22/27(81.48%), Erythromycin: 12/27(44.44%), and metronidazole: 10/27(37.04%). Conclusions: The present results confirm the existence of mixed infection with predominance of anaerobic and facultative anaerobic bacteria in odontogenic abscesses. Penicillin still possesses antimicrobial activity against the majority of bacteria isolated from odontogenic infections. However, if penicillin therapy has failed to be effective, the combination of penicillin with ampicillin or amoxillin with clavulanic acid is recommended.


Article
Clinical Management of an Unusual Case of Gingival Enlargement

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The purpose of this article is to report a case of conditioned gingival enlargement managed by non surgical periodontal therapy. Hormones are specific regulatory molecules that modulate a host of body functions. Hormonal effects reflect physiologic and pathologic changes in almost all tissues of the body with the periodontium being no exception. Physiologic changes like puberty, the menstrual cycle, and pregnancy cause hormonal variations that may cause inflammation of the gingiva. Oral contraceptives that contain estrogen and/or progesterone are associated with gingival enlargement. A 28-year-old female presented with a complaint of swelling of the gingiva with spontaneous bleeding in the maxillary anterior region for a period of one year. The health history documented the use of contraceptives for one year, and a clinical examination revealed the existence of poor oral hygiene and enlarged painful gingival tissues that bleed when touched. This case reaffirms the fact plaque control is the most important procedure in any periodontal therapy. Another factor contributing to the excellent response to therapy is patient compliance. The patient followed home care instructions well and was effective in personal oral hygiene measures.

Table of content: volume:5 issue:4