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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: 2013 volume:10 issue:1

Article
The effect of different root canal irrigants on the sealing ability of Bioceramic sealer.

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Abstract

The aim of this study was to investigate the effect of different irrigants (EDTA, MTAD, CHX) on the sealing ability of new Bioceramic root canal sealer. Material and methods: A total of sixty extracted human single-rooted premolar teeth were used. After instrumentation, teeth were randomly divided into three main groups (n=20) according to the type of final irrigants used. In group (A) 17% EDTA was used. Group (B) irrigants was MTAD. In group (C) irrigant was 2% CHX. Each main group further subdivided into two subgroup (n=10) according to the type of sealer used. Subgroup (1) canals obturated with Bioceramic sealer. In subgroup (2) canals obturated with AH plus sealer. After incubation period for one week the roots were placed in 2% methylene blue dye and kept in incubator for 48 hours then the roots were cleared, dye penetration measured by stereomicroscopic. Results: statistical significant difference was found between groups (p<0.001). In subgroup (1) BC sealer & CHX showed the lowest mean of leakage in comparing to other type of irrigants with highly significance difference with BC sealer & EDTA. In subgroup (2) AH Plus & EDTA showed the lowest mean of apical leakage. A highly significance differences was found between subgroup (1) and subgroup (2) for all type of irrigants. (p<0.001).Conclusion: when Bioceramic sealer is used in obturation of root canal system, it is better to use it in combination with CHX irrigant to improve the apical seal. Keywords: Endosequence bioceramic sealer, irrigants, apical leakage.


Article
Comparison the PH of roots after intra canal placement of four types of calcium hydroxide (An in vitro study)

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Abstract

The successful outcome of endodontic treatment depends on the reduction or elimination of bacteria present in an endodontic infection. It has been reported that chemo-mechanical instrumentation alone is not enough for this purpose. The purpose of this in vitro study was to compare the pH changes that occurred over a period of 14 days using four types of calcium hydroxide. Four types of calcium hydroxide materials were filled in fifty extracted single rooted teeth which were kept in individual vials containing distilled water at a pH of (7.4). Digital pH-meter was used to measure the pH of different groups at two hours, 24 hours, 7 days & 14 days after immersion of the specimens. The mean pH was found for all groups and statistical analysis was carried out using ANOVA and POST HOC TEST (LSD). Calcium hydroxide was found to significantly raise the root PH. Therefore calcium hydroxide is an effective choice in clinical practice to be used as intra canal medicament between appointments.


Article
Experience of Dental Caries of Adult Patients in Relation To The Characteristic of Dental Visit and Brushing Behavior In Tikrit City

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Abstract

Aim: Dental decay is a process in which the hard mineral structure of teeth is dissolved. The process produces a cavity on the crown of the tooth or a softening of the root surface. Without regular dental care people are often unaware of the condition, whereas those who usually seek dental care for a check-up are more likely to have dental decay treated in a timely manner The aim of the present study was to determine the caries experience of public dental patients by age, sex with the type of dental visit and brushing behavior in adults in Tikrit city, Iraq. Subjects and methods: A sample of 1284 individuals(580 males and 704 females)with an age range of (18-60 years) attending the teaching dental hospital of collage of dentistry of Tikrit university and the specialized dental center , were examined according to WHO guidelines using DMFT index. Questionnaires were used to assess the level of dental health attitude among the individuals. Results: The distribution of patients was high at younger age for both sexes. Emergency visit had a higher percentage of patients (82.2%). 63.6% of the patients brush their teeth two or more. The mean DMFT scores were 7.5 (8.3 for female and 6.7 for male). Mean DMFT for both sex increases with age. The percentage of decayed teeth (D/DMFT%) was the highest among younger age group (60.7% for female and 63.1% for male). There was statistically a highly significant difference between age, sex, dental visit type and brushing behavior and DMFT. Emergency patient did show higher level of decayed and missing teeth while general patient did show higher level of filled teeth. Emergency dental visit had higher percentage of decayed teeth (57.3%) than general dental visit (42.5%). One or less brushing patient had higher level of decayed and missing teeth, while two or more brushing patient show higher level of filled teeth. The percentage of decayed teeth for one or less brushing patients was (62.9%) higher than two or more brushing patients (50.1%). Conclusion: It was concluded that the present study findings for DMFT scores was higher than the global standers according to the world health organization (WHO). Therefore, there is a great need to combine restorative-oriented dental services with preventive- oriented dental services in order to improve the oral health status of this population.


Article
The Effect of local injection of strontium on inhibition and repair of orthodontically induced root resorption in rats (An experimental study)

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Abstract

Background: Strontium (Sr) is an alkaline earth trace metal cation that has a high affinity for hydroxyapatite. This study aimed to examine the histological effect of locally injected strontium (Sr) on prevention and repair of induced root resorption of rat molar subjected to orthodontic tooth movement. Materials and Methods: Eighteen ten-week- old male Wister rats were randomly divided into two groups of nine animals for two experiments. In both experiments; uniform standardized expansive springs were used to move maxillary first molars buccally for three weeks and then removed. In experiment No.1, at the time of spring placement, 0.25 ml of the strontium chloride solution at a concentration 240 mg/ml was injected at the sub-periosteum of the buccal side of the maxillary left first molar which was the experimental side. On other hand, 0.25 ml of distilled water was injected at the sub-periosteum of the buccal side of the right maxillary first molar which was the control side. The injections repeated every other day for three weeks whereas in experiment 2 it was begun at the day of spring removal and repeated every other day for another three weeks. After that the animals were scarified humanly and biopsies were taken for histological examination. Results: In experiment 1 the side injected with strontium showed statistically significant lesser root resorption than control side, while in experiment two the strontium injected side showed significantly more repair. Conclusion: Results of the study suggested that local injection of strontium can inhibit root resorption process and enhance repair.


Article
The efficiency and benefit of using, the halogen light source used for bleaching of teeth, in bonding of orthodontic brackets (an in vivo study)

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Abstract

Background: The property of the bleaching light sources is the wide and curved (the negative of the mouth curve) head of exposure. The aim of this study was to, test the efficiency of this devise to bond orthodontic brackets, via unique exposure for the whole teeth, by comparing the rate of the brackets failure with the traditional led light source used in orthodontic brackets bonding which utilizes light exposure for every tooth separately, and evaluating the benefit of time saving through contrasting the time required for bonding with the ordinary led and halogen light sources. Materials and methods: 856Roth 0.22 stainless steel brackets were bonded to 39 patients by using one of the two light sources in the form of three groups; bleaching light group (13 patients / 225 brackets) , ordinary led light group (13 patients /237 brackets), split mouth group( by using combination of the two sources, 13patients / 229 brackets). Results: There is no statistically significant difference between the light source used for bleaching and traditional led light source in bracket failure rates, and the time required for bonding by the bleaching light source is 22% and 5% of that required by ordinary led light and ordinary halogen light respectively. Conclusion: the light sources used for bleaching can be used effectively in bonding of orthodontic brackets with given advantage of saving time and effort. Background: The property of the bleaching light sources is the wide and curved (the negative of the mouth curve) head of exposure. The aim of this study was to, test the efficiency of this devise to bond orthodontic brackets, via unique exposure for the whole teeth, by comparing the rate of the brackets failure with the traditional led light source used in orthodontic brackets bonding which utilizes light exposure for every tooth separately, and evaluating the benefit of time saving through contrasting the time required for bonding with the ordinary led and halogen light sources. Materials and methods: 856Roth 0.22 stainless steel brackets were bonded to 39 patients by using one of the two light sources in the form of three groups; bleaching light group (13 patients / 225 brackets) , ordinary led light group (13 patients /237 brackets), split mouth group( by using combination of the two sources, 13patients / 229 brackets). Results: There is no statistically significant difference between the light source used for bleaching and traditional led light source in bracket failure rates, and the time required for bonding by the bleaching light source is 22% and 5% of that required by ordinary led light and ordinary halogen light respectively. Conclusion: the light sources used for bleaching can be used effectively in bonding of orthodontic brackets with given advantage of saving time and effort.


Article
Periodontal health status and treatment need among Iraqi orthodontic patients wearing fixed appliance

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Abstract

Back ground/Aim: Orthodontic treatment enables the establishment of functional occlusion and improvement of oral health, however, it increases the risk of periodontal disease development through plaque retention and difficulty of keeping a good oral hygiene. So the present study was performed to evaluate the periodontal health status and determination of treatment need among Iraqi orthodontic patients wearing fixed appliance. Material and method: A total number of 224 orthodontic patients wearing fixed appliance were enrolled in the study. They were attending Al-Mustansiria teaching hospital at college of dentistry/Al-Mustansiria University /department of orthodontics, pedodontics and preventive dentistry for follow up visits of their orthodontic fixed appliances in addition to the patients attending the private clinic of the researchers. Evaluation the periodontal health status and determination of treatment need were achieved using CPITN (Community Periodontal Index for Treatment Need), the degree of gingival enlargement and high frenal attachment. The sample was divided into 2 groups according to age factor (adolescents and adults). Results: The total number & percentages of CPITN scores for the total sample were calculated. The highest number and percentage were of (scores 0, 1 &2), {258 (19.19 %), 250 (18.60 %) & 800 (59.52 %)} respectively with highly significant difference of score 2 from other scores. The percentages of scores (0, 1 & 2) in the two age groups (adolescents and adults). The percentages of scores (0, 1 & 2) in the adolescents were (17.32 %, 20.47 % & 60.67 %) respectively with highly significant difference of score 2. The percentages of scores (0, 1 & 2) in the adults were (30.51 %, 27.69% and 39.90 %) respectively with significant difference of score 2. The treatment need for the whole sample was 100% for codes 1 and 2 of treatment need ( oral health instructions & scaling and root planing) also these codes of treatment were higher than other codes significantly, especially code 3 (complex treatment, deep scaling ,surgical intervention) in adolescents and adults were (4.5% and 3%) respectively. Regarding the gingival enlargement the numbers and percentages of the enlargement scores (0, 1, 2 & 3) of the total sample were 115 (43%), 85 (31%), 52 (19%) and 14 (5.26%) respectively

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Article
The effect of oral contraceptive on the oral health with the evaluation of Salivary IgA and Streptococcus Mutans in some Iraqi women

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Aim: To assess if there is any effect of using oral contraceptive and the duration of using on the inflammatory responses of the gingival tissues , concentration of secretary immunoglobulin A ( IgA) and the colony count of mutans StreptococcusMS in saliva . Methods: This study includes 80 women in their reproductive age (16-40) year. 40 women who were using oral contraceptive in different duration, as the study group and 40 women who not used oral contraceptive and it were assigned to the control group. Both groups were clinically examined (for dental caries using DMFS Index, and gingival condition using gingival index GI of Loe&Silness ) and laboratory assessment (by using non stimulated saliva for each woman was collected and homogenized then Mutans Streptococci (MS) were counted ,isolated, purified and diagnosed according to morphological characteristic and biochemical tests also, the Salivary IgA concentration was measured by using single radial immune diffusion method in different duration of oral contraceptive using ). Results: Gingival index was significantly higher among oral contraceptive users than non-users (P<0.01), which was correlated with the duration of usage (r =0.50).sIgA concentration higher in study group than in control group (P<0.01) which also increased positively with duration of using(r=0.80). A positive correlation between sIgA and gingivitis (r=0.54) was found. DMFS Index and the number of MS colony were highly significant in study group than the control (P<0.01). MS colony count was positive correlated with duration of usage (r=0.88) but the DMFS had too weak correlation with the duration of using which was a non significant at (P>0.05). Conclusion: The use of contraceptive pills for a long period increases the likelihood of gingival inflammation and significantly associated with increase sIgA level, so the regular use of oral contraceptive seems to enhance mucosal immune function in study subjects.


Article
Influence of age and gender on salivary flow rate in completely edentulous patients

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The denture retention and stability are dependent on saliva flow rate and quality, patients with dry mouth may have problems with the stability or comfort of maxillary complete dentures. Dry mouth is a common feature in the elderly, but is not clear what proportion of incidences is related to functional disturbances and whether age persue and Gender play a role. The aim of this study is to determine the effect of age on unstimulated (Resting) whole and stimulated saliva flow rates. It was determined in 100 unmedicated, healthy individuals wearing complete dentures. The subjects were divided into two age groups: group A(< 70 years), group B(> 70 years). A significant decrease in the secretion rates of unstimulated whole saliva in relation to age was observed in the study population (p< 0.001). Females had significantly lower mean flow rates than males for unstimulated (resting) whole saliva.


Article
Temperature Effect on the Hardness of Different types of Resin Denture Base Materials

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The cold cured acrylic resin is inferior to heat cured acrylic resin from stand point of strength and degree of polymerization. Many attempts have been made to improve these properties. Because heat affects maturity of the chemical reaction of acrylic resin therefore its maintenance during polymerization will affect the properties of cured resin. The purpose of this study was to evaluate the effect of increase curing temperature on the hardness of two commercially available cold cured acrylic resin material (Holland and Germany type) in comparison to heat cure resin and to those(cold cure) curing by conventional methods in air at 23°C ± 5°C. Ninety specimens,10 specimens from heat cure resin curing by water bath(short cycle) and eighty specimens from cold cured acrylic [forty from cold cured acrylic(Holland Type) and forty from cold cured acrylic(Germany type)] were prepared , flasking and packing procedure were done according to manufacturer direction and divided according to processing as follow:20 specimens(10 from Holland type and 10 from Germany type) were processed in air for two hours at 23°C ± 5°C under press (bench curing) as a control, and 60 specimens(30 from Holland type and 30 from Germany type) were processed by ivomat curing device containing water under air pressure 30 Pascal for 15 minutes at different temperature: 40°C, 60°C, and 80°C(10 specimens for each groups) .All specimens were tested for hardness test by shore D device (adigital model) for measuring the indentation hardness of the specimens the test load was set to 50 Newton for shore (( D ))which is suitable for acrylic resin material . Result showed that heat cure resin show the maximum value of hardness (88.8),followed by cold cured acrylic type Germany( polymerized by elevated temperature 80˚C) (88.696) followed by cold cured acrylic type Holland polymerized at 60˚C(88.471). While control group type Germany (polymerized at air bench) recorded the minimum value of hardness (81.83). All groups that polymerized at high temperature: 40°C, 60°C, and 80°C show the higher value of hardness in comparison to those processed by conventional methods (at air bench at 23°C ± 5°C) with significant and highly significant differences. There were highly significant differences between heat cure acrylic and cold cure (both types) processed by conventional methods and with cold cure Holland type processed at 40˚C, but there were no significant differences between heat cure acrylic and cold cure (both types) processed at high temperatures.


Article
Comparisons the microhardness of different cured acrylic denture base systems after subjected to chemical cleaning solutions

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In selecting chemical cleaning solutions for dental prostheses, compatibility between them and the type of denture base materials must be considered to avoid adverse effects on the hardness of the acrylic resin in different curing systems. This study aimed to compare the effect of different disinfectant and denture cleanser on the surface hardness of the light and heat cured acrylic resin materials. Eighty specimens are made from two different denture base materials. Forty specimens are made of light cured acrylic and forty specimens are made of heat cured acrylic resin. Each material is subdivided into four subgroups according to the type of the disinfectant (0.12% chlorhexidine digluconate, 0.5% sodium hypochlorite), the denture cleansers (Corega) and compared to the distilled water as control group. The surface hardness test is measured for each specimen to show the effect of each chemical cleaning solution on the light and heat cured denture base hardness. The results of the present study showed non significant differences in the surface hardness comparing between the two curing systems light and heat cured acrylic resin. Also there are non significant differences in the surface hardness when different disinfectant and denture cleansers have been used in comparison to the distilled water. It was concluded from this study that the hardness of acrylic materials is not affected by immersion in any type of disinfectant and denture cleanser as well as it is found that there is no different in the hardness of the light cured when compared to the heat cured acrylic denture base.


Article
Oroantral communication - A clinical and radiographic retrospective study of 39 Iraqi patients

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Background: oroantral communication (OAC) is abnormal connection between oral cavity and maxillary sinus. OAC is a rare, well known complication, mostly occurs after the extraction of upper posterior teeth, and if not treated lead to formation of oroantral fistula (OAF) and many complications .surgical repair is very necessary to prevent further complications .The aim of this study to evaluate and analyze the clinical, radiographic aspects of 39 Iraqi patients with oroantral fistula. Materials and methods :the study was carried on 39 patients with oroantral fistula reported to the Department of oral and maxillofacial surgery ,college of dentistry, University of Baghdad ,and private practice from 1983 to 2010 .data regarding the age ,sex , cause ,site ,radiographic features and types of radiographs ,signs and symptoms ,duration ,relation to the adjacent teeth , sinus disease ,methods of treatment . Results: 39 cases of OACs, 26 male, 13 female, the age range was20-65 with a mean age 44.5 year. Highest incidence was seen in the third and fourth decade of life 61.4%. The highest frequency of OACs was seen in relation to upper first molar 48.7% .the commonest cause was complicated extraction 51.2% .pain and tenderness was the most prominent symptoms 80%, escape of fluid from the nose was the most prominent sign 75.6%.there was a long delay in the diagnosis and treatment .most of the OACs occurs near the edentulous areas, occipitomental radiograph was not reliable in detection of displaced roots. Buccal advancement flap was the main method in treatment 81.2%. Conclusions: OACs a rare complication, its management need good clinical and radiological experience, and the treatment should be individualized to have good results.


Article
Evaluation of Immediate post-extraction implants of 34 patients in Basrah province.

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The aim of this study was to evaluate the success rate of the immediate postextraction implants without incision or primary flap closure. Patients and Methods: The study included 34 patients in good general health, referred to the department of oral surgery in the specialized center of dentistry in Basra between August 2009 and July 2010, immediate post extraction implant treatment 20(58.82 % ) female and 14(41.18%)male, aged 22 to 53 years with mean age 32.85 . Each patient had a tooth that required extraction, and each had at least 4 mm of bone beyond the root apex. After tooth extraction, the implants were immediately placed without incision or flap elevation. Implant sites showing bone bone defects or bone fenestrations, were excluded from this study. The secondstage surgical procedure was performed4 months after the first procedure. The following clinical parameters were evaluated at the time of implant placement and at second stage surgery: peri-implant radiolucency and marginal bone loss, which were evaluated radiographically. Results: The postsurgical healing period was uneventful for all patients. Soft tissue closure over the implant sites was achieved in1to 3 weeks after surgery at all sites. At second stage surgery, no peri-implant bone defects were observed or detected by probing. The soft tissue anatomy was considered clinically acceptable in all patients. Conclusions: Immediate post-extraction implant treatment is an implant alternative with a survival rate similar to that of the conventional technique for implant placement and enables preserving both the bone structure and gingival architecture.


Article
Oral Manifestations, Biochemical, and IL-6 Analysis of Saliva in Epileptic Patients under Treatment

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Background: From the ancient Greek (epilepsia). Seizure is common and diverse set of chronic neurological disorders characterized by seizures. Patients and Methods: The sample population comprised 10 epilepsy patients and 10 persons with no history of systemic disease, oral manifestation was recorded as well as saliva samples were taken. The IL-6, alkaline phosphatase and total salivary proteins had been measured. Results: The most frequent oral manifestation was gingival hyperplasia 85.7%, and dry mouth 75%, increased level of IL-6 and total salivary proteins in epilepsy patients receiving treatment, when comparing the level of alkaline phosphatase, slightly decreased in study group, with no statistical significance. Conclusion: In addition to the systemic effects of antiepileptic medication, and oral effects, including saliva composition and oral manifestation was recorded also. Therefore epileptic patients are at an increased risk of developing dry mouth, gingival hyperplasia, and alteration in saliva composition compared with health subjects.


Article
Prevalence of oral mucosal lesions in patients attending college of dentistry – Basrah University

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Background: The aim of study was to find out the prevalence of oral mucosal lesions in patients who are attending the oral diagnosis department of the College of Dentistry – Basrah University and compare it with the prevalence rates of these lesions in other parts of Iraq. Materials and Method: Oral examination of 2318 outpatients, 1202 females (51.8%) and 1116 males (48.2%). The patient's age ranged between 9-74 years. All the patients of this study referred to oral diagnosis department, College of Dentistry, Basrah University seeking for dental treatment (from October 2010-May 2011). Results: Among the 2318 patients, only 206 patients (8.8%) had oral lesions. 115 males had oral lesion constituted 4.9% of total examined patients, while 91 females had oral lesion constituted 3.9%. The age range of the patients was between 9-74 years. Oral lesions were more prevalent among males (4.9%) than females (3.9%), and there was significant statistical difference between males and females. Oral lesions were classified according to the following 4 categories: ulcerated lesions (3.84%), benign lesions (2.93%) ,white lesions (1.12%) and candidiasis (0.99%), The most common oral lesion of the studied populations were the ulcerated lesions, which diagnosed in (3.8%).There were a significant statistical difference between males and females in the traumatic ulcer, lichen planus, pyogenic granuloma and peripheral giant cell granuloma. Conclusions: This study has provided information about the epidemiologic aspects of oral mucosal lesions that may prove valuable in planning of future oral health studies.


Article
Evaluation of the cytological changes of oral mucosal cells in Smokers by using Exfoliative Pap Stain.

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Oral cancer is a major public health issue worldwide; it remains a highly lethal and disfiguring disease. in Iraq little is written regarding the occurrence of oral cancer. The aim of this study is To examine the effect of smoking oral mucosa cytological. Hundred men aged between 40 and 70, comprising 50 smokers and 50 non smokers. Material for exfoliative cytology was collected with a metal spatula from the lateral border of the patient’s tongue and from the floor of the mouth and the samples were then submitted for Papanicolaou staining. Then cytologic smears were classified according to Papanicolaou’s classification. the results of the current study reveals that there is a significant association between smoking (number of cigarette smoked per day and the duration of smoking (year) and the occurrence of cytological changes in the oral mucosa ,p <0.001.and there is a significant association between the age and the papanicolaou’s classes ,p<0.001.


Article
Correlation of mandibular canal wall resorption with angular cortical thickness among edentulous patients using panoramic radiographs (A comparative study between male and female)

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Background Resorption of alveolar bone is the best recognized feature of mandibular aging in the edentate subject. The aim of this is study to evaluate the mandibular canal wall resorption using panoramic radiographs among edentulous male and female. Material and method The sample of this study was collected from patients who attended Teaching Hospital of the College of Dentistry at Al- Mustansiria University and panoramic radiographs were taken in Al-Karama specialized center for dentistry. Forty three patients were selected in this study with age range between 59-85 years (25 males and 18 females) . Panoramic radiographs for all patients and sides were examined and evaluated . Results Chi-square between males and females of angular cortical thickness (ACT) ≥ 1mm and ACT ˂ 1mm was (37.06) which statistically significant with p-value (0.008) and between resorption (grades) and age of males was(34.72) which it statistically significant p-value(0.049) also between resorption (grades) and age of females was(15.6) which was statistically significant p-value (0.003) . Sperman correlation showed statistically significant moderate correlation between gender and age (r=0.581,p-value=0.01) and there was a moderately statistical significant correlation between the grades of mandibular canal resorption and the angular cortical thickness measurements in both gender (r=0.532,p-value=0.033). Conclusion The resorption of the wall is found more often in edentulous females than in the males due to hormonal imbalance.


Article
Efficacy of Diode Laser With Different Intensities as an Adjunct to Traditional Mechanical Treatment of Chronic Periodontitis

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The recent decades, considerable attention has focused on using of different types of laser irradiation in treatment of periodontal diseases. The aim of the present study was the assessment of efficacy of low-level and high-level diode laser treatment in combination with scaling and root planing (SRP) in patients with chronic periodontitis. The total sample of the present study consisted of twelve patients had moderate to severe chronic periodontitis in at least (3) vital single-rooted teeth in different quadrants of each patient. These teeth of the twelve patients were allocated into three groups according to the type of the received treatment (12 teeth from 12 patients for each group). 1- Group A (GA) treated with scaling & root planing ( SRP). 2- Group B (GB) (SRP + low-level laser). 3- Group C (GC) (SRP + high-level laser). Clinical measurements were performed by a single well trained and calibrated examiner, and they included, plaque index (PI), gingival index (GI), bleeding on probing (BOP), clinical attachment level (CAL) and probing pocket depth (PPD). The results of the present study were positive and predictable in both lasers irradiation modes. The differences between the changes of the SRP group (GA), and two lasers low and high density lasers combined with SRP groups (GB & GC) at baseline were not significant. All of the clinical parameters that were investigated in this study have showed a significant improvement at 6 months from the baseline for the three groups of the study. These findings reported that low & high-level diode laser can have a beneficial effect in treatment of chronic periodontitis in combination with traditional mechanical treatment.

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Table of content: volume:10 issue:1