Effect of Photobiomodulation Therapy With an 810-nm Diode Laser on Pain Perception Associated With Dental Injections in Children: A Double-Blind Randomized Controlled Clinical Trial

Introduction: This study investigated the photobiomodulation effect of an 810-nm diode laser in adjunction with topical anesthesia on pain perception during infiltration anesthesia of primary maxillary molars in children. Methods: This double-blind randomized controlled clinical trial was conducted on 64 children (aged 5-9 years) requiring extraction or stainless steel crown for their primary maxillary molars. The patients were randomly allocated into two groups (n=32) of laser and control. In the laser group, the injection site (buccal and palatal mucosa) was irradiated with an 810-nm laser (200 mW, 5.2 J/cm2) after 20% benzocaine topical anesthetic application, while the control group received a placebo laser following topical anesthesia. The pain intensity experienced by children during needle insertion into the buccal and palatal mucosa was determined using a visual analog scale (VAS) and modified behavioral pain scale (MBPS). Results: According to the results of the VAS and MBPS, no significant difference was detected in pain scores between the laser and control groups neither in the buccal nor in the palatal mucosa (P>0.05). Conclusion: Photobiomodulation therapy with an 810-nm laser with the current setting adjunct to topical anesthesia did not promote significant additional effects on the pain intensity.

0307 Is Poor Sleep Associated with Use of Multiple Benzodiazepine Receptor Agonists in Older Veterans?

Introduction

Benzodiazepine receptor agonists (BZAs) are often prescribed for insomnia in older adults. Polypharmacy increases risk of adverse events in this population in general, particularly when medications within the same class are prescribed. During an ongoing hypnotic deprescribing trial, we explored use of more than one BZA (multi-BZA use) and self-reported sleep quality among older adults.

Methods

Telephone surveys were performed for recruitment to an ongoing BZA deprescribing trial. Participants aged ≥ 55 years who were prescribed at least one BZA (i.e., alprazolam, clonazepam, lorazepam, temazepam, or zolpidem) from a Department of Veterans Affairs pharmacy in Southern California were asked about their use of each BZA over the past 3 months for sleep (yes/no). Multi-BZA use was defined as using > 1 different BZA over the past 3 months. Self-reported sleep items included duration of sleep problems (<3, 3-12, or >12 months), sleep quality (very or fairly good, fairly or very bad), and sleep efficiency (mean total sleep time over time in bed). Analyses compared sleep variables between multi-BZA and non-multi-BZA users (Fisher’s Exact or t-tests).

Results

Among participants (N=359), 152 (42.3%) reported using zolpidem, 41 (11.4%) lorazepam, 39 (10.9%) alprazolam, 31 (8.6%) clonazepam, and 29 (8.1%) temazepam during the past 3 months. 35 (9.8%) participants reported taking more than one of these drugs. 93.9% reported their sleep problems were present for ≥3 months. 68.3% of participants reported their sleep was fairly/very bad, and mean sleep efficiency was 67.9 (SD 18.5). There were no significant differences between multi-BZA versus non-multi-BZA users in duration of sleep complaints (Fisher’s Exact=1.0; p=.842), sleep quality (Fisher’s Exact=0.70; p=0.56) or sleep efficiency (p=0.91).

Conclusion

We found 1 in 10 older adults prescribed a BZA for sleep reported multi-BZA use over the past 3 months. Multi-BZA use was unrelated to duration of sleep complaints, sleep quality or sleep efficiency. Whether the use was simultaneous or staggered, these findings are concerning, given the elimination half-life of most of the BZAs and that polypharmacy, especially within medication class, may increase risk of adverse events (e.g., falls). Further research is needed to explore factors contributing to multi-BZA use.

Support (If Any)

NIA R01AG057929, VA IIR 17-234

Posttraumatic Stress Disorder Risk and Benzodiazepine Dependence in Older Veterans with Insomnia Symptoms

OBJECTIVES

To measure the rate of benzodiazepine receptor agonist (BZA) dependence in older veterans with insomnia symptoms chronically using BZAs and to assess for associations between high posttraumatic stress disorder (PTSD) risk and BZA dependence.

METHODS

A cross-sectional study was conducted among veterans aged 55 years and older with insomnia symptoms (current or historical) and chronic use of BZAs (≥3 months). Measurements included the Primary Care-PTSD screen (score >2 indicates high PTSD risk) and Benzodiazepine Dependence Questionnaire. Logistic regression was used to test for associations between PTSD risk and BZA dependence.

RESULTS

A high PTSD risk was observed in 40% of the participants (N = 33). One-fifth (21.7%, N = 18) of participants met the criteria for benzodiazepine dependence (score ≥23 on Benzodiazepine Dependence Questionnaire). Veterans with high PTSD risk were significantly more likely to have BZA dependence (odds ratio 10.09, 95% CI [2.39, 42.54], p = .002).

CONCLUSIONS

In older veterans with insomnia symptoms and chronic use of BZAs, high PTSD risk is associated with elevated risk for BZA dependence, which may make discontinuation of these medications difficult.

CLINICAL IMPLICATIONS

Clinicians should consider the strong association between PTSD symptoms and benzodiazepine dependence when developing plans to taper a BZA in veterans with these symptoms.

The Prevalence and Correlates of Fissured Tongue Among Outpatients in Andkhoy City, Afghanistan: A Cross-Sectional Study

BACKGROUND

Fissured tongue is a common manifestation of the tongue, marked by the presence of multiple prominent grooves or fissures on the dorsal surface of the tongue. However, there is a lack of studies focusing on the prevalence and factors associated with fissured tongue among patients attending an outpatient clinic in Afghanistan.

AIM

The purpose of the current study was to determine the prevalence and factors associated with fissured tongue and its effects on the general health of adult outpatients in Afghanistan.

PATIENTS AND METHODS

The cross-sectional survey was conducted among outpatient populations in Andkhoy City, Afghanistan, between September 2019 and December 2019. A convenience technique was applied by including 1182 patient aged 18-80 years. Socio-economic status, smoking, nass use (smokeless tobacco use) and medical data were collected using face-to-face interviews. We used logistic regression analysis to identify factors associated with fissured tongue. A convenience technique was applied by including patient aged 18-80 years.

RESULTS

The studied population consisted of 1182 participants, of whom 573 (48.5%) were males and 609 (51.5%) females. The prevalence of fissured tongue was 27.2% (95% CI: 24.7-29.9%) with males having significantly higher prevalence than females (47.5%, 95% CI: 43.3-51.6% versus 8.2%, 95% CI: 6.2-10.7%, p<0.001). Male participants (OR=7.1, 95% CI: 4.8-10.3), diabetes mellitus (OR=1.6, 95% CI: 1.1-2.3) and smokeless tobacco use (OR=12.0, 95% CI: 8.1-17.6) were the only variables independently associated with fissured tongue.

CONCLUSION

This study suggested that there was a high rate of fissured tongue among an outpatient clinic in Andkhoy, Afghanistan. Male gender, diabetes mellitus, and nass consumption were associated with fissured tongue. Therefore, these factors might usefully be targeted in local health promotion, prevention and early intervention programs.

Effect of an Educational Pamphlet on Knowledge and Performance of Fitness Trainers about Traumatic Dental Injuries

Objectives: Traumatic dental injuries (TDIs) commonly occur in sport clubs. The knowledge and performance of fitness trainers play an important role in management of such injuries. This study sought to assess the effect of an educational pamphlet on knowledge level and performance of fitness trainers about TDIs in Tehran in 2018. Materials and Methods: In this interventional study, a pamphlet was designed to enhance the knowledge level of fitness trainers. Ninety-five fitness trainers were randomly divided into two groups of intervention and control (n=49 in the control group and n=46 in the interventional group), and were requested to fill out a valid and reliable researcher-designed questionnaire about TDIs before and 1 month after pamphlet distribution. The questionnaire consisted of three domains of demographic information, knowledge questions, and performance questions. The results were analyzed using SPSS 25 via the Chi-square test and repeated measures ANOVA considering the intervention as the between-subject factor. Results: The knowledge score of fitness trainers about TDIs was not adequately high in the intervention or the control group before the intervention. After the intervention, the performance of participants improved in both groups. This increase was significantly greater in the intervention group (P=0.035). There was no significant difference between the two groups in the knowledge domain (P=0.185). Conclusion: Educational pamphlets can effectively enhance the knowledge level of fitness trainers about TDIs. However, the magnitude of this effect was not significant in our study. Future studies are recommended to compare the efficacy of educational pamphlets with other educational tools.

Comparison of Microleakage of Pedo Jacket Crowns and Stainless Steel Crowns Cemented with Different Cements

Objectives

This study aimed to assess the microleakage of Pedo Jacket crowns compared to stainless steel crowns (SSCs) cemented with different luting cements.

Materials and Methods

In this in-vitro experimental study, 80 primary molars were randomly divided into four groups of 20 each. Groups 1 and 2 were subjected to standard tooth preparation for SSC. Crowns in group 1 were cemented with glass ionomer (GI), and crowns in group 2 were cemented with a resin-modified glass ionomer (RMGI) cement. In groups 3 and 4, minimal tooth preparation was performed for Pedo Jacket crowns, and the crowns were cemented with RMGI and Panavia resin cement, respectively. Microleakage was measured at mesial and distal surfaces in micrometers (μm), and the mean value for each tooth was calculated. Oneway analysis of variance (ANOVA) was applied to compare the microleakage of the four groups.

Results

Group 3 (Pedo Jacket cemented with RMGI) showed the highest microleakage (1523.83±250.32 μm) with significant differences with the remaining three groups (P<0.001). Microleakage in group 4 (Pedo Jacket cemented with Panavia) was significantly lower than that in the other three groups (301.25±219.53 μm, P<0.001). Groups 1 (SSCs cemented with GI) and 2 (SSCs cemented with RMGI) were not significantly different in terms of microleakage (P=0.49) although group 1 showed slightly higher microleakage than group 2 (598.43±260.85 μm versus 500.25±124.74 μm).

Conclusion

Pedo Jacket crowns can serve as an acceptable esthetic alternative to SSCs if cemented with resin cements.

Comparative evaluation of the effects of different methods of post space preparation in primary anterior teeth on the fracture resistance of tooth restorations

Background. Severely damaged teeth do not have adequate structure to support the composite crown; therefore, use of the canal space has been suggested to increase retention. Furthermore, the effect of post space irrigation protocols on the fracture resistance of the primary anterior teeth has not definitely been studied in postoperative modalities. This study compared the fracture resistance of restorations of primary anterior teeth following irrigation of the post space with sodium hypochlorite and chlorhexidine with and without application of burs.

Methods. Ninety-four extracted primary anterior teeth were selected. Root canal treatments were carried out, 4 mm of the post space was left empty and 1 mm was regarded as a bed. The post space was prepared with and without a bur and the irrigation procedures were carried out with 0.2% chlorhexidine and 2.5% sodium hypochlorite solutions. Composite posts were inserted into the canals and the crowns were restored. Following composite etching and light-curing, the fracture resistance of the restored teeth was determined by a universal testing machine.

Results. In the sodium hypochlorite group, fracture resistance of the teeth was 376.8±107.29 N and 475.5±186.89 N without and with bur preparation, respectively. For chlorhexidine protocol, the values were 370.88±175.46 N and 430.85±178.22 N without and with bur preparation, respectively. The effect of irrigating material was not significant; however, the bur and irrigating preparation significantly increased the fracture resistance of the restored teeth (P=0.02).

Conclusion. Post space irrigation with 0.2% chlorhexidine or 2.5% sodium hypochlorite did not significantly affect the fracture resistance of primary anterior teeth in the post treatment modality.

Assessment of photobiomodulation therapy by an 8l0-nm diode laser on the reversal of soft tissue local anesthesia in pediatric dentistry: a preliminary randomized clinical trial

During the injection of local anesthesia in pediatric dental procedures, from the injection time until the elimination of tissue anesthesia, inevitable problems were reported. According to the encouraging results of previous studies addressing the positive effects of laser therapy on increasing the microcirculation, we aimed to investigate the clinical effect of photobiomodulation therapy on the reversal of soft tissue anesthesia in children. Using a split-mouth design, 34 children aged 4 to 8 years old, candidate for receiving local infiltration injection at both right and left side in mandible, were enrolled in the study. The mandibular right and left quadrants were randomly assigned to groups of laser or sham laser: in laser side, patients received 810-nm laser irradiation, and in the sham laser group, the patients had the laser in off mode at 45 min after injection with an interval of 7-10 days between two sessions of each quadrant treatments. The degree of anesthesia was evaluated using the palpation technique alternately every 15 min. Data were analyzed using paired sample t test and multiple linear regression test. The mean duration of anesthesia expressed in minutes was equal to 145.15 ± 23.27 and 188.82 ± 12.31 for the laser group and sham laser group, respectively. There was a significant difference in duration of anesthesia between two groups (P < 0.001). Considering the results and limitations of the present study, photobiomodulation therapy by 810-nm diode laser can be proposed as a non-invasive method in order to reduce the duration of anesthesia in pediatric patients.

Thermal Changes in Root Surface of Primary Teeth During Root Canal Treatment With Diode Lasers: An In Vitro Study

Introduction: Increased temperature due to the application of laser during root canal disinfection may damage periodontium, alveolar bone, and permanent dental germ. The aim of this study was to evaluate the temperature increase of the external surface of primary roots due to the application of 810 nm and 980 nm diode lasers. Methods: A total of 58 extracted human primary teeth were prepared and randomly divided into two groups: (a) 810 nm diode laser and (b) 980 nm diode laser. Then, each group was divided into 4 subgroups based on the location of the temperature measurement, including subgroup 1: external root surface of primary anterior roots (A); subgroup 2: external root surface of posterior teeth at inter-root space (IS); subgroup 3: external root surface of posterior teeth at outer-root space (OS) and subgroup 4: external surface of furcation area of posterior teeth (F). Results: The mean temperature rise in group a (7.02±2.95ºC) was less than that of group b (10.62±4.59ºC) (P<0.001). Also, a significant difference was found between the laser groups in terms of the mean temperature rise of the external root surface at IS, OS and F, with higher temperature increase occurring in all points in laser b. The comparison of irradiation points in each laser showed a higher mean temperature rise for IS than OS, but this difference was only significant in group b (P<0.001). Conclusion: Within the studied parameters, 810 nm and 980 nm diode lasers should be used cautiously in primary root canals because of their temperature rise during their application.

Effects of Laser and Fluoride on the Prevention of Enamel Demineralization: An In Vitro Study

Introduction: Investigations have demonstrated that fluoride is an essential element in preventive dentistry. However, there are still controversies about the preventive effects of various kinds of laser. The aim of this study was to examine the effect of diode laser irradiation (810 nm) with or without fluoride therapy in the prevention of deciduous enamel demineralization. Methods: Sixty deciduous molar crowns were randomly assigned to 6 groups: C: received no treatment; F: fluoride varnish application; 2L: 2 times diode laser irradiation; 4L: 4 times diode laser irradiation; F2L: 2 times laser irradiation over fluoride varnish; F4L: 4 times laser irradiation over fluoride varnish. Teeth in all groups were subjected to a pH-cycling process to produce artificial caries-like lesions. Results: The analysis of variance (ANOVA) of microhardness values indicated a significant great effect for laser, fluoride, and the interaction of laser- fluoride on reducing the final microhardness value (P<0.001). However, the 2L group was an exception. Despite the 4L group, it did not show a significant prevention of enamel microhardness loss (P=0.125). These 2 groups exhibited different effects in the absence of fluoride (P _2L-4L=0.05) while in the presence of the fluoride varnish, no statistically significant difference was observed between them (P _F2L-F4L=0.257). Moreover, no statistically significant difference was observed between the laser-fluoride combination group and the fluoride group (P _F2L-F=0.133, P _F4L-F=0.926). Conclusion: Our results suggest that fluoride varnish, diode laser, and their combination decrease the loss of the enamel microhardness value and potentially prevent deciduous enamel demineralization. However, the combination of laser and fluoride was not more effective than fluoride.

Comparison of Canine Overlap in Pediatric Patients Requiring Stainless Steel Crown Placement under General Anesthesia before and after the Procedure

Objectives

Despite the increasing popularity of pediatric dental treatments under general anesthesia, information is scarce regarding occlusal changes in patients receiving stainless steel crowns (SSCs) under general anesthesia. This study sought to compare canine overlap before and after general anesthesia in children receiving SSCs. In case of a change, the possibility of returning to the preoperative state and the time required for this process were also evaluated.

Materials and Methods

This interventional, before-and-after study was performed on 60 children between 2 to 7 years of age requiring dental treatment under general anesthesia. The contact point of the most prominent area of the maxillary primary canine and mandibular primary canine was marked before and immediately after general anesthesia and at one and two weeks postoperatively. The change in canine overlap was analyzed using repeated measures analysis of variance (ANOVA) and linear regression test.

Results

Canine overlap significantly decreased immediately after general anesthesia (P<0.05). The mean bite opening was 0.51±0.22 mm at the site of the right canine and 0.50±0.185 mm at the site of the left canine. These values returned to their normal preoperative state after one week (P<0.05). Repeated measures ANOVA showed significant differences in this respect between the time points (P=0.002).

Conclusion

The occlusion and vertical dimension of pediatric patients may change following dental treatment under general anesthesia; the magnitude of change in canine overlap may vary depending on the class of occlusion and number of SSCs placed. These changes are temporary and often resolve within a week.

Effect of visual distraction on children's anxiety during dental treatment: a crossover randomized clinical trial

AIM

This was to evaluate the effect of visual distraction on anxiety of children during dental treatment.

MATERIALS AND METHODS

This randomized, crossover clinical trial study was conducted on 28 children (aged 4-5 years) randomly divided into two groups of 14 each. Group 1, treatment procedure in the first visit was completed while the patients were watching a cartoon as a visual distraction tool, at the second visit, the procedure was carried out with conventional tell-show-do. Group 2, had visual distraction in their second visit and conventional tell-show-do during the first visit. Treatment procedures were similar in both groups during two sessions. The anxiety level was determined using Venham picture test and pulse rate (PR) at the beginning and the end of each appointment. Patient behaviour was also scored using Frankl behaviour rating scale (FBRS).

RESULTS

Self-reported dental anxiety was reduced significantly by visual distraction (p-value < 0.001) compared to conventional tell-show-do, but it did not change FBRS scores significantly (p-value = 0.24).

CONCLUSION

Use of visual distraction improves self-reported anxiety and decreases PR of children but does not change their behaviour.

Efficacy of articaine infiltration versus lidocaine inferior alveolar nerve block for pulpotomy in mandibular primary second molars: A randomized clinical trial

Background: Successful anesthesia is a major concern in during pulpotomy treatment. The aim of this study was to compare the anesthetic efficacy of inferior alveolar nerve block using 2% lidocaine and buccal infiltration using 4% articaine for pulpotomy of mandibular primary second molars.

Methods: This randomized cross-over clinical trial was performed in 23 children (five to eight-year-old) from July through November 2016, referred to the Department of Pediatric Dentistry, Tehran University of Medical Sciences who needed pulpotomy treatment in both mandibular primary second molars. The Patients’ feeling during injection and their behavior during pulpotomy and post-treatment complications were registered. Wilcoxon Signed Ranks test was used for analyzing the data. A significant level of differences was taken as p≤ 0.05.

Results: Patients’ feeling during injection and post-treatment complications did not significantly differ between two groups (p>0.05). Patients’ behavior during pulpotomy was significantly better in articaine group (p=0.004).

Conclusion: Articaine buccal infiltration can be used successfully in pulpotomy of mandibular primary second molars. Iranian Registry of Clinical Trial: (IRCT2015042321484N2).

Effect of antimicrobial photodynamic therapy on the counts of salivary Streptococcus mutans in children with severe early childhood caries

BACKGROUND

Antimicrobial photodynamic therapy (aPDT) is a novel technique for reduction of pathogenic microorganisms in dentistry. The aim of this study was to evaluate the effects of aPDT on Streptococcus mutans reduction in children with severe early childhood caries.

METHODS

Twenty-two children with severe early childhood caries aged 3-6 years were treated with toluoidine blue O (TBO) for 1min and irradiated by a Light Emitting Diode (LED; FotoSan, CMS Dental, Denmark) with the exposure time of 150s. Saliva samples were collected at baseline, 1h and 7 days after treatment. S. mutans counts were determined using the Dentocult SM Strip mutans.

RESULTS

The counts of S. mutans in saliva decreased significantly after 1h (P<0.001). However, the difference in reduction of S. mutans counts in saliva was not significant between the baseline and 7 days after treatment (P>0.05).

CONCLUSION

aPDT seems to be efficient to reduce salivary S. mutans immediately after treatment in children with severe early childhood caries. However, further research is needed to evaluate different doses and frequency of irradiation in combination with restoring carious teeth to find more durable results.

Comparison of Shear Bond Strength of Composite to Stainless Steel Crowns Using Two Mechanical Surface Treatments and Two Bonding Systems

OBJECTIVES

This study aimed to compare the shear bond strength (SBS) of composite to stainless steel crowns (SSC) using two mechanical surface treatments (MSTs) and two bonding systems.

MATERIALS AND METHODS

Eighty-four SSCs were divided into six groups of 14; Group1: No MST+Scotchbond Universal adhesive (N+U), Group 2: Surface roughening by a diamond bur+Scotchbond Universal adhesive (R+U), Group 3: Sandblasting+Scotchbond Universal adhesive (S+U), Group 4: No MST+Alloy Primer+Clearfil SE Primer and Bond (N+A), Group 5: Surface roughening by a diamond bur+Alloy Primer+Clearfil SE Primer and Bond (R+A), Group 6: Sandblasting+Alloy Primer+Clearfil SE Primer and Bond (S+A). After MST and bonding procedure, composite cylinders were bonded to the lingual surface of SSCs, then the SBS of composite to SSCs was measured using a universal testing machine following thermocycling.

RESULTS

The SBS of groups R+U and S+U was significantly higher than that of group N+U. No significant difference was noted in SBS of groups R+U and S+U. The SBS of group S+A was significantly higher than that of groups N+A and R+A. No significant difference was noted in the SBS of groups N+A and R+A (P>0.05).

CONCLUSIONS

In Scotchbond Universal adhesive groups, sandblasting and surface roughening by diamond bur significantly increased the SBS of composite to SSCs compared to no MST. In Alloy Primer groups, sandblasting significantly increased the SBS of composite to SSC compared to surface roughening with diamond bur and no MST.

Fracture resistance of three different posts in restoration of severely damaged primary anterior teeth: An in vitro study

Background:

Restoration of anterior primary teeth with severe caries lesion is a big challenge. The aim of this study was to compare the fracture resistance of three types of post, including composite resin, customized quartz fiber and prefabricated glass fiber in restoration of severely damaged primary anterior teeth.

Materials and Methods:

Sixty extracted human primary maxillary incisors were randomly divided into three groups: Group 1: Customized quartz fiber post, Group 2: Composite post and Group 3: Prefabricated glass fiber post. Due to the effect of bonded area on the fracture resistance, the bonded surface of each sample was measured 1 mm above cementoenamel junction. An increasing force was subjected with a crosshead speed of 0.5 mm/min by a universal testing machine until fracture occurred, and the failure mode was assessed afterwards. Data were analyzed using One-way analysis of variance and Kruskal–Wallis tests. The level of significance was considered at P < 0.05.

Results:

The mean fracture resistance values of three groups were 343.28 N, 278.70 N and 284.76 N, respectively. Although customized quartz fiber post showed the greatest fracture resistance, statistical analysis revealed no significant difference between groups (P = 0.21). The mean fracture strength values of three groups were 12.82 N/mm^–2, 11.93 N/mm^–2 and 11.31 N/mm^–2, respectively; however, the differences were not statistically significant (P = 0.72). Favorable failure mode was more frequent in all groups (P = 0.12).

Conclusion:

Within the limitations of this study, it can be concluded that all three types of studied posts can be successfully used to restore badly destructed primary anterior teeth.

Excision of epulis granulomatosa with diode laser in 8 years old boy

INTRODUCTION

Epulis granulomatosa is a lesion which grows from an extraction socket. It can be misdiagnosed with lesions of the same clinical appearance such as: foreign body or pyogenic granuloma, or as a herniation of the maxillary sinus. The most common treatment is surgical excision.

CASE REPORT

The present article reports an Epulis granulomatosa which was removed with diode laser (810 nm) due to child's fear related to traditional surgical instruments and bleeding.

RESULTS AND CONCLUSION

Lasers are useful for soft tissue surgery in modern dentistry, especially in relation to pediatric patients due to the rapid and regular wound healing without sutures.

Fracture resistance of cementum-extended composite fillings in severely damaged deciduous incisors: An in vitro study

Objective:

The aim of this study was to comparatively assess the fracture resistance of the cementum-extended and conventional composite fillings with or without intracanal composite posts in severely damaged deciduous incisors.

Materials and Methods:

This in vitro study was performed on 60 extracted deciduous maxillary incisors that were randomly divided into four groups: Group 1: Composite filling (CF); Group 2: Composite filling with composite posts (CF + CP); Group 3: Composite filling extended 0.5 mm to cementum (ceCF); Group 4: Composite filling extended 0.5 mm to cementum with composite posts (ceCF + CP). The fracture resistance was assessed by exerting a progressively increasing load with a cross-head speed of 0.5 mm/min in a Universal Testing Machine.

Statistical Analysis:

Data were analyzed by SPSS-18 using one-way analysis of variance at α < 0.05.

Results:

The mean fracture resistance (MFR) values of the experimental groups were 410.57 ± 139.44 N, 564.44 ± 92.63 N, 507.5 ± 76.37 N and 601.08 ± 96.04 N. A significant difference was found between the MFR of Groups 1 and 2, Groups 1 and 4 and Groups 3 and 4 (P < 0.05).

Conclusion:

A superior outcome was achieved by intracanal composite posts in both conventional and cementum-extended composite fillings.

The effect of using an educational poster on elementary school health teachers' knowledge of emergency management of traumatic dental injuries

OBJECTIVE

The purpose of this study was to evaluate the effect of an educational poster on elementary school health teachers' knowledge about emergency management of traumatic dental injuries.

MATERIALS AND METHODS

Before poster presentation, a questionnaire was distributed to 40 health teachers (30 in the study group and 10 in the control group). One month after poster distribution, the subjects were re-evaluated in both groups using the same questionnaire.

RESULTS

The percentage of participating health teachers who answered the questions correctly after poster distribution regarding crown fracture was 93.3% in the test group vs. 60% in controls; for management of luxation and avulsion, the percentages for cases and controls were 63.3% vs. 40% and 100% vs. 60%, respectively. One month after distribution of the educational poster, rate of correct responses increased in management of crown fracture, luxation, and avulsion in the test group, but there was no improvement in controls (P<0.001).

CONCLUSION

Use of an educational poster enhanced the knowledge of health teachers. Use of posters is an effective way to inform teachers of the management of traumatic dental injuries.

Job satisfaction and its influential factors in dental academic members in tehran, iran

Background:

Assessment of job satisfaction of the faculty members and its underlying factors may increase career fulfillment and raise the educational and research productivity, leading to higher quality of dental services at the community level, ultimately improving public oral health status.

Aim:

This study assessed job satisfaction and its influential factors in dental academic members in Tehran.

Subjects and Methods:

The job satisfaction level of 203 faculty members was assessed using a Likert scale questionnaire from 0 to 4, with 4 representing very satisfied and 0 not at all satisfied. The analysis of variance was used to compare the responses among dental faculty members of three different universities. The impact of age, gender, academic rank, employment status and the date of employment on the overall faculty job satisfaction was identified by multiple linear regression analysis.

Results:

The mean professional satisfaction score among faculty members was 1.5 (0.5) out of four. Among the studied underlying factors, only the date of employment was seen to have a statistically significant impact on the faculties’ overall job satisfaction (P= 0.05). There was no difference in job compensation observed between the three dental faculties. Dissatisfying aspects of the academic work included educational and research policies, monetary strategies, quality of leadership and administration, promotion and tenure policies, job security, educational environment, equipments, and facilities. The only satisfying factor was the interaction between faculty colleagues and students.

Conclusion:

Faculty members of Tehran Dental Schools are dissatisfied with their work environments in Tehran Dental Schools. Issues such as salary and remuneration, facilities, equipments, promotion and tenure policies are strongly believed to account for the dissatisfaction.

In-vitro comparison of instrumentation time and cleaning capacity between endodontic handpiece and manual preparation techniques in primary molar teeth

AIM

The aim of this study was to evaluate and compare the cleaning ability and instrumentation time of manual method and use of endodontic handpiece for preparation of primary molar teeth.

METHODS

Forty primary teeth canals were used in this experimental study. Access cavities were prepared and India ink was injected into the canals. The samples were divided into three groups according to the preparation technique. In the first group the root canals were manually instrumented by k_files. Endodontic handpiece (TEP-ER10, NSK, Japan) were used for canal preparation in the second group and the samples in the third group (control) were not instrumented. After preparing the canal, the teeth were cleared with methyl salicylate and the removal of India ink was measured in the cervical, middle and apical thirds. The instrumentation time was transcribed by chronometer. Statistical analysis was performed using Mann-Whitney and t-test.

RESULTS

There was no significant difference in cleaning capacity between the two techniques, but results of the first and second group differ from those of the control group. In fact, time taken for preparation was significantly shorter with endodontic handpiece system.

CONCLUSION

Seen the shorter working time of endodontic handpiece and the similar cleaning ability of the two techniques, the application of the endodontic handpiece is recommended for preparation of deciduous root canals during pulpectomy.

Treatment of Ankyloglossia with Carbon Dioxide (CO2) Laser in a Pediatric Patient

INTRODUCTION

Laser surgery as an alternative for conventional surgical procedure has gained special attention. Using Carbon Dioxide (CO2) laser has some benefits like less post-operative pain, swelling and infection, decrease in risk of metastasis and edema, and less bleeding providing dry sites for surgery.

CASE REPORT

A 12 years old boy with lingual frenum with indication for excision was referred to the laser department of Tehran University of medical sciences dental school.CO2 laser was used with 10600 nm wavelength, 1.5 W output power, 100 Hz frequency and 400 μsec pulse duration in non-contact mode.

RESULTS

The result of using CO2 laser was dry and bloodless field during operation, no post operative swelling, no pain or discomfort, with normal healing process.

CONCLUSION

We suggest and stimulate the use of CO2 laser for soft tissue surgery because of elimination of suture, convenient coagulation, time saving, patients' comfort and easy manipulation.

Inverted impacted primary maxillary incisors: a case report

Tooth impaction rarely occurs in primary dentition. Most of the primary teeth impactions are seen in second molars. The purpose of this article is to present a 4-year-old girl with bilateral impaction of inverted primary maxillary central incisors which trauma had displaced their tooth germ before erupting.

Microleakage of stainless steel crowns placed on intact and extensively destroyed primary first molars: an in vitro study

PURPOSE

The purpose of this investigation was to evaluate the effect of residual tooth structure on the microleakage of stainless steel crowns cemented with glass ionomer on primary maxillary and mandibular first molars.

METHODS

Thirty extracted primary molars were divided into 2 groups: group 1 included intact teeth; and group 2 included extensively carious samples. Each tooth received standard preparation, and each crown was luted with G-CEM on its specific specimen. Teeth were loaded vertically and transferred to distilled water. After thermocycling and immersing in methylene blue solution, the teeth were sectioned and examined microscopically for microleakage. Data were analyzed using Mann-Whitney U and Wilcoxon signed-rank tests.

RESULTS

All specimens (intact and damaged teeth) had microleakage, although most of these presented only minimum microleakage. No statistically significant differences were found in the microleakage of sound and extensively carious teeth on either the buccal (P=.62) or lingual (P=.65) side. Buccal (P=.73) and lingual (P=.63) surfaces showed similar microleakage scores in primary maxillary and mandibular molars.

CONCLUSIONS

There was no significant difference in the microleakage of sound or extensively carious teeth and primary maxillary or mandibular first molars.

Skull segmentation in 3D neonatal MRI using hybrid Hopfield Neural Network

A fully automated method for segmentation of neonatal skull in Magnetic Resonance (MR) images for source localization of electrical/magnetic encephalography (EEG/MEG) signals is proposed. Finding the source of these signals shows the origin of an abnormality. We propose a hybrid algorithm in which a Bayesian classifying framework is combined with a Hopfield Neural Network (HNN) for neonatal skull segmentation. Due to the non-homogeneity of skull intensities in MR images, local statistical parameters are used for adaptive training of Hopfield neural network based on Bayesian classifier error. The experimental results, which are obtained on high resolution T1-weighted MR images of nine neonates with gestational ages between 39 and 42 weeks, show 65% accuracy which consistently exhibits our scheme's superiority in comparison with previous neonatal skull segmentation methods.

The Prevalence of Bruxism and Correlated Factors in Children Referred to Dental Schools of Tehran, Based on Parent's Report

OBJECTIVE

Bruxism is defined as the habitual nonfunctional forceful contact between occlusal tooth surfaces. The aim of this study was to determine the prevalence of bruxism and correlated factors in children referred to dental schools of Tehran, based on Parent's report.

METHODS

This cross-sectional descriptive study was conducted on 600 4-12 year-old children with a mean age of 7.4±2.4 years, who were referred to four dental schools in Tehran. After collecting information with questionnaire filled out by parents, χ(2), Fisher Test, Mann-Whitney and t-Test were used to analyze the data.

FINDINGS

The prevalence of bruxism was 26.2%. Bruxism begun in average at the age of 4.9±2 years. Also it occurred 2.6 times more in children who had a family history of bruxism (father-mother), compared to children who didn't have such a history. 87% of children with bruxism had a history of distressing events in their life, and 13% of children with bruxism did not report any history of distressing events in their life. In this study most common oral habit was nail biting. In study of parasomnias, drooling was the most, and snoring the least reported sleep disorder. Bruxism in children with drooling was twice more than in other children. The prevalence of bruxism in children with temporomandibular disorder was 63.6% and in children without TMD was 24.7%.

CONCLUSION

Based on Parent's report, 26.2% of children showed bruxism and there was a significant relation between bruxism and mother's job, family history, distressing event in life, parasomnias, especially drooling and sleep walking, TMD, hyperactivity, depression, acrophobia and lygophobia.

Neonatal probabilistic models for brain, CSF and skull using T1-MRI data: preliminary results

Inappropriate results may be produced if one uses adult or pediatric atlases for evaluation of neonatal cerebral images for morphological studies. This is mainly due to anatomical particularities typical for this early stage of development. In this paper, we describe the construction of a digital neonatal brain atlas from a set of images of neonates aged between 39 and 42 weeks. It consists of probabilistic models for brain, cerebrospinal fluid (CSF) and skull. In the first step, the selected images are segmented automatically followed by manual correction. In the second step, the images are normalized to a stereotaxic space defined by the neonatal brain atlas template GRAMFC_T(39-42) using a popular normalization algorithm implemented in Statistical Parametric Mapping (SPM). The normalization parameters of individual subjects are then used to resample the corresponding brain, CSF and skull. Finally, to construct the probabilistic models, the average is computed for each voxel location. The atlas might be used for different applications such as source localization or neonatal structural image analysis.

Segmentation of scalp and skull in neonatal MR images using probabilistic atlas and level set method

In this paper, we present a novel automatic algorithm for scalp and skull segmentation in T1-weighted neonatal head MR images. First, the probabilistic scalp and skull atlases are constructed. Second, the scalp outer surface is extracted based on an active mesh method. Third, maximum number of boundary points corresponding to the scalp inner surface is extracted using the constructed scalp probabilistic atlas and a set of knowledge based rules. In the next step, the skull inner surface and maximum number of boundary points of the outer surface are extracted using a priori information of the head anatomy and the constructed skull probabilistic atlas. Finally, the fast sweeping, tagging and level set methods are applied to reconstruct surfaces from the detected points in three-dimensional space. The results of the new segmentation algorithm on MRI data acquired from nine newborns (including three atlas and six test subjects) were compared with manual segmented data provided by an expert radiologist. The average similarity indices for the scalp and skull segmented regions were equal to 89% and 71% for the atlas and 84% and 63% for the test data, respectively.