Evaluation of discontinuation of antibacterial prophylaxis in children with vesicoureteral reflux

زمینه و هدف: ریفلاکس وزیکویورترال ( VUR ) مهمترین علت زمینه ساز عفونت ادراری در کودکان است. جهت جلوگیری از عفونت ادراری در کودکان با ریفلاکس وزیکویورترال، از آنتی بیوتیک پروفیلاکسی استفاده می شود که می تواند با عدم پذیرش خانواده به دلیل مصرف طولانی مدت دارو همراه باشد. این مطالعه با هدف مقایسه قطع و عدم قطع داروی پروفیلاکسی در کودکان با ریفلاکس وزیکویورترال درجه 1 و 2 انجام شده است. روش بررسی: در این مطالعه نیمه تجربی 54 کودک مبتلا به ریفلاکس وزیکویورترال درجه 1 یا 2 و بالای 5 سال که طی یکسال گذشته فاقد عفونت ادراری بودند به روش در دسترس انتخاب شدند. کودکان به صورت یک در میان به دو گروه قطع (32 کودک) و ادامه (21 کودک) درمان تقسیم و حداقل به مدت 12 ماه پیگیری شدند. میزان عود عفونت در دو گروه مورد مقایسه قرار گرفت. جهت بررسی آماری از آزمون های آماری کای دو ، t ، Logrank و تحلیل رگرسیون کاکسی استفاده شد. یافته ها: میانگین سن کودکان 5/2 ± 8/7 سال و 8/77 دختر بودند. در گروه قطع درمان 5 مورد و در گروه ادامه درمان 7 مورد عود عفونت وجود داشت (05/0 P> ). شانس عود عفونت در دختران 5/1 برابر پسران (05/0 P> ) و در کودکان زیر 7 سال 5 برابر کودکان بالای 7 سال بود (033/0= P ). نتیجه گیری: قطع دارو در کودکان بالای 5 سال با ریفلاکس وزیکویورترال درجه 1یا2 ریسک عود عفونت ادراری را افزایش نداده و قطع درمان پروفیلاکسی می تواند یک روش مطمئن و بی خطر باشد

Evaluation of the buccolingual position of maxillary and mandibular anteriorteeth roots by cone-beam computed tomography(CBCT)

Introduction: Evaluation of the position of anterior teeth in the alveolar bone for planning implant treatments is so important. The aim of this study was to evaluate the thickness of buccolingual/palatal bone at anterior teeth roots and the angle between the tooth root axis and alveolar bone axis. Materials & Methods: In this cross-sectional study, the position of root apex, angle between the tooth root axis and alveolar bone axis as well as thickness of buccolingual/palatal bone in 2,4,6 mm from alveolar crest and root apex areas were evaluated in the cone-beam computed tomography (CBCT) scans of 360 maxillary and mandibular anterior teeth. The data were then analyzed by ANOVA and t-test. Results: Twenty eight females and 27 males with the mean age of 43.13±10.91 participated (181 female teeth and 179 male teeth) in the current study. In maxillary anterior teeth, the buccal bone thickness was thinner than the palatal bone and was significantly smaller in females than males (p≤0.0001). The thinnest area in buccal bone was in 4mm from alveolar crest in female’s lateral incisor of maxilla (0.09±0.02). The thickness of the palatal bone in the maxillary lateral incisors was significantly thicker in females than males. The thickness of lingual bone was thicker in mandibular lateral incisors and canines than in buccal bone and the lingual bone thickness was significantly thicker in males than females. The apex position of anterior teeth was predominantly buccally in the maxilla (%94), while it was middle in the mandible (%44). Conclusion: Due to the small thickness of buccal bone, evaluation of the position of implant fixtures in maxillary anterior teeth is of great importance

Age estimation by pulp/tooth area ratio in anterior teeth using cone-beam computed tomography: comparison of four teeth

Objectives: Age estimation is one of the most important factors in forensic medicine. Measuring secondary dentin deposition using cone-beam computed tomography images is an easy and noninvasive method. The aim of this study was to evaluate cone-beam computed tomography images as a reliable method to estimate chronological age by pulp/teeth ratio in anterior teeth in Iranian population. Methodology: A total of 649 CBCT images from 377 Iranian patients aged between 20 and 69 years were evaluated. Pulp/teeth ratio (PTR) in maxillary and mandibular canine and central incisor teeth was measured in the axial and sagittal sections using OnDemand 3D Dental software. The Pearson correlation coefficient was determined to evaluate the correlation between the variables. Linear regression analysis, as well as age estimation formula, was used for each tooth separately. Results: The regression analyses indicated that maxillary central incisors were more reliable for age estimation (R2=0.586 and standard error of estimate=7.045) compared with the other anterior teeth studied. Maxillary canine teeth had the lowest predictive power (R2=0.392 and standard error of estimate=8.387). Also, comparison of the axial and sagittal sections showed that the axial sections had a higher predictive power. (R2=0.48 for axial plans and R2=0.328 for sagittal plans). Conclusion:The use of cone-beam computed tomography in age estimation by pulp/teeth ratio of anterior teeth is useful and a reliable method for age estimation in Iranian population

Diagnostic Accuracy of Cone-Beam Computed Tomography and Periapical Radiography in Internal Root Resorption

Introduction: The aim of this study was to compare the diagnostic value of cone-beam computed tomography (CBCT) and periapical (PA) radiography in detecting internal root resorption. Methods and Materials: Eighty single rooted human teeth with visible pulps in PA radiography were split mesiodistally along the coronal plane. Internal resorption like lesions were created in three areas (cervical, middle and apical) in labial wall of the canals in different diameters. PA radiography and CBCT images were taken from each tooth. Two observers examined the radiographs and CBCT images to evaluate the presence of resorption cavities. The data were statistically analyzed and degree of agreement was calculated using Cohen’s kappa (k) values. Results: The mean±SD of agreement coefficient of kappa between the two observers of the CBCT images was calculated to be 0.681±0.047. The coefficients for the direct, mesial and distal PA radiography were 0.405±0.059, 0.421±0.060 and 0.432±0.056, respectively (P=0.001). The differences in the diagnostic accuracy of resorption of different sizes were statistically significant (P<0.05); however, the PA radiography and CBCT, had no statistically significant differences in detection of internal resorption lesions in the cervical, middle and apical regions. Conclusion: Though, CBCT has a higher sensitivity, specificity, positive predictive value and negative predictive value in comparison with conventional radiography, this difference was not significant.Keywords: Cone-Beam Computed Tomography; Periapical Radiography; Root Resorptio

Prevalence of mandibular accessory foramina using CBCT in a selected iranian population

Introduction: The aim of the current study was to evaluate the frequency of accessory foramina in human mandible. Material & Methods: In this cross-sectional study, 400 cone beam computed tomography (CBCT) images of mandibles of 273 patients (120 males and 153 females), divided into four groups ≤30, 30–39, 40–49, and ≥50 years) with the mean age of 38.05±13.71 years (40.71±12.83 for males and 35.39±12.05 for females) were evaluated. The number and diameter of accessory foramina from midline to anterior border of ramus with 0.1 mm intervals were investigated. Data were analyzed with SPSS 17 (SPSS Inc., Chicago, I1, USA) using T-Test, Pearson's correlation coefficient and Fisher exact test. Results: Totally, 568 accessory foramina with mean diameter of 0.35±0.15 mm were seen. The frequency of accessory foramina in the studied patients was 83% with mean frequency of 88% in males and 80% in females. These results showed a significant difference between the genders in frequency of accessory foramen (P<0.001) although no difference was observed among different age groups. The highest frequency belonged to anterior lingual of mandible. The frequency of accessory foramina in posterior mandible was higher in females, while males indicated higher frequency in anterior mandible. No significant difference was found in the frequency of accessory foramina between the right and left sides of the mandible. Conclusion: The results suggested, the survey of accessory foramina is recommended in CBCT images of mandible for therapeutic reasons due to higher frequency of accessory foramina in mandible

Clinical and radiographic evaluation of Bio-Gen with biocollagen compared with Bio-Gen with connective tissue in the treatment of class II furcation defects: a randomized clinical trial

OBJECTIVE: Treatment of furcation defects are thought to be challenging. The purpose of this study was to evaluate the clinical and radiographic parameters of Bio-Gen with Biocollagen compared with Bio-Gen with connective tissue in the treatment of Class II furcation defects. MATERIAL AND METHODS: In this clinical trial, 24 patients with Class II furcation defect on a buccal or lingual mandibular molar were recruited. After oral hygiene instruction, scaling and root planing and achievement of acceptable plaque control, the patients were randomly chosen to receive either connective tissue and Bio-Gen (case group) or Biocollagen and Bio-Gen (control group). The following parameters were recorded before the first and re-entry surgery (six months later): vertical clinical attachment level (VCAL), gingival index (GI), plaque index (PI), horizontal probing depth (HPD), vertical probing depth (VPD), gingival recession (GR), furcation vertical component (FVC), furcation to alveolar crest (FAC), fornix to base of defect (FBD), and furcation horizontal component (FHC) were calculated at the time of first surgery and during re-entry. A digital periapical radiograph was taken in parallel before first surgery and re-entry. The radiographs were then analyzed by digital subtraction. The differences with p valu

Cone-Beam Computed Tomography for Evaluation of Apical Transportation in Root Canals Prepared by Two Rotary Systems

Introduction: Due to the importance of apical transportation during root canal preparation, the aim of the current study was to use cone-beam computed tomography (CBCT) to assess the extent of apical transportation caused by ProTaper and Mtwo files. Methods and Materials: Forty extracted maxillary first molars with 19-22 mm length and 20-40 degrees of curvature were selected. The mesiobuccal canals were prepared using either Mtwo or ProTaper rotary files (n=20). CBCT images were obtained before and after canal preparation to compare the apical transportation in different cross-sections of mesial and distal surfaces. The apical transportation values were analyzed using the SPSS software. The results were compared with student’s t-test and Mann-Whitney U test. Results: There was no significant difference in the extent of apical transportation between Mtwo and ProTaper systems in different canal cross-sections. The apical transportation value was less than 0.1 mm in most of the specimens, which was clinically acceptable. Conclusion: Considering the insignificant difference between the two systems, it can be concluded that both system have low rates of apical transportation and can be assuredly used in clinical settings

The use of urinary Insulin-like Growth Factor-I (IGF-I) for determining skeletal age of participants

Introduction: Biochemical markers play an important role in the growth and repair of bone and can be evaluated in different biological fluids. Therefore, the aim of this study was to evaluate the level of insulin-like growth factor-I (IGF-I) in urine as a puberty index and to compare it with cervical vertebral maturational stages (CVMSs) in lateral cephalometry. Materials&Methods: In this cross-sectional study, 50 8-18-year-old patients (males and females), referred to Faculty of Dentistry with CVMS of 2 to 6 and needed orthodontic treatment as well as lateral cephalometry were selected. All of these patients were healthy. The CVMSs were recorded based on lateral cephalometric radiographs and urinary levels of IGF-I was determined using a urine-based ELISA kit. Mean IGF-I values for each CVMS were analyzed by Mann-Whitney, Kruskal-Wallis and Chi-square tests in SPSS. P<0.05 was statistically considered as significant level. Results: In this study, the mean age of participants, ranged from 8 to 18 years was 12.96±3.82. There was no statistically significant difference in gender distribution between CVM groups (P=0.106). The level of urinary IGF-I had no significant difference between groups, except for CVMS3 group (P=0.073). In CS3, the mean urinary IGF-I level was 0.2727, representing a significant difference from other groups (P=0.000). IGF-I levels had no significant differences between males (0.030.04) and females (0.080.011), (P=0.492). Conclusion: The highest urinary IGF-I level was found in both genders in CVMS 3 and 4, which coincided with peak growth spurt in patients

Root and Canal Morphology of Mandibular Molars in a Selected Iranian Population Using Cone-Beam Computed Tomography

Introduction: The aim of this study was to evaluate the root canal morphology of mandibular first and second molars using cone-beam computed tomography (CBCT) in northern Iranian population and also to indicate the thinnest area around root canals. Methods and Materials: We evaluated CBCT images of 154 first molars and 147 second molars. By evaluating three axial, sagittal and coronal planes of each tooth we determined the number of root canals, prevalence of C-shaped Melton types, and prevalence of Vertucci configuration and inter orifice distance. Also the minimum wall thickness of root canals was determined by measuring buccal, lingual, distal and mesial wall thicknesses of each canal in levels with 2 mm intervals from apex to orifice. Results: Amongst 154 first mandibular molars, 149 (96.7%) had two roots, 3 (1.9%) had three roots and 2 (1.2%) had C-shaped root configuration. Of 147 second mandibular molars, 120 (81.6%) had two roots, 1 (0.6%) had three roots and 26 (17.6%) had C-shaped roots. There was no significant difference in the prevalence of Vertucci’s type between two genders. The most common configuration in mesial roots of first and second molars were type IV (57%-42.9%) and type II (31.5%-28%). Mesial and distal walls had the most frequency as the thinnest wall in all levels of root canals with mostly less than 1 mm thickness. In second molars the DB-DL inter orifice distance and in first molars the MB-ML distance were the minimum. MB-D in first molars had the maximum distance while ML-DL, MB-DB and ML-D had the same and maximum distance in second molars. Conclusion: Vertucci’s type IV and type I were the most prevalent configurations in mesial and distal roots of first and second mandibular molars and the thickness of thinnest area around the canals should be considered during endodontic treatments.Keywords: Cone-Beam Computed Tomography; C-Shaped Root Canals; Mandibular First Molar; Mandibular Second Molar; Root Canal Anatomy; Root Canal Morpholog

Cone-beam computed tomography performance and endodontic filling material influence in the diagnosis of horizontal root fracture

Introduction: The aim of this study was to investigate the accuracy of Cone-beam computed tomography(CBCT) in detecting the horizontal root fractures (HRFs) in teeth with and without gutta-percha. Materials & Methods: This in vitro study was performed on 100 mandibular and maxillary single-rooted teeth. In 55 samples, the canals were prepared. Then, the horizontal fracture was induced randomly in 56 (29 with gutta-percha, 27 without gutta-percha) samples. The samples were mounted on a wax rim, and the CBCT scan was provided. The scans were examined by two endodontists twice with two-week interval. Data were analyzed using IBM SPSS 20.0 software (IBM Corp., Armonk, IL, USA). Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio (LR +, LR -) with 95% confidence interval were calculated. Results: The sensitivity and specificity were 72% and 100% for the group with gutta-percha as well as 89% and 100% for the group without gutta-percha, respectively. The coefficient of agreement for each observer within two observations was 0.940±0.034 and 0.960±0.028 (P<0.001). The inter observer agreement was 0.092±0.039 (P<0.001). Conclusion: The CBCT scans have high accuracy in diagnosis of horizontal root fracture and gutta-percha although they reduce the diagnostic accuracy with no significant effect