The overhang rate in posterior teeth restorations among a sample of patients from Sari City, Iran, in year 2017

BACKGROUND: Overhang is the extension of restoration material from the prepared cavity. Restoration overhangs have an important role in plaque accumulation, caries, severe gingival inflammation, and periodontal diseases. Therefore, the aim of this study was to determine the frequency of restoration overhanging, and the managements in order to reduce its prevalence and subsequent complications.METHODS: This descriptive cross-sectional study was conducted on 277 patients, who had at least one restoration in the proximal surface of posterior teeth. At first, all the patients were examined using a mirror, and dental floss under the light of the dental chair. In cases in which the existence of the overhang was suspected, Bitewing radiography was operated on respective regions. Data were analyzed using SPSS software.RESULTS: 120 teeth had overhangs (19.60%) and 492 (80.39%) exhibited no overhangs. From 120 restorations with overhang, 76 (63.33%) were amalgam restorations, and 44 (36.66%) were composite restorations. In total, 55.83% of them (67 restorations) were in maxilla and 44.16% (53 restorations) were in mandible. The prevalence of overhang in mandible was as 37.73% in mesial regions, 54.71% in distal regions, and 7.54% in mesial-occlusal-distal (MOD) regions; in addition, the prevalence rate in maxilla was as 38.80% in mesial regions, 58.20% in distal regions, and 2.98% in MOD.CONCLUSION: The overall frequency of restoration overhang was 19.60%, most of which was in amalgam restorations in comparison to composite restorations; and it is mostly seen in distal surfaces of maxillary teeth

The efficacy of 1% Betadine mouthwash on the incidence of dry socket after mandibular third molar surgery

Dry socket or alveolar osteitis is a delayed healing of alveolar bone after exodontia causing moderate to severe pain 2-4 days after extraction of teeth. Antibacterial agents such as antibiotics and chlorhexidine have been previously proved to prevent or reduce the incidence of dry socket. Betadine is a mixture of iodine and povidone which has bactericidal, antifungal and antiviral effects. The aim of the present study was to evaluate the effect of preoperative povidone iodine 1% mouthwash before surgical extraction of impacted mandibular third molar, however age, gender and oral hygiene were also considered. 189 patients who needed surgical extraction of Pell and Gregory class A and B mandibular third molars were included in this study. The patients who were not willing to participate in the study, took, women who took oral contraceptives or were in the first 22 days of menstrual cycle were excluded. Patients were randomly assigned to control or test group. 97 patients in the test group took preoperative povidone iodine 1% mouthwash and 92 patients in the control group didn?t take any antibiotic or mouthwash. Patients were examined in days 3 and 7 postoperatively for incidence of alveolar osteitis. Chi-square test didn?t show any significant relation between dry socket incidence and gender (p value: 0.848) and Oral hygiene (p value: 0.866). However, it revealed a significant relation between age and dry socket incidence (p value: 0.003) and patients older than 30 were reported to have higher incidence of dry socket. Independent T-Test showed a significant difference between the test and control group in incidence of dry socket (p value: 0.036). Based on the results of this study povidone iodine 1% mouthwash can decrease dry socket incidence also as the age increases, the incidence of dry socket becomes higher

Comparison of the Effects of Articaine and Lidocaine Anesthetics on Blood Pressure after Maxillary Infiltration Technique: A Triple-Blind Randomized Clinical Trial

Background. Many dental procedures begin with local anesthesia. Subsequent increase in blood pressure in healthy individuals commonly occurs and may be affected by several factors such as mental and physical stress, painful stimuli, and action of catecholamines present in local anesthetic solutions.êim of the present study is to compare the effects of 4% articaine with 1 :100000 epinephrine and 2% lidocaine with 1 : 80000 epinephrine on blood pressure after maxillary infiltration technique. Materials and Methods. In this randomized clinical trial, 102 patients were randomly assigned into two groups. One group received 4% articaine with 1 :100000 epinephrine and the other group received 2% lidocaine with 1 : 80000 epinephrine for local maxillary infiltration. Systolic and diastolic blood pressure of both groups was determined twice: once before anesthetic injection and once 10 minutes after injection.%e data were statistically analyzed using descriptive statistics, Shapiro–Wilks test, Levene test, chi-square test, independent t-test, and paired t-test. Results. %e mean systolic blood pressure after anesthetic injection in the articaine and lidocaine groups was 125.00 ± 5.67 and 123.16 ± 6.417 mmHg, respectively, showing no statistically significant difference (p � 0.127). %e mean diastolic blood pressure after injection was 85.02 ± 7.331 in the articaine group and 81.35 ± 12.815mmHg in the lidocaine group. %ese values show no statistically significant difference (p � 0.080). In both groups, the mean systolic and diastolic blood pressures have increased significantly (p < 0.001). Conclusion. Articaine can be regarded as a suitable alternative for lidocaine for maxillary local infiltration, as no significant difference was observed between the effects of the two anesthetic solutions on blood pressure

Evaluating the effect of using anti-stress balls as a distraction technique in reducing pain during inferior alveolar nerve block injection: a randomized clinical trial

Objective: The aim of this study is to evaluate the effect of using anti-stress balls in reducing patients' pain during injection of the inferior alveolar nerve block (IANB). Materials and methods: In this randomized clinical trial, 32 individuals were divided into two groups. The conventional method of anesthesia injection was performed using IANB conventional injection technique. During the injection, individuals in the anti-stress ball group were asked to use the anti-stress ball as a distraction technique. For the control group, no supersede methods were used for pain control. Finally, both groups were asked to record their pain utilizing the numerical rating scale (NRS). The participants' vital signs were monitored before and after injection. Kolmogorov-Smirnov test, independent T-test, and Fisher's exact chi-square test were performed for statistical analysis (α = 0.05). Results: Sixteen females and 16 males in the age range of 40 to 20 years old participated in this study. The mean pain score in the anti-stress ball group was significantly lower (p  0.05). Conclusion and clinical relevance: Utilizing an anti-stress ball reduces patients' pain significantly during IANB in both sexes and individuals who are below 35 years without changing vital signs. Clinical registration number: IRCT20220815055704N1

Cutaneous reactions to carbamazepine in children with epilepsy

BACKGROUND: The main components in controlling and treating seizures are antiepileptic drugs (AEDs). Mostly, the systemic side effects of these drugs are regarded very important; however, these drugs can also cause serious mucocutaneous side effects. Carbamazepine is a drug which is used to treat epilepsy. Side effects of this drug can range from skin rash to toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). The purpose of this study was to evaluate skin complications of carbamazepine in children with epilepsy.METHODS: This study was performed on 99 children, aged 2 months to 11 years, with the diagnosis of skin complications after taking carbamazepine. Records were examined and their initial profiles including their medical skin conditions and rashes were recorded within the checklist. Data were entered into SPSS software. Measures of central tendency and dispersion were achieved. Finally, the relationship between the drug and the cutaneous reactions of these patients was analyzed using the chi-square test.RESULTS: The most common complications among the patients were maculopapular lesions and skin erythroderma, with the prevalence of 37.4% for each. Other types of skin lesions included papules with 14.1%, macules with 8.1%, and SJS with 3.0%. A significant association (P = 0.02) between the types of the skin lesion and the dose of carbamazepine was observed; the more the dosage was, the more severe skin lesions were.CONCLUSION: The most common cutaneous reactions to carbamazepine were erythroderma and maculopapular rash in the patients. The findings of this study also revealed that the lack of drug compliance was of high importance

Histologic Evaluation of the Effects of Folinic Acid Chitosan Hydrogel and Botulinum Toxin A on Wound Repair of Cleft Lip Surgery in Rats

: The aim of the present study was to compare the effects of folinic acid chitosan hydrogel and botulinum toxin A on the wound repair of cleft lip surgery in rat animal models. Cleft lip defects were simulated by triangular incisions in the upper lip of 40 Wistar rats. Then, the rats were randomly assigned to four groups: control (CTRL), chitosan hydrogel (CHIT), and folinic acid chitosan hydrogel (FOLCHIT), in which the wounds were covered by a gauze pad soaked in normal saline, chitosan hydrogel, and folinic acid chitosan hydrogel, respectively for 5 min immediately after closure; and botulinum toxin A (BOT) with the injection of 3 units of botulinum toxin A in the wound region. Fibroblast proliferation, collagen deposition, inflammatory cell infiltration, neovascularization, and epithelial proliferation and each parameter were rated on days 14 and 28. Statistical analysis was performed by Kolmogorov-Smirnov test, Shapiro-Wilk test, Kruskal-Wallis, and post-hoc tests (α = 0.05). The mean score for fibroblast proliferation was significantly higher in the FOLCHIT group compared with the BOT group at days 14 and 28 (p < 0.001, p = 0.012, respectively). At day 28, collagen deposition was significantly higher in the FOLCHIT group compared with the BOT group (p = 0.012). No significant difference was observed between the inflammatory infiltration of the study groups at the two time points (p = 0.096 and p = 1.000, respectively). At day 14, vascular proliferation of group FOLCHIT was significantly higher than groups CTRL and CHIT (p = 0.001 and p = 0.006, respectively). The epithelial proliferation in the FOLCHIT group was significantly higher than groups CHIT and CTRL at day 14 (p = 0.006 and p = 0.001, respectively) and day 28 (p = 0.012). In simulated lip cleft defects, topical application of folinic acid induces faster initial regeneration by higher inflammation and cellular proliferation, at the expense of a higher tendency for scar formation by slightly higher fibroblast proliferation and collagen deposition. While injection of botulinum toxin A provides less fibroblast proliferation and collagen deposition, and thus lower potential for scar formation compared with the folinic acid group. Therefore, in wounds of the esthetic zone, such as cleft lip defects, the application of botulinum toxin A shows promising results

Comparing Postoperative Complications of Impacted Third Molar Extraction between Piezosurgery and Conventional Surgical Handpieces

Background and purpose: Conventionally, rotary devices were used for bone surgery. Recently, new techniques have been proposed such as piezosurgery. The prevalence of impacted teeth which should be removed is high. There are different techniques for bone removal that are associated with specific complications. This study compared the postoperative complications of impacted third molar extraction between piezoelectric method and conventional surgical handpieces. Materials and methods: A cohort study was done in 40 patients (mean age: 22.05±4.13 years) including 20 men and 20 women. They were randomly assigned into two groups to receive either piezosurgery (group A) or conventional handpiece (group B). The participants were recalled after three days and pain and mouth opening were compared with those of baseline scores as well as dry socket. SPSS v. 25 was used for data analysis. Results: The mean difference in mouth opening was significantly lower in group A than group B (P0.05). But, patients in piezoelectric group were more satisfied with their surgery. Dry socket was observed only in two cases of group B. Conclusion: The benefits of handpiece method is high speed in operation and lower costs. However, the piezoelectric method is newer, more convenient, and has less trismus than the handpiece method

Prevalence of Dry Socket Following Tooth Extraction and Associated Factors

Background and purpose: Dry socket is a limiting complication with unknown etiology and acute inflammation of the alveolar bone in the extracted tooth socket that occurs one to three days after tooth extraction with severe pain due to complete or incomplete destruction of the blood clot. The present study aimed at evaluating the prevalence of dry socket following tooth extraction and its related factors. Materials and methods: This descriptive cross-sectional study was performed in 1199 patients aged 18-60 years in patients attending dental clinics in Sari, Iran, 2018. Patients’ satisfaction were obtained and their demographic and dental information were recorded. Within 48-72 hours after tooth extraction, telephone follow-up was done by 4th and 5th year dental students and senior dentists. Data analysis was conducted using SPSS V24. Results: In this study, the prevalence of dry socket was 1.1%. The most common reason for tooth extraction was extensive tooth decay and third molar was the most frequent tooth extracted (45.4%). According to the analyses, those who did not brush their teeth at all were more likely to experience dry socket. Conclusion: In this study, flap technique with bone extraction and simple method resulted in highest and lowest prevalence of dry socket, respectively

Evaluating the Mandibular Trabecular Structure in Patients with and without Bruxism: A Cross-Sectional Study

(1) Background: Fractal analysis has been used as a mathematical method for studying the complexity of fractal structures such as trabecular bone that look similar at different scales. Bruxism is a disorder involving nonfunctional grinding and clenching of the teeth that leads to bone resorption and fractal dimension reduction. This study aimed to evaluate the trabecular pattern of the mandibular condyle, angle, and dental region in panoramic radiographs of individuals with and without bruxism using fractal analysis and a larger sample size. (2) Methods: A total of 365 panoramic radiographs belonging to two groups consisting of bruxism and non-bruxism individuals were assessed using fractal analysis. Fractal dimension (FD) values were calculated on each side for the three regions of interest (ROIs): the mandibular condylar head, mandibular angle, and interdental region between the second premolar and first molar. Statistical analysis was performed using binominal and chi-square tests, the Shapiro–Wilk test, and the Mann–Whitney test (α = 0.05). (3) Results: No significant differences were observed between the FD values of the ROIs in the two groups (p > 0.05). (4) Conclusions: No significant differences existed in the FD values of the ROIs in patients with and without bruxism. This result shows that fractal analysis of panoramic radiographs cannot be useful in detecting patients with bruxism

Application of Platelet-Rich Fibrin and Bone Morphogenetic Protein for Full-Mouth Implant-Based Oral Rehabilitation in a Case of Mandibular Osteoradionecrosis

Osteoradionecrosis (ORN) is a debilitating complication following radiation therapy, which in the head and neck region, occurs most frequently in the mandible. Although ORN is rare, it is complex and multifactorial and requires appropriate management. Manipulation of bone in patients with head and neck cancers before radiotherapy can cause ORN. In this report, we aim to present successful insertion of four dental implants in the interforaminal segment combined with application of platelet-rich fibrin and bone morphogenetic protein in a 60-year-old male with stable ORN in the posterior regions of the mandible