Assessment of anxiety frequency and its trigger factors in patients referred to general dental offices in the city of Hamedan in 2005

"nBackground and Aim: Oral health is a sign of overall health. Sometimes fear of dental office deprives  patients from receiving proper care. This problem decreases the self-esteem of dentists and can also reduce health indices. Understanding anxiety factors may help solve this problem. The purpose of this study was to assess anxiety in patients undergoing treatment in dental offices in the city of Hamedan. "nMaterials and Methods: In this analytic cross sectional study patients above 9 years old and referred to general dental offices in Hamedan were randomly selected and surveyed with questionnaires in two stages. The first questionnaire included 17 standard items based on Dental Anxiety Scale (DAS) and screened anxious patients. Then 400 anxious patients were evaluated with a questionnaire of 64 items based on Corah scale. Data were analyzed by SPSS 13 with multivariate analysis of variance. P<0.05 was considered as the level of significance. "nResults: Factors related to dental office environment with 31.1%, those related to personal imaginations with 19.4% and factor concerning office management and dental treatment each with 19.1% frequency showed to be most related to anxiety in patients. Improper rest-rooms (46.3%), blood stains in the environment (44.5%) and dirty dentist's gowns (43.8%) were reported to be the most prominent environmental factors. Among the factors originated from personal imaginations, the risk of disease transmission was accounted for the most justifiable source of anxiety (67.3%). Regarding factors concerning office management, dentist's nervous behavior (47.8%) and his carelessness to the patient (46.8%) were considered as the most significant anxiety sources. Extraction, injection and root canal therapy (48.3%, 44.5%, 44.3%) were the treatment related factors of higher importance respectively. Previous painful treatment experience (47.3%) and poor oral hygiene of the dentist (34.5%) were reported to be among the other justifiable anxiety sources. In all mentioned situations, variations in anxiety factors were significantly higher in women. "nConclusion: This study showed that the main cause of anxiety in patients undergoing treatment in dental offices in Hamedan is their personal imagination which is by far more obvious in women than men

Evaluation of Clonidine Premedication on Hemodynamic Hyperactivity in Patients Candidate for ERCP

Background and Objectives Autonomic system changes during ERCP lead to increased blood pressure(BP) and heart rate (HR) and decrease in arterial O2 saturation(SPO2). This study was carried out with the objective of evaluating the clonidine pre-medication effects on systolic BP, HR and SPO2 during ERCP.MethodsThis randomized clinical trial study was conducted on 40 ERCP candidates. Patients were classified into two groups. The first group didn't receive any premediacation. The patients of second group were given 0.2 mg clonidine 2 hours before ERCP. BP, HR and SPO2 of all patients were recorded before, during and after ERCP. The collected data were analyzed using chi-square, t-test and repeated measures ANOVA (P0.05). Analysis of variance of systolic BP, HR and SPO2 showed that SBP and HR changes were significantly lower in the clonidine group at different times (during and after endoscopy) {in the order P<0.004, P<0.017}, but no significant difference was observed in SPO2 changes in either groups. The amount of administered sodium thiopental had no significant difference in either groups.ConclusionOn the basis of this study, clonidine as an alpha-2 agonist can inhibit BP and HR increase during ERCP by decreasing sympathic discharge but does not decrease the need for sedative drugs.Keywords: Clonidine; Cholangiopancreatography; Endoscopic Retrograde; Conscious Sedation; Premedication

The effect of collagen removal on shear bond strength of four single bottle adhesive systems

Background and Aim: Achieving adhesion between restorative materials and dentin as a wet and dynamic surface is an important topic in restorative and especially in conservative dentistry. Adhesion of new dentin bonding systems depends on the formation of hybrid layer and micromechanical retention. Nevertheless, an ideal adhesive system has not yet been introduced .Recent studies reveal an increase in bonding stability when the collagen is removed from demineralized dentin surfaces. This study investigates the effect of collagen removal on the shear bond strength of four single bottle dentin bonding systems regarding their structural differences. Materials and Methods: This experimental study was performed on 56 intact human premolar teeth. Smooth surfaces of dentin were prepared on buccal &amp; lingual aspects of teeth, providing 112 dentin surfaces. The dentin surfaces were etched with 37% phosphoric acid for 15 seconds and then rinsed. The specimens were divided into 8 groups. Single bottle adhesive systems [Single Bond (3M), One-Step (Bisco), Prime &amp; Bond NT (Dentsply), and Excite (Vivadent)] were then applied on the dentin surfaces of 4 groups using the wet bonding technique. In the other 4 groups, the demineralized dentin surfaces were treated with a 5.25% solution of sodium hypochlorite for one minute in order to remove the surface organic components. The adhesive systems mentioned before were applied to these 4 groups with the same wet bonding technique. A cylinder of Z100 (3M) dental composite with a 3 mm diameter and 2 mm height was placed on the adhesive covered dentin surface of all groups and light-cured (400 mW/cm2 ,40 sec on each side). The specimens were kept in distilled water at room temperature for one week and then thermocycled for 3000 times (5-55 oc). Shear bond strength of specimens was measured using an Instron (1495) universal mechanical testing machine with cross-head speed of 0.5 mm/minute and chisel form shearing blade. Data were analyzed by Two Way ANOVA and Tukey HSD tests with p0.05). Conclusion: Based on the results of this study, collagen removal from demineralized dentin surface caused a significant decrease in shear bond strength of alcohol &amp; water/alcohol based bonding systems, while the bonding strength of the acetone based systems was not affected. Therefore, the effect of collagen removal on shear bond strength depends on the bonding system applied and its solvent type