Congenital Fusion of Maxilla and Mandible: A Case Report

Objective: Congenital fusion of jaws is a rare disorder which is observed in infants and cab ne syndromic and non-syndromic. Limited mouth opening in patients can affect the child growth and cause difficulties in feeding, swallowing and breathing.Case: A In this study, a female infant from Afghanistan, settled in Qom referred to  AlZahra maternity with upper and lower fusion jaws is reported. According to clinical and laboratory examinations, infant had no other disorders except the above said disease, and her jaw fusion was non-syndromic.Conclusion: Treatment of this disease in early stages not only is easier, but also can be effective in terms of child’s growth and feeding; because in most cases TMJ ankylosis occurs due to the lack of mobility and loss of function which leads to difficulties in oral operations

Frequency of intra and extra oral manifestations of pregnant women in Rasht (2013)

Background: Pregnancy is a specific condition that may affected the oral mucosa. The knowledge from intra & extra oral manifestation is necessary for medical doctor and dentists for diagnosis and treatment. Objective: The aim of this study was determination of intra & extra oral manifestations frequency of pregnant women in Rasht city. Methods: This descriptive-cross sectional study was conducted on 300 pregnant women referring to Alzahra and Tamin Ejtemaei Hospital in Rasht city in 2013. A questionnaire was designed that included biographical characteristics, month of pregnancy, oral hygiene, frequency of dental visits, systemic diseases, nausea and vomiting and entered the data in questionnaire after patients’ examination. The data was analyzed by student's t-test, and chi-square test. Findings: The average of age of studied women was 26.6±4.5 year (16-43 years old) and the frequency of intra and extra oral manifestation was 80.3% and 7.3% respectively. Pregnancy gingivitis (59%), and halitosis (37.7%) were the most intra oral manifestation, and choloasma (6.7%) was the most extra oral manifestations. The most oral manifestations were seen in third trimester (8th and 9th month of pregnancy). The frequency of pregnancy tumor was 1%. Fifty-nine percent of women had gingival bleeding during tooth brushing. The correlation between nausea, vomiting and sialorhea was significant. Conclusion: As the relative high frequency of intra oral manifestations in pregnant women, it is necessary to alert the physicians to refer these people to dentists, and training pregnant women for oral hygiene, and preventing incidence of oral and dental diseases and pregnancy gingivitis. Keywords: Pregnancy, Mouth Disease, Tooth Disease, Oral Manifestation

In vitro effect of chlorhexidine gel on torque and detorque values of implant abutment screw

Purpose: Use of chlorhexidine (CHX) gel to eliminate the malodor of implant cavity may decrease the friction coefficient and effective preload and result in abutment screw loosening. This study aimed to assess the effect of CHX gel on the preload, torque, and detorque values. Materials and Methods: This in vitro experimental study was conducted on three groups of five implants. Group A (G1) was the control group and no material was applied to the implant cavity. In Group B (G2), implant cavity was filled with saliva before abutment screw tightening. In Group C (G3), implant cavity was first filled with saliva and then with CHX gel. The abutments were torqued to 24 N/cm2 according to the manufacturer's instructions and were then loosened. These processes were repeated five times. The ratio of the mean percentage of detorque to torque values was measured in all groups. The collected data were analyzed using ANOVA and post hoc Tukey's test. Results: No significant difference was noted between G1 and G2. Group G2 had significantly higher detorque value (p < 0.05). ANOVA detected a significant difference in the mean torque (p < 0.05) and detorque (p < 0.001) values among the three groups. G3 showed maximum difference between torque and detorque values; the minimum difference was noted in G2. Conclusion: Application of CHX gel (to decrease the malodor of the implant cavity) decreases the detorque and preload values and increases the risk of screw loosening

Assessment of digital panoramic radiography's diagnostic value in angular bony lesions with 5 mm or deeper pocket depth in mandibular molars

Background: Assessment of alveolar bone level in periodontitis is very important in determining prognosis and treatment plan. Panoramic radiography is a diagnostic tool used to screen patients. The aim of the present study was to assess the diagnostic value of digital panoramic radiography in angular bony defects with 5 mm or deeper pocket depth in mandibular molars. Materials and Methods: In this cross-sectional study, ninety angular bony defects in mandibular molars teeth with 5 mm or deeper pocket depth were selected in sixty patients with the diagnosis of chronic periodontitis. Before surgery, bone probing was performed. During the surgery, the vertical distance from cementoenamel junction to the most apical part of bony defect was measured using a Williams probe and this measurements were employed as gold standard. This distance was measured on the panoramic radiographs by a Digital Calliper and Digital Ruler. All data were compare dusing independent samples t-test and Pearson's correlation coefficient. Results: No significant difference was found between the results of bone probing and intra-surgical measurements (P = 0.377). The mean defect depth determined by Digital Caliper and Digital Ruler on panoramic radiographs was significantly less than surgical measurements (P < 0.001). The correlation between bone probing and surgical measurements in determining the defect depth was strong (r = 0.98, P < 0.001). Radiographic measurements made by Digital Ruler (r = 0.86), comparing to Digital Caliper (r = 0.79), showed a higher degree of correlation with surgical measurements. Conclusion: Based on this study, bone probing is a reliable method in vertical alveolar bone defect measurements. While the information obtained from digital panoramic radiographs should be used with caution and the ability of digital panoramic radiography in the determination of defect depth is limited

Factors associated with Cyclosporine A-induced gingival enlargement in kidney transplant patients

Background and Aim: Cyclosporine-A (CsA) is commonly prescribed for kidney transplant patients to suppress their immune systems, which can lead to gingival enlargement (GE) . The present study aimed at determining the prevalence of associated factors with CsA-induced gingival enlargement in kidney transplant patients in Rasht during 2012. Materials and Methods: In this cross sectional research, information about kidney transplant patients was recorded in respective questionnaires after their examinations. Then, gingival enlargement and gingival index (GI) were divided into 4 degrees at 4 points and plaque index (PI) was recorded according to Oleary index. Finally, the obtained results were analyzed by means of SPSS Software (V:16), using Chi-square and T-Test. Results: Seventy-five renal transplant patients (31 women and 44 men) with the mean age 43.18 years (age range 18-73years) participated in this study. Gingival enlargement was diagnosed in 50% of the patients that had used cyclosporine. The average dosage of the drug was 179.6 mg. The increased prevalence of gingival enlargement was observed in the maxilla rather than in the mandible and more in the anterior than in the posterior parts of the jaws. Gingival enlargement was significantly correlated with GI and PI (P=0.01 and P=0.03, respectively). Conclusion: PI and GI were higher in patients with gingival enlargement than patients without gingival enlargement. Thus, it is suggested that periodontal proper hygiene be done to prevent gingival enlargement

A Survey of the Knowledge of General Dentists about the Accurate Prescription of Dental Radiographic Techniques in Rasht, Iran

Introduction:Radiography is among the most effective paraclinical methods used for accurate diagnosis and treatment in dentistry. Considering the possible risks of X-ray exposure for patients, dentists are professionally obliged to have adequate knowledge in the accurate prescription of various radiographic techniques to minimize unnecessary radiographs. The present study aimed to survey the knowledge of general dentists regarding the correct prescription of various radiographic techniques in Rasht, Iran. Materials and Methods: In this descriptive, cross-sectional study, 126 practicing dentists were visited and asked to complete designed questionnaires. Knowledge level of the participants was evaluated in nine domains regarding the accurate prescription of oral radiographs, and each domain was compared in terms of age, gender, and work experience. Data analysis was performed in SPSS version 21 using Chi-square and Kruskal-Wallis test. Results: Overall knowledge of the general dentists about the accurate prescription of oral radiographic techniques was acceptable. The highest knowledge level was observed in the pediatric field (78.6%), followed by the Bitewing techniques (54%) and panoramic radiography (40.5%). The lowest knowledge level was denoted in the case of high-risk patients for caries (40.5%). No significant association was observed between the gender and knowledge of the dentists (P=0.333), while age had a significant correlation with the level of knowledge (P=0.024). Conclusion: Despite the acceptable overall knowledge of the dentists, the level of knowledge was variable in the nine studied domains. Therefore, it is recommended that retraining courses be implemented based on valid guidelines in order to improve the knowledge of dentists about dental radiographic techniques, particularly in cases of high-risk patients for dental caries, periapical techniques, and periodontal techniques

Effect of Topical Gel Chlorhexidine 0.2% on Non-Surgical Treatment of Chronic Periodontitis

BACKGROUND AND OBJECTIVE: Pathogenic bacteria cause degeneration of periodontal tissues, which is essential for the reduction of gingival bacteria in order to reduce scaling and leveling. But there is no perfect treatment in pockets with a depth of more than 4 mm. Therefore, this study was conducted to investigate the effect of chlorhexidine gel as a topical supplementation after scaling and leveling the root surface in the treatment of moderate to advanced periodontitis. METHODS: This tripartite clinical trial was performed on 31 patients with chronic periodontitis, each with at least four pockets of depth of 4 to 6 mm. 62 areas as controls and 62 regions of the experimental group were selected randomly. In all patients, scaling and leveling of the root surface were done. In the experimental group, in addition to the scaling and leveling, the chlorhexidine gel surface was injected into the pockets. In four steps, before treatment, 2, 3 and 6 months after treatment, the clinical parameters of gingival index, bleeding index, plaque index, adhesion index and probe index depth index were measured and recorded. (IRCT:1R1N2013081314350). FINDINGS: The plaque index, bleeding index, gingival index and pocket probe depth in the group receiving the topical gel of chlorhexidine showed a significant difference in all levels of measurement compared to the control group (PI: control group was 2.75&plusmn;0.44 and case group was 1.94&plusmn;0.38, p=0.000, BI: The control group was 1.0&plusmn;0.5, the case group was 0.05&plusmn;0.44, p=0.000, PPD: the control group was 4.62&plusmn;0.73, the case group was 3.88&plusmn;0.83, p=0.000, GI: The control group was 1.77&plusmn;0.42, case group was 1.18&plusmn;0.18, p=0.000). CONCLUSION: The results showed that injection of chlorhexidine gel with scaling and leveling of the root surface resulted in a greater improvement in periodontal clinical indices than SRP alone

Diagnostic value of panoramic indices to predict osteoporosis and osteopenia in postmenopausal women

Background: Osteoporosis is characterized by the progressive loss of bone density, which leads to severe fractures. This study conducted to evaluate the diagnostic value of the mandibular radiomorphometric indices of panoramic radiographs to predict the status of bone mineral density (BMD) in postmenopausal women. Materials and Methods: Panoramic radiographs of ninety postmenopausal women (thirty osteoporotic, thirty osteopenic, and thirty controls) with the mean age of 54.47 years were evaluated. Bone densitometry was performed by using the dual-energy X-ray absorptiometry method. Variables such as the mandibular cortical width (MCW), panoramic mandibular index (PMI), gonial angle, mandibular cortical index (MCI), and the number of teeth lost were assessed. Results: The average of MCW in normal, osteopenic, and osteoporotic groups were 4.56, 3.97, and 3.39 mm, respectively. The PMI in normal, osteopenic, and osteoporotic groups was calculated as 0.33, 0.28, and 0.24, respectively. The MCW, PMI, and the number of teeth lost in the three groups showed statistically significant differences (P = 0.0001). The MCI had a significant difference in the three groups (P = 0.0001). The optimal cutoff points for MCW and PMI to predict low BMD were 4.13 mm and 0.29, respectively. Conclusions: The MCW, PMI, and MCI have a high diagnostic value to predict low BMD. By increasing the age and the postmenopausal duration, MCW and PMI decrease, whereas C3 form of MCI and the number of teeth lost showed increase. About 1 mm decrease in MCW increased the odds of reduced BMD (osteoporosis, osteopenia) up to 3.22-fold