Original Article

Evaluation of Pulp Tissue Following Direct Pulp Capping with Propolis versus Calcium Hydroxide: A Clinical Trial

Zohreh Ahangari, Fatemeh Mashhadiabbas, Mojgan Feli, Zeinab Jafari, Saeede Zadsirjan

Journal of Dental School, Shahid Beheshti University of Medical Sciences, Vol. 38 No. 4 (2020), 18 December 2021, Page 134-138

Objectives Direct pulp capping may result in formation of a dentinal bridge and preservation of pulp vitality. This randomized controlled clinical trial sought to histologically assess and compare pulp tissue following pulp capping with propolis and calcium hydroxide.

Methods In A cavity was prepared at the center of the occlusal surface of 10 third molars scheduled for extraction by using a cylindrical bur. The pulp chamber was exposed with a round bur. Samples were randomly divided into two groups (5 teeth in each group). The first group underwent direct pulp capping with propolis and the second group with calcium hydroxide. Auto-polymerizing glass ionomer was then applied to seal the cavity. The teeth were extracted after 45 days, and histologically evaluated. The obtained data were analyzed using the Fisher’s exact test.

Results The quality (P=0.048) and quantity (P=0.008) of dentinal bridge were significantly different between the two groups. Propolis resulted in formation of a continuous dentinal bridge with irregular tubular dentin; whereas, calcium hydroxide resulted in formation of osteodentin (low quality dentin).

Conclusion Propolis induced the formation of tubular dentin with higher quality compared with calcium hydroxide.

Antimicrobial Effects of Mass and Oral-B Mouthwashes on Streptococcus mutans and Candida albicans: An In Vitro Study

Mina Biria, Samira Cheraghi, Ava Bararzadeh Soorati, Mahshid Namdari, Zahra Yadegari

Journal of Dental School, Shahid Beheshti University of Medical Sciences, Vol. 38 No. 4 (2020), 18 December 2021, Page 139-143

Objectives The present study aimed to compare the antimicrobial properties of Iranian Mass mouthwash and alcohol-free Oral-B mouthwash against Streptococcus mutans (S. mutans) and Candida albicans (C. albicans).

Methods In this in vitro study, S. mutans and C. albicans were separately cultured on BHI agar plates. The agar well-diffusion method was used to compare the antimicrobial properties of Mass and Oral-B mouthwashes, and 0.2% chlorhexidine (CHX) as the positive control and saline as the negative control. The diameter of growth inhibition zones was then measured. The experiment was performed in triplicate. The minimum inhibitory concentration (MIC), and the minimum bactericidal concentration (MBC) of the two mouthwashes were determined for each microorganism using the broth micro-dilution method. Data were analyzed by the Kruskal-Wallis and Dunn's test (Benjamini-Hochberg).

Results The mean diameter of the growth inhibition zone of S. mutans was 26.33 and 27.66 mm for Mass and Oral-B mouthwashes, respectively. These values were 18 mm and 17.66 mm, respectively for C. albicans.  There was no significant difference in the mean diameter of growth inhibition zones of the two mouthwashes against C. albicans (P=0.38) or S. mutans (P=0.23). The MIC of Mass and Oral-B mouthwash for S mutans was in 1/1024 dilution ratio and the MIC of Mass and Oral-B mouthwashes for C. albicans was in 1/512 and 1/256 dilution ratios, respectively. The MBC values were the same as the MIC values for both mouthwashes.

Conclusion Mass mouthwash was as effective as Oral-B mouthwash against S. mutans and C. albicans.

Occurrence of Herpes Simplex Virus Type 1 in Dental Students: A Cross-Sectional Study

parvin parvaei, freshteh osmani, Saideh EbrahimianBaghan

Journal of Dental School, Shahid Beheshti University of Medical Sciences, Vol. 38 No. 4 (2020), 18 December 2021, Page 144-147

Objectives Herpes viruses are ubiquitous human pathogens that can be found in the oral environment. Dental practitioners have a close relationship with many patients and are at risk of cross-infection. Thus, the herpes simplex virus type 1 (HSV-1) infection as a potential occupational hazard for dental workers is important. This study aimed to measure the level of HSV1 antibody in dental students.

Methods This descriptive cross-sectional study was performed on 100 dental students of Birjand University of Medical Sciences during a six-month period. After taking written informed consent, demographic information and history of genital or oral lesions were recorded using a researcher-made questionnaire. Next, peripheral blood samples (5 mL) were taken from the participants, and the level of anti-HSV1 IgG was measured by a pathologist using the respective kit by ELISA. Data were analyzed by SPSS 21.

Results About half of the subjects (41%) had contact with HSV1 and were antibody carriers. The prevalence of HSV1 antibody was higher in senior than junior dental students but not significantly (P>0.05).

Conclusion The prevalence of HSV1 antibody in dental students evaluated in this study was lower than the level reported in European countries, which may be due to cultural differences; however, further studies are required.

Inter and Intra-rater Reliability of Lateral Cephalometric Analysis Using 2D Dolphin Imaging Software

Sarvin Khosravani, Saharnaz Esmaeili, Nazanin Malek Mohammadi, Ladan Eslamian, Kazem Dalaei, Saeed Reza Motamedian

Journal of Dental School, Shahid Beheshti University of Medical Sciences, Vol. 38 No. 4 (2020), 18 December 2021, Page 148-152

Objectives Cephalometric radiographs are widely used in diagnosis and treatment planning. In the past, these radiographs used to be analyzed manually, but nowadays due to the possibility of errors and time-consuming nature of manual tracing, digital methods are replacing the manual methods. The reliability of computer-assisted analysis is of great importance. The purpose of this study was to investigate the inter and intra-rater reliability of 2D Dolphin imaging software version

Methods To assess the intra-rater reliability of lateral cephalometric analysis, 25 lateral cephalograms traced by one operator using Dolphin imaging software were traced again by the same examiner 2 weeks later. To assess the inter-rater reliability, 25 lateral cephalograms were traced independently by two examiners. Overall, 80 measurements including 43 linear, 34 angular, and 3 ratio measurements were made. The interclass correlation coefficient (ICC) was calculated to assess the inter-rater and intra-rater reliability. ICCs above 0.75 were considered good.

Results The ICC for intra-rater reliability was above 0.75 for all parameters except lower vertical height depth ratio (ICC=0.51), inter-labial gap (ICC=0.54), superior sulcus depth (ICC=0.67), articular angle (ICC=0.733), and ramus height (ICC=0.728). The ICC for inter-rater reliability was above 0.75 for all parameters except nose prominence (ICC=0.73).

Conclusion Dolphin imaging software showed good intra-rater reliability for most parameters and good inter-rater reliability for almost all parameters.

Cone-Beam Computed Tomographic Assessment of Anatomical Variations of the Interforaminal Region in a Selected Iranian Population

Solmaz Valizadeh, Hessam Alesheikh, Mina Iranparvar Alamdari

Journal of Dental School, Shahid Beheshti University of Medical Sciences, Vol. 38 No. 4 (2020), 18 December 2021, Page 153-157

Objectives This study assessed the anatomical variations of the mental foramen (MF) and presence and length of the anterior loop and the incisive canal in a selected Iranian population using cone-beam computed tomography (CBCT).

Methods This descriptive, cross-sectional study evaluated CBCT scans of 256 patients (123 males, 133 females) over 18 years of age. The CBCT multiplanar reformatted panoramic images (10-mm thickness) were used to assess the anatomical position of the MF and presence/absence and length of the anterior loop. The cross-sectional images were used to assess the presence/absence and length of the incisive canal. The anatomical variations were compared in the right and left sides and between males and females using dependent and independent t-test. SPSS version 21was used for statistical analysis.

Results The most common position of MF was adjacent to the apex of the second premolar, noted in 41.4% of the patients. The second common position of MF was between the apices of the first and second premolars (30.1% of the patients). The anterior loop was present in 44.3% of the patients. The mean length of the anterior loop and the incisive canal was 2.64 mm and 7.15 mm, respectively. No significant difference was noted between males and females or right and left sides in any variable (P>0.05).

Conclusion Anatomical variations of the anaterior mandible indicate the significance of 3D imaging to prevent nerve traumatization by proper treatment planning.

Review Article

Pediatric Dentistry at the Time of COVID-19 Pandemic: A Review of Literature and Guidelines

Bahareh Nazemi Salman , Leila Eftekhar, Nazila Biglar, Nazanin Sharafi

Journal of Dental School, Shahid Beheshti University of Medical Sciences, Vol. 38 No. 4 (2020), 18 December 2021, Page 158-164

Objectives The aim of the present study was to review practical considerations, special precautions, and novel challenges of pediatric dentistry at the time of coronavirus disease 2019 (COVID-19) pandemic.

Methods PubMed (Medline), Scopus, and Google Scholar were searched for related articles. The websites of organizations related to public health and dentistry were also electronically searched. All searches were performed before November 2020.

Results In this paper, the findings were categorized as: (I) how to triage patients, (II) waiting room modifications, (III) how to use personal protective equipment, (IV) mouthwashes, (V) how to minimize aerosol production, (VI) how to manage routine dental treatments, (VII) pharmacological management, (VIII) how to manage pharmacological sedation and general anesthesia, and (IX) coincidence of COVID-19 and seasonal influenza. Some lifestyle changes during the pandemic which are important to know for pediatric dentists were also discussed.

Conclusion The emergence of COVID-19 has brought novel challenges for dental professionals. Pediatric dentistry is even more important because children can be asymptomatic carriers of the virus since they usually present mild or no symptoms. In addition to the standard precautions, pediatric dentists should implement special precautions to prevent disease transmission.

Case Report

Keratoacanthoma: A Case Report, An Update, and Review of Literature

Fatemeh Mashhadiabbas, Mohammad Jafarian, Nafiseh Shamloo, Roohallah Safarpour

Journal of Dental School, Shahid Beheshti University of Medical Sciences, Vol. 38 No. 4 (2020), 18 December 2021, Page 165-167

Objectives This study aimed to review and briefly discuss the literature about keratoacanthoma (KA) and present a case of KA of the facial skin under the right eye with over 6-months of follow-up after removal.

Case: An 86-year-old healthy man was referred to a private clinic with a 5-6-week history of a rapidly growing, crateriform nodule with a central hemorrhagic crust on the facial skin under the right eye. Surgical excision was the treatment chosen to differentiate the lesion from squamous cell carcinoma (SCC). Thereafter, the lesion was completely excised. Histopathological analysis confirmed the diagnosis of KA. During over 6 months of follow-up after removal of the lesion, the patient was completely satisfied with the process of treatment, and no recurrence occurred.

Conclusion Solitary KA lesions are commonly found on sun-exposed skin in older adults, similar to our case. Early diagnosis and treatment could reduce the risk of malignancy and recurrence. Moreover, close follow-up of patients with a history of KA is needed, because the possibility of developing a new KA lesion, due to trauma or medical and cosmetic procedures, especially on the UV damaged skin, still exists.

Clinical Management of Hypoplastic Amelogenesis Imperfecta in Pediatric Patients: A Case Report and Review of Literature

Sanaz Kamareh , Ghassem Ansari, Ali Asghar Soleymani , Romina Roodgarian, Atiye Yadegari

Journal of Dental School, Shahid Beheshti University of Medical Sciences, Vol. 38 No. 4 (2020), 18 December 2021, Page 169-171

Objectives Amelogenesis imperfecta (AI) refers to a group of hereditary disorders that affect the quality and/or quantity of dental enamel of both primary and permanent dentitions. Also, these patients may suffer from certain systemic disorders and other dental and skeletal defects or abnormalities.

Case: A 9-year-old female patient with hypoplastic type AI with unerupted maxillary first molars, and pulpal calcifications is reported. Her permanent anterior teeth were restored with composite veneer while the posterior teeth received stainless steel crowns.

Conclusion Hypoplastic type AI is a rather uncommon disorder. Early treatment of AI, not only prevents tooth wear, but also has a positive psychological impact on children. The possible association of AI with nephrocalcinosis can also be monitored through initial radiographic evidence of pulp stones.