Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Onset of action and duration of efficacy of inferior alveolar nerve block versus single lingual subperi-osteal injection of 4% articaine in mandibular second molars: A randomized clinical trial 119 124 EN E Esnaashari Department of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran SH Mirzaei Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran AA Moshari Department of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran P Razavi Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Background and Aim: Achieving adequate pulpal anesthesia could be challenging in mandibular molars. There are some disagreements about the success rate of local infiltration anesthesia with articaine as primary injection. Therefore, the aim of this study was to assess the efficacy of 4% articaine lingual subperiosteal injection as the primary injection for permanent mandibular second molars in comparison with inferior alveolar nerve block (IANB).   Materials and Methods: Fifteen healthy adult volunteers participated in this study. A randomized, split-mouth, single-blind design was used to allocate each side of the mandible in each patient to the test or control group. On the test side, lingual subperiosteal injection with 4% articaine and 1:100,000 epinephrine was performed for the mandibular second molar; whereas, in the control group, an IANB with 2% lidocaine and 1:80,000 epinephrine was administered. Electric pulp testing was done at baseline, and also at 5, 8, 11, 15, 20, 25, 30, 45, 60, 75, and 90 minutes after injection. Statistical analysis was carried out using t-test and Chi-square test. Results: The success rate of IANB was significantly higher than that of lingual subperiosteal injection (P=0.0001). The difference in the onset of action between the two groups was significant (P<0.05). Anesthesia duration was 61.0±28.0 minutes in IANB group and 10.2±12.4 minutes in lingual subperiosteal injection group, with a significant difference between them (P<0.01). Conclusion: IANB with 2% lidocaine is preferable to 4% articaine lingual subperiosteal injection due to its superior success rate, faster onset of action, and longer duration of effect.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 A Comparative Study of the Solubility and Sorption Properties of Resin Modified Glass Ionomer and a Bioactive Liner 125 132 EN H Heshmat Dental Material Research Center, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran M hoorizad ganjkar Department of Operative Dentistry, Faculty of Dentistry, Islamic Azad University, Tehran, Iran N Sanaei Private Dentistry office, Tehran, Iran SF Tabatabaei Department of Operative Dentistry, Faculty of Dentistry, Islamic Azad University, Tehran, Iran MJ Kharazifard Dental Research Center, Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran Background and Aim: This study aimed to compare the sorption and solubility properties of ACTIVA BioACTIVE liner and resin modified glass ionomer (RMGI).   Materials and Methods: In this in vitro study, a total of 30 samples were fabricated from each liner measuring 15 mm in diameter and 1 mm in thickness according to ISO 2009:4049. They were then divided into 6 subgroups (n=5) to assess their water solubility after 1 week and 8 weeks, water sorption after 1 week and 8 weeks, and acid solubility after 1 week and 8 weeks. The samples were then weighed, and placed in vials containing artificial saliva or lactic acid and incubated at 37°C for 1 week or 8 weeks according to specimen grouping. Afterwards, each specimen was weighed again. Sorption and solubility were calculated according to difference in weight of the samples. Data were analyzed by two-way ANOVA(alpha=0.05). Results: RMGI showed greater water solubility and sorption compared with ACTIVA BioACTIVE liner after 1 week of storage (P=0.00). No significant difference was found in water solubility (P=0.64) and sorption (P=0.15) after 8 weeks of storage. There was no significant difference in acid solubility of RMGI and ACTIVA BioACTIVE liner after 1 week (P=0.30) or 8 weeks of storage (P=0.60) Conclusion: Water sorption and solubility of RMGI were greater than those of ACTIVA BioACTIVE within the first week after setting but they were similar in long-term assessment. RMGI and ACTIVA BioACTIVE were not different in terms of acid resistance.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Minimum Inhibitory Concentration of Peganum Harmala Extract Against Candida Species 133 141 EN M Baharvand Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran M Hakemi-Vala Department of Microbiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran M Mehdipour Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran L Dehghani School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran E Jalali Private Dental Practice, Oral & Maxillofacial Radiology private practice, Miami, Florida, USA F Anbari Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran Background and Aim: There are some rich sources of antifungals in medicinal herbs. They have general acceptance due to their low cost and insignificant side effects. The efficacy of Peganum harmala (P. harmala) extract against Candida species was investigated in this study.    Materials and Methods: In this in vitro study, we used the maceration technique to obtain P. harmala aqueous and alcoholic extracts, and assess their antifungal activity against different species of Candida albicans (C. albicans), Candida glabrata (C. glabrata) and Candida krusei (C. krusei). We used the microdilution method to calculate the minimum inhibitory concentration (MIC). The tests were repeated in triplicate for higher accuracy. Results: The aqueous and alcoholic P. harmala extracts showed antifungal activity against C. albicans in 100 mg/mL concentration. The antifungal efficacy of P. harmala alcoholic extract against C. glabrata (MIC: 100 mg/mL) was higher than the aqueous extract (MIC:200 mg/mL). The antifungal efficacy of P. harmala alcoholic extract against C. krusei (MIC: 1.56 mg/mL) was higher than the aqueous extract (MIC: 12.5 mg/mL). Conclusion: The aqueous and alcoholic extracts of P. harmala were effective against all species of Candida particularly Candida krusei. The alcoholic extract of P. harmala was more effective than its aqueous extract against C. glabrata and C. krusei.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Efficacy of XP-Endo Finisher R in Removing Root Filling Remnants in Root Canal Retreatment 142 147 EN P Amooyan Private Dentistry Practice, Tehran, Iran H Akhavan Department of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran E Esnaashari Department of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Background and Aim: Complete removal of gutta-percha from the root canal system and its remnants is a challenge in endodontic retreatment. This ex-vivo study aimed to assess the efficacy of XP-Endo Finisher R (XEFR) in removing root filling remnants from straight canals of mandibular premolars in root canal retreatment.   Materials and Methods: In this ex-vivo study, 30 single-rooted mandibular premolars with straight roots were selected. The root canals were instrumented and filled. Retreatment was then performed using D RaCe system. Teeth were then randomized into two groups of A and B (n=15). In group A, root canal retreatment was completed with XEFR. In group B, XEFR was not used. To evaluate the filling material remnants, the roots were split into halves and assessed under a stereomicroscope and photographed. The amount of remaining gutta-percha in the coronal, middle and apical thirds of the roots was measured by AUTOCAD software and analyzed with two-way ANOVA. Results: The amount of residual filling material was significantly lower in the coronal, middle and apical thirds and the entire root length in XEFR group (P<0.001). Conclusion:  Use of XEFR significantly decreased the residual root filling material in the root canals.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Effect of a Bone Replacement Material on Vertical Bone Level Alterations around Immediately Placed Mandibular Molar Implants 148 154 EN D Veljanovski Clinic for Oral Surgery “Hami Optimum”, Skopje, N. Macedonia B Stefanovikj Dental practice “Optimum Dental”, Skopje, N. Macedonia Ma Bogdanovski Dental practice “Molar”, Skopje, N. Macedonia M Stojkova Dental practice “Lukanovski”, Skopje, N. Macedonia D Krstevski Dental practice “Stela”, Skopje, N. Macedonia Background and Aim: Immediate implant placement is a predictable therapeutic option to replace the missing teeth. However, it is technique-sensitive, and requires strict case selection criteria. Tooth extraction triggers the biologic phenomenon of bone resorption, which is not prevented with immediate implant placement. This study aimed to evaluate the influence of deproteinized bovine bone mineral (DBBM) use on vertical bone loss around immediately placed mandibular molar implants.   Materials and Methods: In this non-randomized clinical study, 14 patients with immediate molar implants in the lower jaw, restored with screw-retained single crowns were evaluated. The case group (with bone material use) received DBBM in conjunction with implant placement, while no grafting was performed in the control group. The vertical bone level changes were radiographically measured at the mesial and distal implant sides as the distance between the implant shoulder and first implant-bone contact in apical direction. Measurements were made at two time points of six months postoperatively and one year post-functional loading. The acquired data were statistically analyzed using two-way ANOVA. Results: The mean values for vertical bone loss at the mesial and distal reference points were greater in the control group (without bone replacement material use) than in the case group both six months postoperatively and one year post-functional loading. The difference was statistically significant at both time points (P<0.05). Conclusion: Within the limitation of this study, it can be concluded that the use of DBBM in immediate implants can reduce vertical bone loss.  

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Oral Symptoms and Factors Associated with COVID-19: A Case-Control Study 155 161 EN F Sarkarat Oral and Maxillofacial Surgery Department; Craniomaxillofacial Research Center, Tehran Islamic Azad University of Medical Sciences, Farhikhtegan Hospital, Dental Branch, Tehran, Iran AR Tootoonchian Oral and Maxillofacial Surgery Department; Craniomaxillofacial Research Center, Tehran Islamic Azad University of Medical Sciences, Farhikhtegan Hospital, Dental Branch, Tehran, Iran SH Mirpour Oral and Maxillofacial Surgery Department; Craniomaxillofacial Research Center, Tehran Islamic Azad University of Medical Sciences, Farhikhtegan Hospital, Dental Branch, Tehran, Iran M Moogahi Nezhad Oral and Maxillofacial Surgery Department; Craniomaxillofacial Research Center, Tehran Islamic Azad University of Medical Sciences, Farhikhtegan Hospital, Dental Branch, Tehran, Iran SH Haeri Araghi Oral and Maxillofacial Surgery Department; Craniomaxillofacial Research Center, Tehran Islamic Azad University of Medical Sciences, Farhikhtegan Hospital, Dental Branch, Tehran, Iran V Rakhshan Private Dentistry Practice, Tehran, Iran Background and Aim: Coronavirus disease-2019 (COVID-19) is a serious pandemic situation. Assessment of associated factors contributing to its severity is of clinical significance. This study assessed the factors associated with COVID-19 and its severity.    Materials and Methods: In this case-control study, we assessed self-reports of 93 COVID-19 patients and 50 healthy controls regarding demographics, smoking habit, sinusitis, rhinoplasty or tonsillectomy history, xerostomia, dysosmia, dysgeusia, taste disturbances (metallic taste and foul taste), and bleeding or inflammation in the oral cavity. Further admission to ICU or death were recorded later. We also assessed the patients’ laboratory tests including WBC, neutrophils, lymphocytes, basophils, eosinophils, C reactive protein (CRP), and erythrocyte sedimentation rate (ESR) at the time of admission. Diagnosis of patients was based on clinical assessments, Reverse transcriptase polymerase chain reaction (RT-PCR) and chest computed tomography (CT) scan results. Healthy controls had no flu like signs and symptoms in the past 1 month prior to the study. Associations between the abovementioned factors and disease, and disease severity were analyzed by the Chi-square test, independent-sample t-test, one-sample t-test, and Spearman’s correlation coefficient (α=0.05). Results: Variables with statistically significant associations with COVID-19 included smoking (P=0.004), xerostomia (P=0.000), dysgeusia (P=0.000), dysosmia (P=0.000), and taste disturbances (P=0.000). CRP (P=0.000), ESR (P=0.000), and neutrophil percentage (P=0.000) were also elevated in patients. Eosinophil (P=0.000) and basophil percentages (P=0.016) were lower than normal range in patients. Age was associated with death (P=0.010) and ICU admission (P=0.009). Conclusion: Xerostomia, dysgeusia, dysosmia, and taste disturbances can be early markers of COVID-19. Older ages are prone to more severe forms of disease.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Epidemiologic Study of Patients with Chronic Vesiculobullous Lesions 162 167 EN F lavaee Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran B Vahdatifar School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran B Afroozi Oral and Maxillofacial Medicine Department, School of Dentistry, Yasuj University of Medical Sciences, Yasuj, Iran F Tavakoli Oral and Dental Disease Research Center, Oral and Maxillofacial Medicine Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran Background and Aim: Vesiculobullous diseases (VBDs) are characterized by the formation of vesicles or bullae. The aim of this study was to perform an epidemiological survey on patients with chronic VBDs referred to Shiraz Dental School during 2006-2016.    Materials and Methods: In this retrospective cross-sectional study, epidemiological data (age, sex, prevalence, involvement location, prescribed medication, and underlying diseases) of patients diagnosed with VBDs were collected. The relationship between the epidemiological factors and the occurrence of VBDs was analyzed. SPSS version 18 was used to analyze the data by the Chi-square test and Spearman’s correlation test. Results: Totally, 120 patients were evaluated; out of which, 88.3% had pemphigus vulgaris (PV), 4.2% had bullous pemphigoid (BP), 6.8% had mucous membrane pemphigoid (MMP), and 0.1% had pemphigus herpetiformis (PH). Most patients were females (68.3%) and 31.7% were males. The mean age of patients was 43.14±11.41 years. The mucosal and cutaneous involvement in PV patients was as follows: 31.13% had mucosal, 0.94% had cutaneous, 37.73% had both mucosal and cutaneous, and 30.18% had mucosal-cutaneous involvement associated with involvement of other organs. Prednisolone was the first-line treatment in all patients. There was a significant correlation between age and incidence of VBDs in patients (P=0.030). Conclusion: Our findings indicated that the epidemiological properties of VBDs in our study were similar to those in other countries. However, PV was the most common VBD followed by BP.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Zirconia Crowns with Porcelain Veneers for Optimal Esthetics in Children Using CAD/CAM Technology: A Case Report 168 174 EN P Bakhtiary Department of Pediatric Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran P Aref Department of Pediatric Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Background and Aim: Stainless steel crowns (SSCs) are the gold standard for restoration of severely damaged primary teeth. However, the unesthetic appearance of SSCs is responsible for their lower acceptance by clinicians and patients. Zirconia crowns are another option for reconstruction of severely damaged teeth, which also provide optimal esthetics.   Case Presentation: Our patient was a 5-year-old child with a carious primary mandibular first molar. A prefabricated zirconia crown was considered for the tooth because the parents disapproved the color of SSC. The computer-aided design/computer-aided manufacturing (CAD/CAM) technology was used to fabricate a zirconia crown with porcelain veneering since the size of prefabricated crowns did not match the size of the respective tooth. Conclusion: At the 1-year follow-up, the crown fabricated with this technique showed optimal esthetics, function, and durability. Although these crowns have shortcomings such as the risk of porcelain chipping, and require greater tooth preparation than SSCs, they can serve as a suitable alternative for reconstruction of severely damaged primary teeth when esthetics is an important parameter to consider.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Role of Droplets and Aerosols in Transmission of COVID-19 in Dental Practice: A Literature Review 175 180 EN S Helli Department of Oral Medicine, Faculty of Dentistry, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran E Shafiee Department of Prosthodontics, Faculty of Dentistry, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran K Mogharrab Alile Faculty of Dentistry, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran Background and Aim: This study sought to review the role of aerosols and droplets in transmission of coronavirus disease 2019 (COVID-19) in dental practice .   Materials and Methods: Published papers concerning the transmission routes of COVID-19 in dental environment were retrieved from the search engines, websites of related health organizations, and electronic databases. Out of primarily retrieved 120 articles, 40 articles met the inclusion criteria. Results: Many Studies reported that the main transmission routes of COVID-19 were direct contact, droplets and aerosols. Because of the adjacency to the patient's oral cavity and use of aerosol-generating headpieces, dental practitioners are at high risk of COVID-19. Adherence to clinical protocols and guidelines in the working environment was highly emphasized in all studies to minimize the risk of infection and prevent cross-contamination in dental office setting. Conclusion: Dental healthcare providers should be well aware of the most recent guidelines and protocols to prevent COVID-19 transmission and constantly update their knowledge in this regard.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 3 2022 7 1 Techniques and Materials for Treatment of Bone Loss Due to Periodontitis: A Review 181 193 EN S Hassani Private Practice, Tehran, Iran F Hashemi moghaddam Private Practice, Tehran, Iran S Akbari foroud Private Practice, Tehran, Iran SH Aghayan Periodontology Dept, Faculty of Dentistry,Islamic Azad University of Medical Sciences, Tehran, Iran. Background and Aim: Stainless steel crowns (SSCs) are the gold standard for restoration of severely damaged primary teeth. However, the unesthetic appearance of SSCs is responsible for their lower acceptance by clinicians and patients. Zirconia crowns areanother option for reconstruction of severely damaged teeth, which also provide optimal esthetics.   Case Presentation: Our patient was a 5-year-old child with acarious primary mandibular first molar. A prefabricated zirconia crown was considered for the tooth because the parents disapproved the color of SSC. The computer-aided design/computer-aidedmanufacturing (CAD/CAM) technology was used to fabricate azirconia crown with porcelain veneering since the size ofprefabricated crowns did not match the size of the respective tooth. Conclusion: At the 1-year follow-up, the crown fabricated with this technique showed optimal esthetics, function, and durability. Although these crowns have shortcomings such as the risk ofporcelain chipping, and require greater tooth preparation than SSCs, they can serve as a suitable alternative for reconstruction of severely damaged primary teeth when esthetics is an important parameter to consider.