Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Materials, Methods, and Equipment used by General Dentists of Southeastern Iran for Endodontic Treat-ment 194 201 EN M Rafiei Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran E Moradi Askari Endodontics Department, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran M Sadeghi Restorative Dentistry Department, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran M Mollahasani kahdouyi Department of Oral and Maxillofacial Radiology, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran N Zeini Department of Oral and Maxillofacial Radiology, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Background and Aim: The present study aimed to evaluate the materials, methods, and equipment used by general dentists in southeastern Iran for endodontic treatments in 2021.   Materials and Methods: In this cross-sectional study, 121 standard questionnaires were distributed among general dentists in Rafsanjan city, Iran. The questionnaire included demographics and questions regarding the type of materials, methods, and equipment selected by general dentists. The collected data were analyzed by SPSS version 22 using the Chi-square test and ANOVA. Results: The response rate of the participants was 83%(n=100); of which, 55% were females and 45% were males. Only 28% of dentists performed pulp vitality tests, and 46% performed sinus tract tracing in case of infection. Cotton rolls were used by 71% for further isolation, apex locator and radiography were used concurrently to determine the working length by 62%, and canal preparation was done by rotary and manual files by 48%. Rotary M3 and ProTaper files were more commonly used by dentists. Electric rotary handpieces were used for canal instrumentation by 64%, and rotary orifice shapers were more commonly used for canal flaring (61%). The most commonly used obturation method was lateral compaction. Most general dentists used formocresol-impregnated cotton pellets for pulpotomy (43%). Half of the dentists used saline for canal irrigation. Calcium hydroxide was the most commonly used intracanal medicament (87%), and 53% used polymerized sealers. Conclusion: General dentists evaluated in this study violated some of the standards and need to take more training courses.  

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Oral Health-Related Quality of Life of 2 to 5-Year-Old Children in Iran 202 209 EN M Taghian Department of Oral and maxillofacial surgery Dentistry, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran L Sadri Department of Pediatric Dentistry, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran B Soleimani Department of Pediatric Dentistry, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran M Moosazadeh Faculty of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran A Dehestani Faculty of Dentistry, Mazandaran Uni-versity of Medical Sciences, Sari, Iran A Tabarestani Student research committee, Faculty of Dentistry, Mazandaran university of medical sciences, Sari, Iran Background and Aim: Traumatic dental injuries (TDI) and dental caries are among the prevalent oral health issues in preschool children that can lead to psychosocial and physical complications. Therefore, it is crucial to assess their effects on children’s oral health-related quality of life (OHRQoL). This study aimed to assess the effect of oral health status on OHRQoL of 2- to 5-year-old children in Sari, Iran.    Materials and Methods: This cross-sectional study was conducted on 540 randomly selected children between 2 to 5 years. Their decayed, missing, and filled teeth (DMFT) indices was determined by oral clinical examination. The Early Childhood Oral Health Impact Scale (ECOHIS) was completed by the parents. SPSS 16 was used for statistical analysis by the Chi-square test, independent t-test, and ANOVA. Results: The ECOHIS mean scores in the Family Impact Section (FIS) and Child Impact Section (CIS) were 1.8±3.0 and 2.7±4.2, respectively. The mean DMFT score of children was 3.2±3.07, with 47% having a DMFT of 0. The frequency of TDI was 11.5%. The DMFT index and ECOHIS were significantly correlated (r=0.571, P<0.001). A statistically significant correlation was found between ECOHIS and TDI, indicating lower quality of life (QoL) in patients with a history of TDI (P<0.001). Conclusion: Children’s oral health considerably affects their own and their parents’ QoL. Its effect on children’s QoL is greater than its impact on the QoL of the parents.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Correlation of Bone Mineral Density and Fractal Analysis of the Mandibular Condyle in Women with Temporomandibular Joint Osteoarthritis: A Pilot Study 210 218 EN M Imanimoghaddam Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran A Bagherpour Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran A Madani Department of Prosthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran M Foroozandeh Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran F Hafez Maleki Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran M Alimohammadi Department of Oral and Maxillofacial Radiology, School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran SH Moeini Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran Background and Aim: Temporomandibular joint osteoarthritis (TMJOA) appears to be more common in osteoporotic patients. Fractal analysis is a mathematical method that can be used to assess trabecular bone. The aim of this study was to assess the correlation of bone mineral density (BMD) and fractal dimension (FD) of the condyles in women with TMJOA using cone-beam computed tomography (CBCT).   Materials and Methods: In this cross-sectional study, the FD and lacunarity of the condylar head were assessed on CBCT images of 39 women (20 healthy women with no signs/symptoms of TMJOA, and 19 TMJOA patients). The BMD and the T-score of the hip and lumbar vertebrae were determined using dual energy X-ray absorptiometry. Data were analyzed by t-test, chi-square test, and Pearson’s correlation coefficient. Results: TMJOA patients and healthy controls did not differ significantly in terms of the mean age (P=0.63), BMD and T-score (P>0.05), or FD and lacunarity (P>0.05). A significant correlation was observed, however, between lacunarity in the two condyles (r=0.47, P=0.003) and BMD of the lumbar vertebrae and the hip (r=0.40, P=0.01).     Conclusion: The mean BMD of total spine and hip did not differ significantly in the two groups of healthy controls and TMJOA patients. The FD and lacunarity also       showed no significant difference between the groups. FD based on CBCT images of the TMJ is not a reliable indicator for categorization of skeletal status.  

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Ex Vivo Comparison of File Fracture and File Deformation in Canals with Moderate Curvature: Neolix Rotary System versus Manual K-files 219 225 EN A Mesgarani Department of Endodontics, Sari Dental School, Mazandaran University of Medical Sciences, Sari, Iran N Hoshyari Department of Endodontics, Sari Dental School, Mazandaran University of Medical Sciences, Sari, Iran M Mousazadeh Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran A Kabbazzadeh Private Dentistry Practice, Sari, Iran Background and Aim: Cleaning and shaping is one of the important steps in endodontic treatment, which has an important role in root canal treatment outcome. This study evaluated the rate of file fracture and file deformation in Neolix rotary system and K-files in shaping of the mesiobuccal canal of maxillary first molars with moderate curvature.    Materials and Methods: In this ex vivo experimental study, the mesiobuccal root curvature of maxillary first molars was measured by the Schneider’s method, and canal preparation was performed in 2 groups of 30 with Neolix rotary system and manual K-files. To determine the fracture rate of files, a file was used until it broke or deformed, and the number of canals cleaned by that file was recorded. The data were analyzed by the Mann-Whitney U test.   Results: File fracture rate in the rotary group was slightly higher than that in the manual K-file group but, the frequency of file deformation in manual K-files was slightly more than that in the rotary group. There was no statistically significant relationship between file type and frequency of file fracture or deformation (P>0.05).   Conclusion: Manual stainless steel K files and Neolix NiTi rotary files were the same in terms of file fracture and file deformation in preparation of canals with              moderate curvature.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Effect of Platelet-Rich Fibrin Application on the Maxillary Sinus Schneiderian Membrane Thickness Following Sinus Floor Augmentation: A Clinical Trial 226 232 EN S Salimzade Department of Periodontology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran S Sadat Mansouri Department of Periodontology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran A Etemadi Department of Periodontology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Background and Aim: Considering the efficacy of platelet-rich fibrin (PRF) in enhancement of healing by releasing growth factors, this study aimed to assess the efficacy of PRF application as a protective barrier right beneath the sinus membrane on the Schneiderian membrane thickness following sinus floor augmentation.   Materials and Methods: This randomized controlled split-mouth clinical trial was conducted on 18 patients (36 sinuses) who required bilateral sinus floor augmentation. Two patients (n=4 sinuses) were excluded due to chronic sinusitis, and one patient due to perioperative sinus membrane perforation. Fifteen patients (n=30 sinuses) were finally assessed. In the test side, PRF membrane was placed beneath the Schneiderian membrane while augmentation was performed without a PRF membrane in the control side. Cone-beam computed tomography (CBCT) scans were taken preoperatively, and at 1 week and 2 months postoperatively, and the Schneiderian membrane thickness was compared at the two sides using ANOVA and a post-hoc test. Results: The mean membrane thickness was 1.85±0.85 mm in the control and 2.17±0.87 mm in the test group before the intervention (P=0.6). At 1 week, the mean thickness was 2.45±1.22 in the control and 3.77±1.42 mm in the case group (P=0.2). At 2 months, the mean thickness was 2.54±1.66 mm in the control and 1.71±1.31 mm in the test group (P=0.2). ANOVA showed no significant difference between the two groups at any time point (P>0.05). Conclusion: Application of PRF under the Schneiderian membrane in sinus floor augmentation had no significant effect on the Schneiderian membrane thickness.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Knowledge, Attitude and Practice of Dental Interns and Postgraduates towards Managing Medical Emergencies in Dental Chair 233 240 EN V Arivazhagan Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamilnadu, India AC Lakshmi Rathan Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamilnadu, India S Chandran Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamilnadu, India V Narayanan Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamilnadu, India K Ramakrishnan Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamilnadu, India Background and Aim: Medical emergencies can happen habitually in dental setting. It is ultimately a dentist's responsibility to foresee the situation and manage it effectively. The aim was to assess the knowledge, attitude, and practice of dental interns and postgraduates regarding managing medical emergencies in dental chair.   Materials and Methods: A cross-sectional study was conducted for a period of 6 months from June 2021 to November 2021 on postgraduates and dental interns studying in dental colleges in and around the Chennai city. A pre-validated questionnaire consisting of 20 close-ended questions was circulated through Google forms. It consisted of questions on experience of medical emergencies encountered by interns during their graduation, knowledge about the essential drugs and equipment, amount of medical emergency training undertaken by participants, and preparedness of interns in handling of medical emergencies. Extracted data were statistically analysed by the Chi square test. Results: Of 217 participants, only 50.63% of interns and 49.37% of postgraduates had good knowledge about drugs used in medical emergencies; 71.65% of interns and 28.35% of postgraduates had come across medical emergencies and were confident enough in handling them during their practice. Also, 64.79% of interns and 35.21% of postgraduates were well informed about treating patients with airway obstruction, haemophilia, diabetes, epilepsy, spontaneous bleeding after extraction, acute asthmatic attack, and adrenal crisis. Conclusion: The majority of postgraduates had a good knowledge about management of medical emergencies in dental chair while the interns lacked confidence in handling some of the medical emergencies.  

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Effect of Paracetamol and Magnesium Sulfate on Level of Pain and Opioid Intake following Orthognathic Surgery: A Clinical Trial 241 248 EN M Khalili Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran K Farazmehr Department of Anesthesiology and Critical Care, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran SH Shafaeefard Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran F Irani Private Dentistry practice, Tehran, Iran Background and Aim: Considering the side effects of high doses of opioids taken postoperatively for pain control, paracetamol and magnesium sulfate may be able to aid in pain control. This study assessed the effects of paracetamol and magnesium sulfate on the level of pain and opioid intake following orthognathic surgery.    Materials and Methods: In this double-blind randomized clinical trial, patients scheduled for bimaxillary orthognathic surgery were randomly assigned to two groups of 25. Group 1 patients received 1 g infusion of intravenous acetaminophen (paracetamol) administered within 20 minutes while group 2 patients received 50 mg/kg magnesium sulfate infusion one hour prior to completion of surgery. The patients were asked to express their level of pain prior to discharge from the recovery, and every 4 hours for 12 hours using a visual analog scale (VAS). Patients with pain score > 5 at any time received 30 mg pethidine. The total received dosage of pethidine postoperatively was recorded and those that received pethidine were not included in pain score analysis. Data were analyzed by generalized estimating equation (GEE), and Mann-Whitney U, Chi-square, and t-tests. Results: The pain score was not significantly different between the two groups at the time of recovery and 4 and 8 hours (P>0.05). The magnesium sulfate group had significantly lower pain score at 12 hours (P=0.009). The difference in pethidine dosage was not significant (P>0.05). Conclusion: Both magnesium sulfate and paracetamol decreased postoperative pain and the need for opioid consumption, but magnesium sulfate was slightly more effective.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Common Etiologies of Generalized Tooth Mobility: A Review of Literature 249 259 EN K Ghods Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran A Alaee Oral Medicine Department, Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran A Jafari Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran A Rahimi Oral Medicine Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Background and Aim: Tooth mobility, which is prevalent among patients seeking dental healthcare services, happens when the tooth is reversibly displaced horizontally or vertically beyond its normal physiological limits. Tooth mobility is classified into 2 subgroups: localized and generalized. Generalized tooth mobility occurs when more than 2 teeth are mobile. In this review, the available studies regarding the common etiologies of generalized tooth mobility are discussed.   Materials and Methods: In this review article, data were collected by reviewing the available articles published between 2011 to 2021 in national and international journals by searching the PubMed, PubMed Central, Medline, EBSCO, Google Scholar, and Embase databases using the key words “Tooth Mobility”, “Tooth Movement” “Periodontal Disease”, “Systemic Disease”, and “Malignant Disease”. Among the relevant articles, 51 were chosen. Results: It seems that numerous etiologies, which can be either physiological or pathological, can result in generalized tooth mobility. Conclusion: Since an optimal treatment outcome depends on accurate diagnosis, it is crucial for the dentists to be aware of the common etiologies of this condition.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Palatal Rugae in Gender Discrimination: Auxiliary or Hindrance? A Systematic Review 260 266 EN L Reddy Department of Oral Medicine and Radiology, Government Dental College and Hospital, Afzalgunji, Hyderabad. India M Boringi Department of Oral Medicine and Radiology, Panineeya Dental College and Hospital Kamalanagar, Dilsukhnagar, Hyderabad, India K Alluri Department of Oral Medicine and Radiology, Panineeya Dental College and Hospital Kamalanagar, Dilsukhnagar, Hyderabad, India M Sujatha Government Dental College and Hospital, Vijayawada, India Background and Aim: Uniqueness of rugae can be utilized similar to finger prints when compared with other methods in identification of a person, even with the presence of discrepancies in the patterns obtained in different populations. Nonetheless, it still cannot be used as a potential tool in gender discrimination. This study explored the debatable way of the use of palatal rugae for gender discrimination.   Materials and Methods: Key words including “palatal rugae” and “sex determination” were used for searching of the following databases: PubMed Central, EMBASE, EBSCOhost and Cochrane from the earliest available date to January 2019. Out of 296 articles, 257 were excluded after abstract analysis. Only 8 articles were finally included. Results: A total of 1,152 subjects participated in this study, among them, 577 were females and 575 were males. Significant differences were observed in the number, length, and shape of the rugae patterns in both genders from one study to another. Conclusion: In this analysis, we observed that females and males showed varied patterns of rugae on the palate, but males predominantly showed a particular pattern compared with females. Palatal rugae cannot be used as the only tool for gender discrimination.

Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 7 4 2022 10 1 Sandwich Technique in Primary Teeth: A Review 267 272 EN H Kadhi Department of Pediatric and Preventive Dentistry, D Y Patil Deemed to be University, School of Dentistry, Nerul, Navi Mumbai, Maharashtra, India J Winnier Department of Pediatric and Preventive Dentistry, D Y Patil Deemed to be University, School of Dentistry, Nerul, Navi Mumbai, Maharashtra, India Background and Aim: The sandwich technique is a restorative method where the lost dentin is replaced with glass ionomer (GI) cement and the lost enamel is replaced with composite resin. Various modifications of this technique have been introduced in order to increase the longevity of this restoration. Hence, the aim of this review article was to assess the use of sandwich technique in primary teeth.    Materials and Methods: After an initial screening of potentially relevant articles through electronic search of journals indexed in PubMed Central, Science Direct, Wiley Online Library, Springer and Google Scholar, articles on sandwich restorations in primary teeth were included. Results: Literature suggests that the sandwich technique is successfully practiced in carious lesions in permanent teeth; however, very few studies are done on primary teeth. Conclusion: With the advent of newer resin cements and bonding agents, the sandwich technique is much simplified. However not enough clinical studies are available in the literature on the sandwich technique and its modifications in primary teeth. More studies need to be conducted in primary teeth using this restorative technique.