Virulence Genes, Antibiotic Resistance and Capsule Locus Polymorphisms in Enterococcus faecalis isolated from Canals of Root-Filled Teeth with Periapical Lesions / 감염과화학요법

Frequent isolation of Enterococcus faecalis from root canal treated teeth with apical periodontitis, has proposed the role of this organism in endodontic treatment failures. Different factors have been suggested in the pathogenicity of this organism. In this study, 22 E. faecalis isolates from canals of root-filled teeth were identified, and phenotypic and genotypic characteristics were investigated. No resistance to vancomycin and gentamicin was noted, and most isolates (91%) were susceptible to ampicillin. Biofilm formation was detected in 73% of the isolates and may be considered as the most important virulence factor involved in the pathogenesis of these isolates.

Effective factors on oral health behaviors of 12-year-old children in cities and villages of Iran: a path analysis

Statement of the Problem: Oral and general health status depends on several factors such as the individual's personal attributes, behaviors, and perceptions

Purpose: This study aimed to evaluate the factors affecting the oral health-related behaviors in 12-year-old children

Materials and Method: This cross-sectional study was based on the data obtained from 1554 students being 12 years old and from five provinces in Iran. The data were collected with a culturally adapted questionnaire about the students' demo-graphic characteristics, knowledge, attitudes, and practice [KAP]. Path analysis was conducted to evaluate the effect of these factors on oral health-related behav-iors in urban and rural areas

Results: Based on the findings, 61.1% of the samples resided in urban and 38.9% in rural areas. The mean scores were relatively good for knowledge [74.1+/-21.1%] and attitudes [72.6+/-21.1%], but unsatisfactory for oral health practice [51.8+/-12%]. Having measured the correlation between the independent variables and oral health-related behaviors, the province of residence and the parents' education and job had the most significant correlations. Behavioral biases were seen in all dimen-sions of practice such as brushing habits, dental visits, and diet. In urban areas, 30% and in rural areas 49% of oral health behaviors were directly related to knowledge and attitudes. All of the calculated effects exhibited significant differ-ences from zero [p< 0.0001]

Conclusion: Path analysis identified some direct and indirect factors influencing the children's oral health-related behaviors. Factors included in this model could only justify a part of oral health behaviors. Thus, other educational models should be considered based on the psychology or social learning theories

Virulence Genes, Antibiotic Resistance and Capsule Locus Polymorphisms in Enterococcus faecalis isolated from Canals of Root-Filled Teeth with Periapical Lesions / 감염과화학요법

Frequent isolation of Enterococcus faecalis from root canal treated teeth with apical periodontitis, has proposed the role of this organism in endodontic treatment failures. Different factors have been suggested in the pathogenicity of this organism. In this study, 22 E. faecalis isolates from canals of root-filled teeth were identified, and phenotypic and genotypic characteristics were investigated. No resistance to vancomycin and gentamicin was noted, and most isolates (91%) were susceptible to ampicillin. Biofilm formation was detected in 73% of the isolates and may be considered as the most important virulence factor involved in the pathogenesis of these isolates.

Occupational stress and coping behaviours among dentists in Kerman, Iran

Objectives: recognising causes of stress can help prevent associated adverse effects. This study aimed to investigate causes of occupational stress and coping behaviours among general dentists in Iran

Methods: this cross-sectional study was carried out from April to December 2014. A modified version of the Occupational Stress Indicator questionnaire was used to assess causes of stress and coping behaviours among 142 general dentists in Kerman, Iran

Results: a total of 93 dentists participated in the study [response rate: 65.5%]. Of these, 58.9% reported often being stressed. The mean general stress score was 63.33 +/- 19.99. The most common causes of stress were maintaining high levels of concentration while working [65.6%], time pressures [64.5%], concern over their ability to deliver dental services in future [60.2%] and rising costs [59.1%]. No significant relationships between stress and gender, age, workplace or working hours per week were noted [P >0.05]. However, there was a significant correlation between general stress scores and years of job experience [P = 0.05] and number of patients treated daily [P = 0.03]. The most common methods for coping with stress were resting [71.0%], sports [45.2%] and entertainment [43.0%]. Most dentists felt that stress management courses could help to reduce stress [89.7%]

Conclusion: general dentists in Kerman were subject to many sources of stress in their workplaces, with significant relationships between stress scores and years of work experience and number of patients treated daily. Dentists should be encouraged to participate in stress management courses to help alleviate stress

Knowledge and use of evidence-based dentistry among Iranian dentists

The objective of this study was to assess the knowledge and use of evidence-based dentistry [EBD] among Iranian dentists. A cross-sectional survey was conducted by means of a questionnaire among dentists attending the 52[nd] National Annual Congress of the Iranian Dental Association in Tehran in April 2012. The questions covered the participants' level of knowledge and use of EBD. The mean knowledge score of the 310 respondents was 3.66 +/- +/- 1.19 out of a maximum of 5. The majority of the dentists had little [56.1%] or no [20.7%] knowledge of EBD. The main reported barrier to the use of EBD was lack of time [44.1% of respondents] with 42.8% of dentists using the Internet less than one hour per week. EBD was not a familiar concept to these Iranian dentists; the majority of them preferred consultation with colleagues over seeking evidence from electronic databases

Effect of family structure and behavioral and eyesight problems on caries severity in pupils by using an ordinal logistic model

Dental caries is one of the most preventable yet prevalent chronic diseases worldwide. Our objective was to evaluate the effect of family structure and behavioral and eyesight problems as they relate to caries severity in schoolchildren. This research was carried out on 845 primary schoolchildren aged 9 yr in Kerman, Iran, in 2012. Ten variables, including health records, family structure information and a dmft / DMFT index, were collected. Children were categorized into three groups based on the WHO caries severity classification. Low caries level was defined as dmft/DMFT<2.6, moderate as dmft/DMFT of 2.7-4.4 and high as dmft/DMFT>4.4. The Cochran-Armitage test and ordinal logistic regression were employed for data analysis. Almost half of pupils had moderate or high caries severity. The odds of being in a higher caries severity category in pupils with behavioral problems [OR=2.37, 95% CI: 1.29-4.38] and girls [OR=1.6, 95% CI: 1.22-2.06] were higher than in other categories. In addition, pupils with eyesight problems [OR=0.58, 95% CI: 0.37-0.90] and overweight pupils [OR=0.46, 95% CI: 0.31-0.71] had lower caries severity than others. The effects of parents' education, birth rank, living with parents and consanguineous relationship between parents were not significant on caries severity [P>0.05]. Female pupils with behavioral problems were at a higher risk of caries severity than other pupils. These pupils need to be educated and coached on proper dental care. In addition, overweight pupils and those with eyesight problems had less caries severity than others. Family structure in this study did not have an effect on the severity of dental caries

Reporting of ethical considerations associated with clinical trials published in Iranian dental journals between 2001 and 2011

Ethical consideration is a basic requirement for design of randomized clinical trials. The purpose of this study was to assess whether reports of Iranian dental clinical trials complied with the requirements of the ethical principles of human research. In this retrospective observational study electronic search was performed to identify all dental clinical trials published between 2001 and 2011. Each trial report was assessed for inclusion of a statement that 17 items about research ethics. Totally 242 papers were identified, of which 15.3%, stated that ethical approval had been obtained and 50.4% of the trial reports indicated that informed consent had been obtained. The mean ethical score for the mentioned studies was 7/68 out of 17. Most Iranian dental clinical trial reports failed to consider important ethical principles. The reporting of the ethical issues associated with these trials could be improved further not only by the instructions to authors, but also by Journal editors refusing to publish trials that do not comply

Overextension of nonsetting calcium hydroxide in endodontic treatment: literature review and case report

Premixed non-setting calcium hydroxide [CaOH2] paste in pressure syringe system is commonly used in root canal therapy. The aim of this paper is to present a case involving an iatrogenic extrusion of the medicament during endodontic treatment and a literature review of similar reports. The present case demonstrates severe tissue necrosis and other deleterious effects following the extrusion of CaOH2 paste beyond root apex. A 21-year old female was referred for endodontic treatment of her maxillary left first premolar. After completion of the canal preparation, root canals were filled by premixed CaOH2 paste. In the second appointment, a gingival detachment and an irregular zone of necrosis adjacent to the tooth apex was observed. To treat this complication, a mucoperiosteal flap was raised and the extruded material and necrotic tissues were currettaged and the area sutured. The patient was prescribed antibiotics and followed up at 2 weeks, 6 months and 2 years. Two week follow up showed good soft tissue healing. Two years postoperatively, complete radiographic and clinical healing was observed. We can conclude that the application of CaOH2 should be carried out with care and preferably applied free hand or with a lentulo spiral rather than in a pressure syringe

Apical sealing ability of MTA in different liquid to powder ratios and packing methods

In apical surgery, after apicoectomy and retro-preparation of canal, a retrofil material is applied to seal the apical region of the root canal. Mineral trioxide aggregate [MTA] is the gold standard material for this purpose. Changing water/powder ratios of MTA affects its properties. The purpose of this in vitro study was to determine the effect of liquid/powder ratio of retrofil MTA on apical dye leakage, and also compare two packing techniques for MTA. In this in vitro study, 126 intact single-root extracted teeth were instrumented using step-back technique, and obturated with lateral condensation method. The apical 3 mm of roots was resected, and retrograde preparation was performed by an ultrasonic device. Specimens were randomly assigned to 6 groups of 20 each and 6 teeth served as positive and negative controls. All teeth were retrofilled with White ProRoot MTA. Three groups were retrofilled with 0.28, 0.33, and 0.40 water/powder ratios of MTA and packed with plugger; the other three groups were retrofilled with 0.28, 0.33, and 0.40 water/powder ratios and packed with wet-cotton. Linear dye leakage was used to check apical sealing ability, and data were statistically analyzed using Kruskal-Wallis test. In 0.40 liquid/powder ratio the best applicator for packing MTA was plugger. In 0.28 liquid/powder ratio, moist cotton pellet was the best applicator; in 0.33 liquid/powder ratio, there was no significant difference between the two techniques. Under the condition of this in vitro study, packing with moist cotton pellet in lower liquid/powder ratios of MTA, as well as packing with a plugger in higher liquid/powder ration decreased apical dye leakage

Periapical status and quality of root canal fillings and coronal restorations in Iranian population

This cross-sectional survey determined the dental prevalence of apical periodontitis [AP] in selected Iranian population, and evaluated the influence of the quality of root canal treatment [RCT] and their coronal restorations [CR] on the periapical status. A total of 1064 panoramic radiographies were evaluated by two observers during 2009. The quality of RCT i.e. length/density of root fillings and CR in addition to periapical status of endodontically treated teeth were recorded. Their interrelationship was analyzed by Chi-squared, logistic regression and Spearman's rho statistics. Hosmer and Lemeshow tests were used for assessing fitness of logistic regression model and one sample k-s test was used for evaluating of normality of the data. Our results showed that 527 teeth [52%] of the endodontically treated teeth presented with AP radiographically. The percentages of teeth which fulfilled the criteria of an acceptable RCT or CR radiographically were 42.3 and 62.5 respectively. Incidence of AP among teeth with acceptable RCT [29.1%] was significantly lower than those suffering from unacceptable RCT [68.8%] [P<0.001]. Moreover, adequate CR demonstrated a significantly better periapical status [58.6%] compared to teeth with inadequate CR [30.3%] [P<0.001]. The incidence of AP ranged from 25.6% [good qualities] to 79.5% [bad qualities] [P<0.001]. Cases with both unacceptable RCT/CR were 11 times more likely to have AP than cases with acceptable RCT/CR. The quality of RCT and CR were found to impact the periapical health of endodontically treated teeth. There are a significant high number of technically unacceptable endodontic and restorative treatments in Iran; therefore considerable efforts are needed to improve the standards of endodontic and restorative treatments

digital stereomicroscopic study of the furcation wall thickness of mesiobuccal roots of maxillary first and second molars

This study aimed to compare the thickness of the mesiobuccal furcal canal watts of first and second maxillary motes. This study was performed on total of 30 first and second extracted molar teeth [15 each]. The mesiobuccal roots of each tooth were separated at the cement-enamel junction [CEJ] level and embedded in acrylic resin. The embedded roots were cut horizontally at two and four mm below the CEJ using a 0.20 mm blade [overall three sections CEJ, two and four mm below]. Next, photographs of all the horizontal sections were taken using a digital stereomicroscope with identical magnifications [x20]. Using the photographs, two independent observers measured and recorded the minimal thickness from the canal wall of the first mesiobuccal [MB1] and the second mesiobuccal [MB2] canals to the furcation area. Data analysis was performed by repeating the measurement Analysis of Variance. The analysis was completed by making paired comparisons using the Bonferroni alpha adjustment method. Statistical significance was set at P<0.05. In maxillary first molars, the mean [ +/- SD] thickness of the canal furcal wall MB1 in three sections were significantly higher than thickness of the canal furcal wall in MB2 [P<0.05]. However there was no statistical difference between the mean [ +/- SD] thickness of the canal furcal wall in the three sections [CEJ, 2 and 4 mm below] of maxillary second molars MB1 and MB2 canals. Only the maxillary first molars demonstrated significantly lower furcal canal wall thickness [FCWT] values in the MB2 canals. Maxillary second molars MB canals did not demonstrate Statistical difference in FCWT values