[Mast cell numbers in aggressive periodontitis]

Aggressive periodontitis is a destructive disease that leads to a quick and extensive periodontal tissue loss. Mast cells are known to play important roles in allergic reactions, host defense against bacterial infections, local homeostasis, inflammation, and angiogenesis. The aim of the present study was to evaluate the relationship between mast cell numbers and aggressive periodontitis. A descriptive analytical and blind study was designed and gingival specimens from 19 moderate to advanced aggressive periodontitis sites [case group] and 18 gingivitis sites [control group] was taken during flap and crown lengthening surgeries. Toluidine blue and Hematoxylin Eosin staining were done for mast cell counting and inflammation assessment, respectively. Inflammatory and mast cells in 5 micron sections were assessed by two trained observers utilizing light microscopy. ANOVAs and T test with an alpha error level less than 5% were used to analyze the data. The mean values of the mast cell numbers were 7.6 +/- 10.8 and 9.8 +/- 13.0 in aggressive periodontitis and gingivitis sites, respectively. There were no statistically significant differences among the mast cell counts, clinical attachment loss, or pathologic inflammation [P> 0.05]. The present study indicates that mast cell numbers were not significantly different between aggressive periodontitis and gingivitis. Further studies are required to evaluate dynamic aspects of host defense

Comparison of local anesthetic effects of tramadol and lidocaine used subcutaneously in minor surgeries with local anesthesia

In this study, the local anesthetic and post-operative analgesic effects of tramadol were compared to those of lidocaine in minor surgeries under local anesthesia. This double-blind clinical trial study included 70 patients in ASA physical status I and II, aging between 20 and 50 years, undergoing minor surgery [lipoma excision and revision of scars less than 4 cm within 30 minutes or less] under local anesthesia. The patients were randomly assigned to receive either 2 mg/kg tramadol [group T, n=35] or 1 mg/kg lidocaine 2% [group L, n=35] subcutaneously. Scores of the pain sensation were recorded as VAS [visual analogue scale 0-10] during injection, incision and 15, 30 and 45 minutes after incision, and then 2, 4 and 6 hours post-operatively at the ward. There was no significant difference between pain scores of the two groups during injection, incision and surgery or in the post-operative period at the ward [p=0. 181]. Incidence of nausea was 0% and 22. 8% in group L and group T, respectively. The difference was statistically significant [p=0.002]. Furthermore, 82. 9% of subjects in group L and 60% of subjects in group T needed acetaminophen to control their pain and the difference was significant [p=0.004]. Tramadol 2 mg/kg has local anesthetic and post-operative analgesic effect equal to lidocaine 1 mg/kg in minor surgeries performed subcutaneously. Therefore, we concluded that tramadol can be used as an alternative drug to lidocaine in local anesthesia and has the ability to decrease the demand for post operative analgesics

Dental implants for growing children

Traumatic tooth loss or congenital missing is frequently encountered in children. Removable prosthesis is often the treatment of choice but it may lead to increased caries, residual alveolar resorption and periodontal problems. The implant benefits in retention, stability, esthetic, and mastication have been proved. The concerns about implants placement for the patients in this age are related to jaw growth. The aim of this paper was to review the growth of the jaws and determination of skeletal maturity and to discuss the indications for placement of implant in a growing child, which are based on not only growth but also the numbers and locations of the missing teeth in each jaw. The literature review was performed through, Science direct, Blackwell Synergy, Embase, Pubmed and Scholar Google for the references published between 1970-2008. Also, the related English references were taken into consideration

[ comparison of chlorhexidine impregnated floss vs. conventional dental floss on gingivitis]

Plaque induced gingivitis is the most prevalent form of periodontal diseases and there are several reports demonstrating low efficiency of mechanical methods to control the dental plaque completely. Chemical method has been found as an adjunct to mechanical plaque control. The purpose of this clinical trial was to evaluate the clinical outcomes of chlorhexidine when used subgingivally with dental floss versus normal flossing alone. Thirty-seven female dental students with gingivitis and at least 2 sites with probing depth of 2mm and bleeding on probing in each quadrant participated in this split mouth clinical trial study. Following the initial evaluation of Plaque Index [PI], Bleeding Index [BI] and Gingival Index [GI], all patient received oral hygiene instruction, polishing and SRP [Scaling and Root Planning] if needed and their quadrants were affected by chlorhexidine impregnated floss in one side and dental floss in another side randomly. The measurements were repeated at 3 and 6 weeks. Then data were analyzed statistically within each group [Paired T Test] and between the groups [T Test] with an alpha-error level less than 0.05. Both methods presented significant improvement in PI and GI after 3 and 6 weeks and chlorhexidine impregnated floss showed a significantly greater reduction in PI after 3 weeks [1.5 +/- 0.7] and GI after 6 weeks [1.2 +/- 0.4] as compared to dental floss alone [respectively 1.7 +/- 0.65, 1.5 +/- 0.35, P<0.05]. The results indicated that chlorhexidine impregnated floss provided a more significant improvement of clinical outcomes than dental floss alone and recommends long term studies on various samples to validate these results

[Comparison between local anesthetic effects of Tramadol and Lidocaine used subcutaneously in minor surgeries]

Recent studies have shown that Tramadol has local anesthetic effects in addition to its classical analgesic effect. In this study, the local anesthetic and postoperative analgesic effects of Tramadol were compared with those of Lidocaine in minor surgeries under local anesthesia. If the efficacy of Tramadol in this regard is proven, it will make considerable advances in the local anesthetic area. In this random double-blinded clinical trial study, seventy patients aged between 20 to 50 in ASA physical status of I and II underwent subcutaneous block for minor surgeries. The patients were randomly assigned to receive either 2 mg/kg of Tramadol [group T, n=35], or 1 mg/kg of Lidocaine 2% [group T, n35] subcutaneously. The mean degrees of pain sensation were recorded on the VAS [visual analogue scale 0-10] during injection, incision, and every 15 minutes at the 15th, 30th, and 45th minutes after the incision, and then every two hours at the 2nd, 4th, and 6th hours postoperatively in the ward. The data were analyzed using repeated measures and Chi-square. When the VAS of pain during surgery exceeded 4, an additional 0.5 mg/kg of the study drug was injected. The patients with the VAS of 4 or more were advised to take Acetaminophen 325 mg if necessary. There were no significant differences between the pain score of the two groups during injection, incision, surgery, and postoperative time [p=0.181]. Additionally, no significant differences were found in local skin reaction [p=0.104], bleeding quantity [p=0.112], additional dose of local anesthetic [p=0.48], and incidence of vomiting [p=0.114]. The incidence of nausea [0%] in group L and [22.8%] in group T, showed a statistically significant difference [p=0.002]. In group L, need for Acetaminophen to control their pain was higher than in group T. Tramadol 2 mg/kg has equal local anesthetic and postoperative analgesic effects like Lidocaine 1 mg/kg for minor surgeries performed subcutaneously. Therefore, it is recommended that Tramadol can be used as an alternative drug to Lidocaine in local anesthesia because it is able to decrease the demand for postoperative analgesics

[Cytotoxic effects of chlorhexidine on rat L929 fibroblast cell line]

Recent studies has shown that toxic effects of chlorhexidine [CHL], is not limited to bactyeria but also noxious for a variety of cells including sperms, polymorphonuclears, macrophages, epithelial cells, erythrocytes and gingival fibroblasts. To evaluate cytoxic effects of chlorhexidine on rat L929 fibroblast cell line and also determining the safest and most effective dose of this agent. L 929 fibroblast cell cultures supplemented with FBS were treated with 0.2, 0.12 and 0.009% of chlorhexidine concentrations for 30 seconds, 1 minute and 5 minutes. Then, Media was removed and cells were washed with RPMI three times and were incubated in new culture media with MTT for 4 hours. Since chlorhexidne cytotoxicity affects mitochondrial dehydrogenase in viable cells, no MTT reduction and further formazan crystal formation occurs. The optical density of the color changes was detected using ELISA reader. CHL was cytotoxic at all concentrations and time intervals used in our study. ANOVA showed a lack of any significant difference in toxic effects of chorhexidine at different concentrations and durations. Regarding the cytotoxicity of CHL at concentrations and durations much less than those in clinical application, conservative use of chlorhexidine is recommended. Also, additional studies on CHL to determine a safe and effective dose dose and duration are suggested

Coverage of abraded roots by coronally advanced flap using connective tissue graft

Various surgical techniques are used to cover gingival recessions; however, in most cases the teeth under manipulation are free of any abrasion. In the past, abraded roots were excluded from the study or were planned with burs or curettes to prevent interference with surgical results. This study presents a case of severely abraded roots in which the recessions were covered. Coronally advanced flap using connective tissue graft was accomplished to cover the Class 1 gingival recession in severely abraded roots of right maxillary premolars in a 57 years old healthy man. In this case, the sharp edges of recessions were not planned which was in contrast to most previous studies. Eighty-six percent of denuded roots were covered after 3 months following the surgery. This report suggests the application of long term and split mouth clinical trials with this method to compare the results with alternative approaches to cover the severely abraded roots

effect of coronally advanced flap in root coverage of miller class 1 recessions in single rooted teeth

Gingival recession has a high prevalence. Tooth sensitivity and esthetic problem are two complications of gingival recessions. This study was designed to evaluate the clinical outcome following treatment of localized gingival recessions using coronally advanced flaps [CAF]. Seven consecutively patients in Shahid Beheshty faculty of dentistry [2002] with buccal Class I Miller gingival recession having high level of oral hygiene, were included in this study. Blind calibrated evaluation, provided 20 sites in single-rooted teeth. Clinical measurements including recession height [RH], clinical attachment level [CAL], height of keratinized gingiva [KG] and probing depth [PD] were taken by means of Williams probe, Caliper and acrylic stent. During surgical procedures, CAF was similarly carried out in all of teeth. Clinical measurements were repeated fallowing 3 month post-surgery and areas of covered roots were calculated with AutoCad software by means of 5 points of each root. CAF resulted in a significant decrease in recession depth [2.39 +/- 0/82m, 60.8% and recession width [2/1 +/- 2 mm, 43/7%, P<0.002] and gain in CAL[2.63 +/- 0.9, P<0.001]. Area of covered root was 10.44 +/- 7.04mm in CAF [p<0.01] after the 3-month evaluation. PD and KG changes were small and not significant. Using CAF 55% of roots of the teeth were covered by more than 12.5 mm2 [two-third of highest value]. The CAF operation offers a predictable, simple and convenient approach to root coverage procedure in Miller Class I recession defects

[Knowledge of women working in hospitals of Lorestan medical sciences university about smoking effects on fertility]

Smoking has some undesirable effects on human health. Its effect on fertility is one of health problems, which public has little knowledge about them. Considering the prevalent of smoking between youth, we decided to assess the knowledge of women working in hospitals of Lorestan Medical Sciences University regarding the effect of smoking on fertility. This is a cross sectional study. 280 women were chosen so to assess the knowledge of women working in hospitals of Lorestan Medical Sciences University in 2001. Information were gathered through questionnaire which was prepared base on objectives of study and was used after proving to be valid. Results showed that 75.7% of women knew about respiratory disease, 79.1% knew about heart disease and 69.3% had knowledge about addictive effect of smoking. Base on results of this study, few women knew about fertility problem of smoking. Only 37.5% knew about infertility effect, 47% knew about intra uterine fetal death, 70.7% knew about spontaneous abortion, 52.1% knew about infant death and 10.7% had knowledge on early menopause effect of smoking. Therefore by increasing knowledge of women on effects of smoking, we can reduce the related effects