Design of a Knowledge Evaluation Questionnaire for Dental Specialists on Preservation and Extraction Indications of the First Permanent Molars.

Statement of the Problem: The first permanent molar (FPM) teeth are the most important elements of mastication and are crucial in the improvement of functionally proper occlusion. However, in childhood, these teeth are most susceptible to caries. The loss of an FPM in a child can cause changes in the dental arches. These changes can occur throughout a person's life. In such cases, the dentists and dental specialists need to decide whether to preserve or extract the FPM. Purpose: This study aimed to evaluate the extent of knowledge of dental specialists in Shiraz (Iran) on clinical guidelines for the preservation and extraction indications of FPMs. Materials and Method: The authors developed a dedicated questionnaire for the purpose of knowledge evaluation. A total of 6 orthodontists and 15 dental specialists, respectively confirmed the validity and reliability of the questionnaire. The 19-item questionnaire covered topics such as demographic data, preservation criteria for FPM teeth, and indications for FPM extraction. The survey was carried out across six dental disciplines in Shiraz (Iran) during July-August 2018. The data were analyzed using the SPSS software (version 22.0) with the dependent sample t test and one-way ANOVA. p Value< 0.05 was considered statistically significant. Results: Out of 89 dental specialists, 64 participants (53% male, 47% female) completed the questionnaire. The mean knowledge score for all participants was 10.09±3.93 (maximum of 19). The level of knowledge had a significant and inverse correlation with age (p< 0.001) and years of experience (p= 0.017). It also had a significant relationship with dental specialization (p< 0.001). Conclusion: The overall level of knowledge of the specialists was insufficient, except for the pedodontists and orthodontists. A re-education training program for dental specialists is strongly recommended.

Comparing the effects of Elaegnus Angustifolia, Hypericum Perforatum and Psidium Guajava extracts on metabolic activity of dental pulp-derived mesenchymal stem cells.

Dental pulp derived-mesenchymal stem cells (DP-MSCs) is considered a suitable are candidate for tissue engineering techniques and osseous reconstruction. Based on the hypothesis that Hypericum perforatum, Elaeagnus Angustifolia and Psidium guajava extracts can be used in cell-based bone tissue engineering due to meagre cytotoxicity response in the cell culture medium, their effects on the viability and metabolic activity of DP-MSCs were investigated and compared with each extract. DP-MSCs were extracted from human dental pulp, characterized by flow cytometry, and differentiated into Osteogenic and adipogenic lineages which were then cultured in different concentrations of E. Angustifolia, H. perforatum and P. guajava extracts at different time intervals followed by MTT assay evaluation. The dental pulp mesenchymal stem cells were evaluated for their plastic adherence ability, fibroblast-like and spindle morphology. According to flow cytometry data, isolated cells from DP-MSCs expressed MSCs markers. A comparison of herbal extracts' concentrations revealed that 500 µg/ml was toxic to dental pulp stem cells, a guide to the toxic dose for DP-MSCs. The P.guajava bore low toxicity and increased dental pulp stem cell viability in comparison to the other two herbal extracts. The hydro-alcoholic extracts of E. Angustifolia, H. perforatum, and P. guajava were efficient in DP-MSCs viability, and therefore were concluded to be useful in maintaining structural and functional cell viability. It was also concluded that the co-culture of stem cells with herbal elements could stimulate endogenous factors to enhance the proliferation and viability of MSCs.

Evaluation of the Effect of a Topical Gel Form of Pistacia Atlantica and Trachyspermum Ammi on Induced Oral Mucositis in Male Golden Hamsters by Bio-Marker Indices and Stereological Assessment.

STATEMENT OF THE PROBLEM: Oral mucositis (OM) is a common inflammatory complication consequent to chemotherapy or radiotherapy in cancer patients that affects their quality of life. Therefore, finding an effective treatment for OM is always imperative. PURPOSE: The purpose of this experimental study was to measure the stereological, anti-inflammatory and antioxidant markers of hydro-alcoholic extract of Pistacia Atlantica (P. atlantica) leaves, Trachyspermum Ammi (T. ammi) fruits and their mixture on induced OM in hamsters. MATERIALS AND METHOD: In Experimental study, OM was generated by the method employed by Tanideh et al., in 90 hamsters, by 5-FU (5-fluorouracil 65 mg/kg, IP). All the animals were divided into 5 groups: control, topical gel base, hydro-alcoholic extract 3% of P. atlantica, hydro-alcoholic extract 1% of T. ammi, and a mixture of the extracts of the two plants. On days 13, 15, and 17, the cheek pouch samples were harvested. Stereological scores and the levels of malondialdehyde (MDA), Superoxide dismutase (SOD), myeloperoxidase (MPO), and interleukin-1B (IL-1B) in the pouch tissue were measured. RESULTS: Lower levels of MPO, MDA, and IL-1B and an increase of SOD level were discovered in the mixture-treated group in comparison with other groups. As an aspect of MDA, no significant differences were detected between the topical gel form of P. atlantica and T. ammi groups on days 13 (p= 0.648), 15 (p= 0.981) and 17 (p= 0.540). No variations of MPO were detected among P. atlantica and T. ammi groups on days 13 (p= 0.159) and 15 (p= 0.694); however, the MPO activity of the T. ammi group was significantly lower than the P. atlantica group on day 17 (5.57±0.56 vs. 6.48±0.35 U/ml, p< .001). The volume density of the epithelium increased in the mixture- treated group (p< 0.05). CONCLUSION: The results of this study indicated that the mixture of P. atlantica leaves and T. Ammi fruits might be effective in the treatment of OM.

Anterior screw fixation in type II odontoid fracture in an 18-month-old girl: a case report and review of the literature.

Odontoid fractures are among the rare cervical spine injuries in pediatric population and thus the optimal management of these injuries is controversial. The increasing trend in road traffic accidents and improvement in diagnostic modalities has led to an increased detection of odontoid fractures in pediatric population. We herein report type II odontoid fracture in an 18-month-old girl after falling off the motorcycle leading to hyperextension and flexion injury. She was successfully treated with anterior odontoid screw fixation followed by immobilization with hard collar for 2 months. Callus formation was detected after 6 weeks and complete remodeling was observed at 6-year follow-up visit. This girl is among the youngest patients with type II odontoid fracture reported in literature being treated with anterior screw fixation. Further clinical series are needed to provide evidence for optimal management of odontoid fractures.

Clinical and radiological outcomes after decompression and posterior fusion in patients with degenerative scoliosis.

OBJECTIVE: The prevalence of degenerative scoliosis (DS) increases with age and an overall increase is seen due to the aging population. This study aims to evaluate the clinical and radiological outcomes after decompression and posterior fusion in patients with DS. METHODS: In this is prospective study, 43 patients with DS, aged 37 to 70 years, were eligible to undergo decompression and posterior fusion. Primary outcomes were low back pain (LBP) with or without radicular pain, which was evaluated preoperatively and at 12 and 24 months after surgery with the use of a visual analog scale (VAS), and the quality of life (QOL), which was assessed at the same time periods by the Oswestry Disability Index (ODI) questionnaire. The Cobb's method was used to measure the degree of scoliosis in each patient preoperatively and at 24 hours, 12 and 24 months after the surgery. RESULTS: VAS scores improved significantly from a mean of 8.18 preoperatively to 4.48 at 12 months and 3.07 at 24 months postoperatively (P < .001). The mean radicular pain scores also decreased significantly (P < .001). At postoperative 12 months, the mean ODI score was significantly lower than the mean preoperative ODI score (47.81 ± 16.06 vs. 72.18 ± 12.28; P = .001). ODI score at 24 months postoperatively was significantly better than the preoperative ODI (15.53 ± 7.21 vs. 72.18 ± 12.28; P = .016). The mean Cobb angle changed significantly from 31.4° ± 4.88 preoperatively to 3.28° ± 2.10 at 24 months postoperatively (P < .001). CONCLUSIONS: Our findings suggest that decompression and posterior fusion in the patients with DS is an effective surgical method which is associated with satisfying clinical results in terms of improvement of postoperative LBP, radicular pain, and QOL, and correction of Cobb angle at 12 and 24 months after the surgery and restoration of sagittal alignment at 2 months postoperatively.

Pain and functional improvement effects of methylene blue injection on the soft tissue around fusion site after traumatic thoracolumbar fixation: A double-blind, randomized placebo-controlled study.

OBJECTIVE: Fractures of the thoracolumbar spine can cause pain, long-term reductions in quality of life (QOL), and neural deficits. The aim of this study was to investigate the effects of methylene blue (MB) on preventing postoperative pain and improving QOL in patients with throracolumbar fractures undergoing posterior pedicle screw fixation. METHODS: Fifty patients underwent standard posterior pedicular screw fixation for stabilization of the thoracolumbar fractures: 25 received 1ml of MB solution at a concentration of 0.5% and 25 received normal saline on the soft tissue around fusion site. Primary outcomes were the control of pain, evaluated at 48h, 2 and 6 months after surgery with the use of a visual analog scale (VAS), and the improvement of QOL, assessed 2 and 6 months postoperatively by means of Oswestry Disability Index (ODI) questionnaire. RESULTS: The mean VAS scores for pain were significantly lower in the MB group compared with the control group at 2 months (1.30±0.45 vs. 2.60±1.19, P<0.001) and 6 months (1.17±0.37 vs. 1.60±0.87; P=0.028) after treatment. At 2 months after the surgery, the mean ODI score was significantly lower in the MB-treated patients than the control group (20.4±10.92 vs. 34.8±15.11; P=0.001). The ODI score in the MB-treated patients was better than the control group at 6 months after the surgery (12.2±11.66 vs. 20.8±11.14; P=0.016). CONCLUSION: A single dose of MB on the soft tissue around fusion site shows promising results in terms of safety, reduction of postoperative pain, and functional results when compared with placebo 6 months after surgery.