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Sulaimani Dental Journal: Vol 3 Issue 1: July, 2016.

Cover pages to Table of Content  - Volume 3, Issue 1 2016  PDF

1- Temporomandibular joint disorders (Review Article)
     Shanaz M Gaphor


Temporomandibular joint (TMJ) is a sensitive and highly mobile joint. Temporomandibular disorders (TMDs) have been considered as a common orofacial pain condition. The term (TMDs) characterized by pain in the temporomandibular joint (TMJ) area, the periauricular area, or the muscles of mastication, TMJ sounds during mandibular movement and deviations, or restriction in mandibular movement.

2- The Effect of Lase Peroxide Sense and Whitening Lase II radiation on Gingival Microleakage of Different Types of Composite Resin Filling Materials. (An in Vitro Study)
     Niaz H. Hama-Saeed


Aim: This in vitro study was conducted to evaluate the effect of lase peroxide sense, and whitening lase II radiation on gingival microleakage of three types of composite filling materials (tartaric N Ceram, SDR, GC).
Materials and Methods: This study was performed on thirty caries free upper first premolar teeth. The Standardized class V cavity preparation on buccal and lingual surfaces of each tooth was done, then the teeth were randomly divided into two major groups: group 1 unbleached and group 2 bleached composites, then each main group divided into three subgroups; ten cavities (5teeth) for each group. The cavities were cleaned, and acid etched with 37% phosphoric acid, then bonding agent (G-permio bond) was applied according to the manufacturer's instructions. Group I and II the cavities were filled with tetric N ceram composite(Vivadent), group III and IVthe cavities were filled with SDR composite (SDI), and group V and VI the cavities filled with GC Essentia composite(GC). After filling the teeth in groups II, IV, VI were subjected to whitening lase II (DMC, USA) laser bleaching, according to manufacturer's instructions, then the teeth were thermo cycled for 500 cycles. After thermocycling all teeth were immersed in a freshly prepared solution of 2% methylene blue for 24 hours at 37Co then sectioned longitudinally. For gingival margins, dye penetration at the tooth/composite interfaces was analyzed using a stereomicroscope.
Results: Statistical analysis of data by using Mann-Whitney Test Revealed that there was a significant difference among the different groups in both bleached and unbleached composite, Kruskal-Wallis Test revealed that there is a significant difference between bleached and unbleached composite for every type of material.
Conclusions: All samples in this study showed microleakage with different levels. Hydrogen peroxide increased Microleakage in all tested materials.

3- Evaluation of different modalities of intraorally harvested bone graft in oral and maxillofacial reconstructive surgery
     Suha N Aloosi & Waleed Jaleel


Objectives: Although the iliac crest is most often used in major jaw reconstruction for dental implants and other maxillofacial reconstructive surgeries it has the disadvantages of higher costs, alteration of ambulation, and the need for hospitalization and general anesthesia. , bone grafts harvested from the maxilla and mandible offer several benefits. This study was conducted to the quality and the quantity of intraorally harvested bone graft from different sites, and assessing the suitability of each donor site for the selected recipient site.
Material and Method: Twenty-two patients (27 bone graft donor sites) (5 of them with bilateral alveolar reconstruction), of both sexes (9 males and 17 females), were operated on by harvesting intraoral bone grafts from different sites used in different reconstructive surgeries. Specific intraoral donor sites were used for specific type of surgery according to the feasibility and need. Preoperative and intraoperative evaluation of the recipient defect size and selecting proper intraoral donor sites was the paramount parameter in our study.
Results: The success rate was 96.2% in a follow-up period of 6-18 months, the patients were evaluated for bone graft stability, ability to insert the dental implant, stability of the implant, stability in orthognathic surgery, and the satisfactory aesthetic and functional results, all the patient had satisfactory results and only one case of particulates cortical bone had developed fibrous union ,
Conclusion: Intraoral bone graft can successfully be used for treating small and selected facial and alveolar defect with minimal complications in the donor sites, patients report minimal discomfort and morbidity and all complications were temporary. Types of fixation, prompt graft adaptation were the most important factors for success. Symphysis of the mandible has the advantage of easy access and visibility and can easily be done under local anesthesia. However, for reconstruction of a bigger bony defect, an extraoral bone grafting is recommended .

4- β-catenin expression in perilesional area of different grades of oral squamous cell carcinoma
      Marwa A. Hamied


Objectives: Background: Multistep carcinogenesis discusses a stepwise accumulation of alterations, both genotypic and phenotypic. Arresting one or several of the steps may disturb or delay the development of cancer. Current guidelines describe histopathologic margin of >5 mm as “clear margin” and 1-5 mm as “close margin”. β-catenin plays a critical structural role in mediating cadherin junctions and is also an essential transcriptional co-activator in the canonical Wnt pathway. A predictor marker is needed to confirm the clearance of margins surrounding a resected tumor. The current study aim is to assess β-catenin expression at the perilesional area of OSCC and relate such expression to OSCC histopathological grading.
Materials and Methods: Immunohistochemical evaluation of β-catenin expression at the perilesional area of 25 OSCC and ten normal oral mucosae from archival paraffin blocks was done. The sections were assessed according to the ability of surface epithelium at the perilesional area of OSCC in showing normal expression pattern of β-catenin in the oral mucosa.
Results: Normal oral epithelium showed strong β-catenin expression at the cell membrane, but no cytoplasmic or nuclear expression. There was no significant difference between the immunoreactivity for β-catenin in the perilesional area of the different histological grade of OSCCs.
Conclusion: β-catenin expression does not represent a valuable tool to predict the free margin.

5- Impact of chronic oral mucosal diseases on quality of life in Kurdish patients, Preliminary observations in Sulaimani city
      Balkees T. Garib, Shanaz M Gaphor & Mustafa Jamil


Chronic oral mucosa disorders are often recurrent or painful with a long standing course that affects the quality of patients’ life. Scoring such effect with a predominance of oral health– specific quality-of-life measures currently used to a limited extent in oral medicine practice.
Objectives: to measure the impact of chronic oral mucosal diseases on quality of life in Kurdish patients. Evaluate the efficacy of the discipline-specific quality-of-life measure developed in the field of oral medicine.
Patients and Methods: Fifty patients with different chronic oral mucosal diseases participated in this study and filled the questionnaire.
Results: The quality-of-life mean score significantly differed among various chronic oral mucosal diseases. Nevertheless, there were no significant differences in medication nor patient support. Behçet’s disease had the highest value (3.36). They had a significantly high score for pain, functional limitation, social and emotional domains. Positive, simple–count score was only significantly differentiating between recurrent aphthous ulceration and recurrent herpes labialis (24 versus 9.62). Chronic oral mucosal diseased patients have moderate difficulty in carrying out daily oral hygiene (mean score 2.34). They felt discomfort with certain food features (mean score 2.02). Also, they were not satisfied with their treatment (mean score 2.5) and were worry from no curing (mean score 2.09). They had bothering from the unpredictability of their oral condition (mean score 2.04). They were moderately satisfied with the level of support and understanding shown to them by family (mean score 2.2). Fortunately, chronic oral mucosal diseases did not disrupt their social activities and did not hold them to the feeling of isolation (mean score 0.98 and 0.74 respectively).
Conclusion: Dentists should pay particular attention to mucosal-diseased patients because they are likely to experience oral impacts on daily performances. They should also consider the 26 questions included in the chronic OMD-QOL system for better understanding those patients’ need.

6- Patient's Satisfaction with Orthodontic Treatment in Sulaimani City
     Trefa Mohammed Ali Mahmood & Mohamed Khalel 


Objectives: The aim of the study: The objective of this study is to evaluate the patient’s satisfaction with orthodontic treatment for a sample of orthodontic patients treated in Sulaimani city and identify the possible factors that may affect the satisfaction with their dentition and profile after treatment.
Material and Methods: This is a retrospective study where 581 patients had consecutively completed active orthodontic treatment in Sulaimani Governorate, those patients were asked to complete self-administered questionnaires, only 500 patients were included (178 males and 322 females; mean age, 25.5; standard deviation [SD], 9.5. All the patients were treated with full fixed appliances, some in combination with removable and functional appliances. (57.2%) were very satisfied with the orthodontist, (33.8%) were very satisfied with improvement in the facial appearance, 80.8% were very satisfied with improvement in alignment of teeth, 24.8% were very satisfied with improvement in chewing, 43% were very satisfied with improvement in cleaning, 24 4.8% were very satisfied with the color of the teeth, 29% were very satisfied with the speech quality, 32.4% were very satisfied with the total treatment time, 39.8% were very satisfied with the number of visits per month, 8.4% were very satisfied with time that one appointment lasts, 1.4% were very satisfied with waiting time at each appointment, 21.8% were very satisfied with the service of orthodontic staff in clinic or hospital.
Conclusions: Personality and satisfaction were correlated, but no correlation was found between gender and patient satisfaction. Also, patients with high neuroticism scores who treated orthodontically were linked with lower levels of satisfaction with the dentition. Beside satisfaction with oral comfort, general performance, eating capacities, and pain dimensions during orthodontic treatment had definitive effects on total satisfaction. On the other side, most of them were unsatisfied with waiting for each appointment.

7- Effect of different bonded base materials on the fracture resistance and failure mode of complex cavity of endodontically treated premolars. (An in Vitro Study)
     Gollshang A. Mhammed, Bestoon M. Faraj, Rukhosh H. Abdalrahim & Mohammed A. Mahmood


Objectives: Objective: The aim of this study was to evaluate the effect of different bonded base materials on fracture resistance of endodontically with complex cavities, and the assessment of the mode and type of fracture of each experimental group.
Materials and Methods: Fifty freshly extracted, intact, non-carious human maxillary second premolar teeth with similar anatomic characteristics were selected, the teeth were classified according to their mesiodistal and buccolingual dimensions into five groups. Endodontic treatment performed for all the groups except Group 1
Group 1 intact teeth (control group).
Group 2 unrestored teeth with endodontic treatment.
Group 3 endodontically treated as in group 2 and restored with (smart dentine replacement) SDR bulk-fill.
Group 4 restored with Vertise flow self-adhering flowable composite with optibond technology.
Group 5 endodontically treated as in group 2 and restored with GC EQUIA Fill.
The cavities in group 3,4 and five were then filled with Filtek Z250XT composite. Fracture resistance testing: All specimens were subjected to axial compressive loading until fracture in Hydraulic Universal Testing Machine (WDW 2006, China). The force required fracturing each tooth was recorded in kilo-Newtons. Assessment of fracture type and mode: After using ink perfusion of each sample for 5 min. Macroscopic fracture patterns were observed.
Results: the results showed that the mean fracture load values were (1.94, 1.61, 1.79, 1.91 and 1.89 Kn) for each group from group1 to group 5 respectively. The mean fracture load value recorded by each material (group3, 4 and 5) was near the mean value of the sound intact tooth (group 1) which means that all of the bonded base materials used in this study can improve the fracture resistance of the endodontically treated teeth to a great extent. Although the group 4 (self-bonded Vertise flow base material) showed the highest value of the other materials (group 3 and 5), there were no significant statistical differences.
Conclusion: The results predict that the three types of bonded base materials can increase the fracture resistance of the endodontically treated teeth to different extents depending on their bonding mechanisms and physical characteristics.

8- Correlations of the number of emerged primary teeth with physical growth among Kurdish children 
      Dilsoz A. Ali, Niyaz O. Muhammad, Arass J. Noori & Fadil A. Kareem


Objectives: The need for deeper understanding of the influence of growth parameters on the human dentition is of importance for the dental as a well as forensic specialists. The present study tries to provide reference data on normal dental development and to evaluate the influence of age, gender, weight, and height on the number of erupted primary teeth among Kurdish population.
Materials and Methods: A cross-sectional study was carried out over the course of 10 months involving a clinical oral examination, and weight and height measurements of 867 children from patients of health care center in Sulaimani city. All measurements were carried out following standardized guidelines according to the Anthropometric Standardization Reference Manual. A tooth is counted as erupted if any part of its crown has emerged through the gingiva of the oral cavity.
Results: A total of 867 children aged 4-48 months were examined for this study and the numbers of children were categorized in 3-month interval age groups. The overall mean age (±S.D.) of the children was 17.1  ±  10.9 months (Males, 17.5  ±  10.8; Females, 16.7  ±  10.8). The total number of erupted teeth increased with age with a mean number of erupted teeth of 8.6 teeth/child (For Males: 9.1 teeth/child and for Females: 8.1 teeth/child). Males had more teeth than females by an average of about one tooth per child (P<0.05). Partial correlation coefficients of the total numbers of erupted teeth were positively significant with both height and weight while controlling for age in both males and females (P<0.001). Furthermore, the same results were present, when Z-scores for length/height for age and weight for age were partially correlated with the total number of erupted deciduous teeth while controlling for age (P<0.01).
Conclusions: According to the results of the present study and the data presented; it can be concluded that there is a relation between gender, height and weight and the total number of erupted primary teeth.

9- Comparison of Topical Metronidazole, Ciprofloxacin, Cimetidine, and Meloxicam Treatment in Plaque- Induced Gingivitis
      Hiwa K. Saaed & Sara A. Muhammad


Objectives: The aim of the present study was to evaluate and compare the clinical effectiveness of newly prepared topical dosage forms as an adjunct to scaling and polishing (S & P) in plaque-induced gingivitis.
Materials and Methods: The study was conducted on 75 patients (35 males and 40 females) with a moderate to severe gingivitis randomly divided into five groups, each including 15 patients. In each group, the patients received (S & P) plus one of the oral gels (1% metronidazole, 1% ciprofloxacin, 1% cimetidine, 0.5% meloxicam) twice daily for seven days, except group 0 which were treated by (S & P) alone without any drug application. All the patients were evaluated before treatment and 7 days after treatment for plaque index [PLI], gingival index [GI], and bleeding on probing [BOP] and biochemical parameters (salivary enzymes) like aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), and lactate dehydrogenase (LDH).
Results: There was a significant improvement following all treatments type when compared to pretreatment records with minor differences in the effects of treatment modalities on the clinical parameters (PLI, GI, and BOP). Combination therapy of (S & P) plus ciprofloxacin gel resulted in the best improvement of PLI and BOP whereas the highest significant improvement in GI was with the combination therapy of (S & P) plus cimetidine gel. Similarly, AST, ALT, CK, and LDH significantly reduced in all five groups, with the most observed reduction of both AST and CK was found in the combination therapy of metronidazole gel along with (S & P). The highest decrease in ALT and LDH was observed with the combination therapy of cimetidine gel along with (S & P).
Conclusion: The above studies revealed that adjunctive use of topical gels particularly ciprofloxacin and cimetidine along with (S & P) results in significant benefits in the treatment of plaque-associated gingivitis.