Variables That Affect the Ability to Find the Second Mesiobuccal Root Canals in Maxillary Molars.

Introduction: The study aimed to investigate the influence of various factors on the localization of the second mesiobuccal (MB2) canal in maxillary molars, a commonly missed canal during endodontic treatment. Materials and Methods: A comprehensive assessment of maxillary molars treated over three years with a dental operative microscope was conducted. Factors such as patient gender, age, tooth type, pulp status, pre-operative cone-beam computed tomography (CBCT), and treatment modality were examined. Statistical analyses included chi-square and multiple logistic regression. Results: Among 333 treated maxillary molars, the MB2 canal was identified in 60.1%. The prevalence of MB2 canals was significantly higher in the first molars (72.3%) compared to the second molars (40.2%; P=0.001). Multiple logistic regression models showed that gender, tooth type, and treatment modality emerged as significant determinants of MB2 canal localization: males [odds ratio 3.01(CI 95%:1.71-5.32), P<0.001], first molar tooth [odds ratio 4.26 (CI 95%:2.53-7.18), P<0.001] and secondary endodontic treatment [odds ratio 0.06 (CI 95%: 0.004-0.890), P<0.04]. Conclusions: Patient gender, tooth type, and treatment modality play pivotal roles in the identification of the MB2 canal. Additionally, the availability of pre-operative CBCT imaging was associated with a heightened ability to locate the MB2 canal.

Effect of Administration of Lidocaine at Body Temperature on Anesthesia Success in Rodent Model: A Behavioral and Electrophysiology Study.

Introduction: Success in anesthesia administration relieves the perception of pain during surgery. Lidocaine is the most commonly used local anesthetic agent in clinical medicine. Moreover, anesthetic agents' temperature changes can influence cell membrane permeability. Here, the effectiveness of different temperatures of Lidocaine (Lid.) on anesthesia success rate has been investigated in rats. Methods: Wistar male rats were pretreated by fast injection of lidocaine or saline into the hind paw or intradermal cheek at Room Temperature (RT) and Body Temperature (BT) (22°C and 37°C, respectively). Then, rat behaviors were evaluated by formalin-induced hind paw pain and orofacial pain tests, respectively. Moreover, using a single-unit recording technique, the spontaneous activity of the marginal nerve was recorded at room temperature in the RT-Lid. and BT-Lid. groups. Results: Data analysis revealed that lidocaine had significant antinociceptive effects in both the BT-Lid. and RT-Lid. groups compared to the control groups (P<0.05). Also, the number of spikes in the BT-Lid. and RT-Lid. groups were significantly lower than their baselines (P<0.05). However, lidocaine at body temperature decreased the total time spent licking the hind paw, the number of lip rubbings, and the number of spikes firing by about 10%-15% compared to room temperature. Conclusion: In both behavioral and neural levels of the study, our results showed that an increase in the temperature of lidocaine toward body temperature could increase anesthesia success rate compared to administration of lidocaine at room temperature. These findings can be considered in the treatment of patients. Highlights: Lidocaine at body temperature acted better than room temperature on pain control in the formalin-induced hind paw test.Lidocaine at body temperature acted better than room temperature on pain control in the orofacial formalin test.Lidocaine with different temperatures decreased the firing rate of the marginal nerve. Plain Language Summary: Pain is defined as an unpleasant experience caused by tissue damage or fear of injury. During anesthetic injection in dentistry, pain has long been one of the problems of dentists. Studies have shown that one out of every three people is worried about going to dentistry, and one of four dental patients is afraid of injections. The fear of a patient in one of twenty patients is so much that interferes with dental treatment which consequently leads to stress when you visit the dentist, results in less oral hygiene and reduces the number of referrals. Lidocaine is the most commonly used local anesthetic agent in clinical medicine. Here, the effectiveness of different temperatures of lidocaine on anesthesia success rate in rats has been investigated in rats. The present study showed that warming the lidocaine cartridges to 37°C increased anesthesia success compared to anesthesia-induced at room temperature in both behavioral and neural levels of the study. Accordingly, a warmed anesthetic cartridge could be used to control pain by increasing the success rate during dental injection and designed a new animal model study for further investigation in comparing other anesthesia drugs.

Determinants of oral-health-related quality of life among adult people in Iran.

Background: Oral health-related quality of life (OHRQoL) assesses the subjective perception of oral health and its impact on the quality of life. The aim of this study is to measure the OHRQoL and its determinants among adult people living in Kerman, Iran. Materials and Methods: In this cross-sectional study, a total of 5657 adult people (18-64 years) residing in the Kerman district, both in the rural and urban areas, were enrolled in the study between September 2014 and April 2018. The Oral Health Impact Profile (OHIP-14) and the oral health indices, such as the total decayed, missing, filled teeth (DMFT), community periodontal index (CPI), gingival index (GI), and xerostomia, were measured by an experienced dentist. The demographic variables of gender, age, educational status, and marital status were also recorded. The impact of the studied variables on OHRQoL was evaluated with multiple logistic regression. Results: Participants were 2239 (39.58%) men, and average age was 45.39. The mean scores for OHRQoL, DMFT, CPI and GI were respectively: 24.07 (7.76), 10.7 (6.86), 0.76 (0.96), 0.63 (0.8). The frequency of people with xerostomia was 37.4. 301 (53.3%) of people had poor quality of life related to oral health. In multivariable analysis, there was a statistically significant increase in OHRQoL with an increase in the DMFT (P < 0.001), xerostomia (P < 0.001), CPI, (P < 0.001). Men had a significantly higher OHIP score than women (P < 0.001). Conclusion: According to the results of this study, DMFT, xerostomia, and CPI scores are strongly related to OHIP scores. In addition, between CPI and GI scores, the CPI score is the better predictor.

The Effect of the Anatomic Variables on the Success Rate of Anesthesia in Maxillary Molars with Irreversible Pulpitis.

INTRODUCTION: Obtaining anesthesia of teeth with irreversible pulpitis is 1 of the most challenging issues in endodontic practice. The aim of this study was to evaluate the effect of anatomic variables on the success rate of anesthesia in maxillary molars with irreversible pulpitis. METHODS: Patients who had maxillary molars with irreversible pulpitis and who had already had a cone-beam computed tomographic (CBCT) scan performed were included in this study. After infiltration injection of an anesthetic solution, the success rate of anesthesia was recorded by asking the patients to rate their pain during access cavity preparation and root canal instrumentation as well as their need for a supplementary injection during the treatment. The distance of the palatal root to the buccal cortical plate was calculated using the Romexis Viewer (Planmeca, Helsinki, Finland) measuring tools in both the axial and coronal views. Data were analyzed by chi-square and t tests as well as receiver operating characteristic curve analysis. RESULTS: Forty-seven maxillary first and second molar teeth were eligible to be included in this study. The overall success rate of anesthesia was 63.80%. The palatal roots that had their apex located more than 12.34 mm from the buccal cortical plate in the axial view, and 12.46 mm in the coronal view had a higher chance of anesthesia failure compared with the teeth with smaller distances. The presence of the maxillary sinus between the cortical plate and roots had no significant impact on the efficacy of anesthesia (P > .05). CONCLUSIONS: The potential of anesthesia failure during the treatment of irreversible pulpitis in maxillary molars with a divergent palatal root is significantly higher than in teeth with shorter distances from the palatal root apex to the buccal cortical plate. If a patient already had a CBCT scan done for other reasons or the CBCT is available in his or her records, a dental practitioner can use it to predict anesthesia success for maxillary molars with irreversible pulpitis.

The impact of diabetes on cutaneous leishmaniasis: a case-control field assessment.

This study aimed to assess the associated-risk determinants for cutaneous leishmaniasis (CL) in patients with diabetes mellitus (DM) compared to patients without DM. This case-control study was performed between 2017 and 2019 in southeastern Iran. Overall, 206 participants were selected from patients with DM without CL (11.2%), patients with CL without DM (6.2%), and DM patients concomitance with CL (27.6%) as case groups and healthy individuals as a control group 64 (76%). These cases were compared for parasitological, immunological, biochemical, and hematological parameters. The findings demonstrated that parasitological factors regarding the number, duration, and size of the lesion in CL patients showed a significant difference among patients with and without DM (p < 0.05). Data analysis showed that six major risk factors, including female (odds ratio (OR) = 3.47, confidence interval (CI) = 1.84-6.53, p < 0.001), total protein in CL group (OR = 4.9, CI = 2.3-10.44, p < 0.001), alanine aminotransferase (ALT) concentration in CL group (OR = 0.87, CI = 0.81-0.93, p < 0.001) and DM co-infected with CL group (OR = 0.8, CI = 0.72-0.88, p < 0.001) than healthy group, aspartate aminotransferase (AST) concentration in DM group (OR = 0.86, CI = 0.76-0.98, p = 0.02), transforming growth factor beta)TGF-ß( level in the CL group (OR = 1.03, CI = 1.003-1.05, p = 0.02), and presence of diabetes disease (OR = 2.07, CI = 1.16-3.7, p < 0.05), were significantly linked with the induction of CL lesion. The findings demonstrated a significant relationship between DM and CL in distinct risk determinants. Also, the study revealed that DM enhanced the severity of active CL.

The effect of demographic characteristics on the relationship between smoking and dry mouth in Iran: a cross-sectional, case-control study.

OBJECTIVES: The effect of age, sex, and other demographic factors on the relationship between smoking and dry mouth remains unknown. The aim of this study was to investigate the effects of demographic characteristics on the relationship between dry mouth, also known as xerostomia, and smoking. METHODS: This case-control study included 5,640 randomly-selected subjects from the second phase of the Kerman Coronary Artery Disease Risk Factors Study, which observed 10,000 participants from 2014 to 2018. A checklist was used to record the participants' demographic characteristics and smoking frequency. Each participant completed a six-item Fox questionnaire to measure dry mouth as a dependent variable. The interaction terms of daily cigarette smoking with sex, age, educational level, and marital status were entered into the model. Non-significant terms were removed using hierarchical model selection. RESULTS: Of the sample, 3,429 (60.8%) did not have dry mouth and were analyzed as controls, whereas 2,211 (39.2%) had xerostomia and were deemed to be cases. Smokers were more likely to have dry mouth in all ages and both sexes (p < 0.001). As male became older, the chance of having dry mouth increased more rapidly than among female smokers (p < 0.001). In addition, female smokers were more likely to have dry mouth than male smokers (p < 0.001). CONCLUSIONS: The likelihood of dry mouth among daily smokers depended on age and sex. Female smokers were more likely to have dry mouth, and its likelihood increased with age in daily smokers of both sexes, though more rapidly in males.

Oral Health Determinants among Opium Users in Kerman, Iran.

BACKGROUND: Promoting oral health is a complicated issue among drug abusers and opium is the most frequent drug abused in Iran. This study aims to find the oral health determinants of opium users in Kerman, Iran. METHODS: This cross-sectional study was a part of the second phase of Kerman coronary artery disease risk factors study (KERCADRS, 2014-2018). In this survey, the data of 1140 opium users were analyzed. The information about using a toothbrush, dental floss, number of dental visits at last year, age of first use of opium, duration, and opium consumption frequency was recorded. The total number of decayed, missing, and filled teeth (DMFT) index and Community Periodontal Index (CPI) was recorded by an oral examination. Poisson and logistic regressions analyses were used for assessing the relationship among variables. FINDINGS: The mean age of participants was 52 ± 12 years. 74.4% were men and 24.6% were women. The average DMFT index was 15.7 ± 7.6 and the prevalence of a healthy CPI score was 18.5%. Educational level (P < 0.001), brushing (P < 0.001), flossing (P < 0.001), dental visit (P < 0.001), first age of using opium (P < 0.001), frequency of consumption (P < 0.001), and age (P < 0.001) were associated with DMFT index. Only using floss (P < 0.001), dental visit [odds ratio (OR) = 1.80, P = 0.030], frequency of consumption (OR = 2.92, P < 0.001), and age (P = 0.001) were associated with CPI score. CONCLUSION: The frequency of opium consumption has the same effect on caries incidence as oral hygiene habits. Moreover, using dental floss has a more significant effect on the periodontal health of participants.

The Knowledge and Attitude of Diabetic Patients Regarding Oral and Dental Disorders in Kerman Diabetes Clinics.

STATEMENT OF THE PROBLEM: Diabetes mellitus is one of the most common endocrine disorders. This disease has devastating effects on many organs and tissues of the body including oral and dental tissues. PURPOSE: The aim of this study was to evaluate the knowledge and attitude of diabetic patients about dental and oral diseases. MATERIALS AND METHOD: In this cross-sectional study, 433 diabetic patients who referred to Kerman Diabetes Clinics were included. Data were collected using a questionnaire consisted of three parts of demographic characteristics, knowledge of oral and systemic complications of diabetes mellitus, and patients' attitude regarding their oral health. Data were analyzed using SPSS version 21 and employing t-test and multiple linear regression analysis. Statistically significant values were considered at p≤ 0.05. RESULTS: The mean scores for the knowledge of systemic and oral complications were 0.80±0.21 and 0.39±0.23, respectively. The mean total knowledge of diabetic patients was 0.53±0.18, and the mean score for the patients' attitude was 0.63±0.11. It was revealed that people with a family history of diabetes did not have significantly greater overall knowledge (p= 0.082). Also, people with longer disease duration (p= 0.004) and female patients (p= 0.05) had significantly a better knowledge and attitude in terms of oral health. CONCLUSION: The knowledge and attitude of patients regarding their oral and dental health and diseases were at moderate level, which should be promoted by constant planning and education according to the current needs of society.

Prevention of secondary caries by a new antibacterial compound.

BACKGROUND: Since secondary caries is one of the main problems of dental composites. The creation of an antibacterial property in these composites is essential. The objective of this study was to synthesize 3-(2, 5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one and check its biocompatibility and antibacterial properties in flowable dental composites. MATERIALS AND METHODS: In this animal study, the antibacterial activity of flowable resin composites containing 0-5 wt% 3-(2,5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one was investigated by using agar diffusion and direct contact tests on the cured resins. Statistical analysis was performed using one-way ANOVA test (P < 0.001). Thirty male albino Wistar rats were used, weighing 200-250 g. Animals were randomly divided into three groups of ten; each animal received three implants, 3-(2, 5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one, penicillin V, and an empty polyethylene tube. A pathologist, without knowing the type of material tested and the timing of the test, examined the samples. Statistical analysis was performed using Kruskal-Wallis test (P < 0.001). RESULTS: According to our findings, although the agar diffusion test reveals no significant difference between the groups, the direct contact test demonstrates that, by increasing the 3-(2,5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one content, the bacterial growth was significantly diminished and the 3-(2,5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one has a good biocompatibility (P < 0.05). CONCLUSION: Incorporation of 3-(2,5-dimethylfuran-3-yl)-IH-pyrazole-5(4H)-one into flowable resin composites can be useful to prevent Streptococcus mutans activity.

Niosomal formulation of amphotericin B alone and in combination with glucantime: In vitro and in vivo leishmanicidal effects.

This study aimed to evaluate the efficacy of glucantime and amphotericin B (AmB) encapsulated in niosome against cutaneous leishmaniasis (CL) using in vitro and in vivo models. The niosomal formulations of the drugs alone and in combination were prepared and characterized. Subsequent to the examination of their cytotoxicity, their efficacy was evaluated using an in vitro MTT assay, macrophage model, flow cytometry, and gene expression profiling. For evaluation of therapeutic effect of niosomal combination on the lesion induced by Leishmania major in inbred BALB/c mice, the size of lesions and number of parasites in spleen was assessed. The niosomal formulations demonstrated significantly greater inhibitory effects compared with the non-niosomal forms when the IC50 was considered. The niosomal combination showed an increase in the apoptotic values and gene expression levels of IL-12 and metacaspase and a decrease in the levels of IL-10 with a dose-response effect. The niosomal combination was also effective in reducing the lesion size and splenic parasite burden in mice. Our findings indicated that there is a synergistic effect between AmB and glucantime in niosomal form in the inhibition of intracellular and extracellular forms of L. tropica. Additionally, the in vivo results on L. major suggest that topical niosomal formulation could be useful in the treatment of CL.

A Novel Niosomal Combination of Selenium Coupled with Glucantime against Leishmania tropica.

There is no effective treatment modality available against different forms of leishmaniasis. Therefore, the aim of this study was to improve the penetration and efficacy of selenium and glucantime coupled with niosomes and compared them with their simple forms alone on in vitro susceptibility assays. In this study, the niosomal formulations of selenium and in combination with glucantime were prepared. The size and morphology of the niosomal formulations were characterized and the effectivity of the new formulation was also evaluated using in vitro MTT assay, intra-macrophage model, and gene expression profile. From the results obtained, no cytotoxicity effect was observed for niosomal and simple forms of drugs, as alone or in combination. Niosomal formulations of the drugs significantly showed more inhibitory effects (P ≤ 0.001) than the simple drugs when the selectivity index was considered. The gene expression levels of Interleukin (IL-10) significantly decreased, while the level of IL-12 and metacaspase significantly increased (P ≤ 0.001). The results of the present study showed that selenium plus glucantime niosome possess a potent anti-leishmanial effect and enhanced their lethal activity as evidenced by the in vitro experiments.

The Effect of Mineral Trioxide Aggregate Mixed with Chlorhexidine as Direct Pulp Capping Agent in Dogs Teeth: A Histologic Study.

INTRODUCTION: The aim of the present investigation was to compare the efficacy of mineral trioxide aggregate (MTA) and 0.2% chlorhexidine (CHX) mixture to pure MTA, as a pulp capping material. METHODS AND MATERIALS: The pulp of 24 lateral incisors and canines from four dogs were exposed and capped either with MTA or MTA+0.2% CHX. After 2 months the animals were sacrificed and the teeth were prepared for histological evaluation in terms of calcified bridge formation, the degree of inflammation and presence of necrosis. The Fisher's exact test was used for data analysis. RESULTS: The results showed that formation of complete calcified bridge in MTA specimens was significantly more than MTA+CHX (P<0.05). No significant difference was found in the degree of inflammation and necrosis between MTA and MTA+CHX groups (P>0.05). CONCLUSION: Mixing MTA with CHX as pulp capping agent had a significant negative impact on formation of calcified bridge on directly capped dog's teeth.

Indexing of Iranian Publications in Well-known Endodontic Textbooks: A Scientometric Analysis.

INTRODUCTION: Quoting an article in well-known textbooks is held as a credit for that paper. The numbers of Iranian publications mentioned in endodontic textbooks have increased during recent years. The aim of this investigation was to evaluate the number of Iranian articles quoted in eminent endodontic textbooks. METHODS AND MATERIALS: Three known textbooks (Ingle's Endodontics, Seltzer and Bender's Dental Pulp and Cohen's Pathways of the Pulp) were chosen and all the editions of the textbooks since 2000 were investigated for quoted Iranian publications. Only Iranian authors with affiliations from a domestic university were chosen. All references at the end of each chapter were read by hand searching, and results were noted. The trend and percentage of Iranian publications in different editions of the textbooks were also calculated. The number of citations of these publications in Google Scholar and Scopus databases were also obtained. RESULTS: The number of Iranian publications in all well-known textbooks have notably increased since 2000. The number and percentage of Iranian publications in the latest edition of Cohen's Pathways of the Pulp was higher compared to other textbooks as well as the previous edition of the same text. CONCLUSION: Number and percentage of Iranian publications in the field of endodontics in all three textbooks have remarkably increased since 2000.

Prevalence of toothache and associated factors: a population-based study in southeast iran.

INTRODUCTION: This study was carried out to estimate toothache prevalence among adult residents in Kerman. MATERIALS AND METHODS: This cross-sectional, population-based study was conducted among individuals aged over 18 years (n=1800). The relevant data on the prevalence of toothache and associated factors were collected by interviewing the individuals in their homes and filling out a questionnaire designed by the examiners. Prevalence of toothache and associated factors that patients recalled previous to their interview were analyzed by chi-square test and multivariate logistic regression analysis. RESULTS: Nine hundred ninety-one individuals (55.1%) reported toothache during the 6 months before the interview. The participants who flossed daily, had regular dental visits, and had higher education showed a significantly lower prevalence of toothache (P<0.05), whereas regular tooth brushing and economic level of residency had no significant effect on the prevalence of toothache. Individuals between the ages of 26 and 45 [odds ratio (OR)=2.0], with a family size of more than 4 (OR=1.5), not using dental floss (OR=1.5), or having a mental or psychological illness (OR=1.5) were more likely to have a history of toothache. CONCLUSION: High prevalence of toothache (more than half) among residents of Kerman shows a serious and major public health problem. Toothache prevalence in middle aged adults, lower education, bigger family size, lower dental hygiene habit and/or those having mental or psychological illness were more common in the city of Kerman.

The frequency of medically compromised patients in endodontic offices in iran.

INTRODUCTION: As the result of epidemiological transition and aging of Iranian population, the frequencies of systemic diseases among patients in of need endodontic treatment has increased, especially within developed cities. However, there have been no concise reports of systemic diseases in Iranian patients. Based on this need, the present investigation was conducted to assess the frequency of systemic disease among patients referred to endodontic private practice in three main cities in Iran. MATERIALS AND METHODS: In a retrospective study, the frequency of systematic diseases were abstracted from the health records of patients who were referred to three private practices limited to endodontics in Kerman, Mashhad, and Tehran between 1994 to 2011. RESULTS: Overall, 15,413 records of patients were assessed. The patterns of systematic diseases among endodontic patients in these three cities were different. The overall frequency of systemic disease in Kerman was significantly higher than two other cities (Kerman: 55.03%, Mashhad: 24.32%, Tehran: 22.16%; P<0.001). The most commonly occurring diseases were cardiac disease, hypertension, allergy and neurological disorders. CONCLUSION: Since the number of endodontic patients with systematic diseases is considerably significant and varied, special training and educations for treatment of medically compromised patient should be considered at both post- and undergraduate training.

A comparative in vivo study of tissue reactions to four suturing materials.

INTRODUCTION: The purpose of this study was to compare the histopathologic reaction of four suturing materials: silk, polyvinylidene fluoride (PVDF), polyglycolic acid, and catgut in the oral mucosa of albino rabbits. MATERIALS AND METHODS: The twenty-one male mature albino rabbits which were used in this study were randomly divided into three groups of seven each. Silk, PVDF, polyglycolic acid and catgut suture materials were tested in the oral mucosa of these animals. The animals were sacrificed 2, 4, and 7 days after suturing. Two pathologists evaluated the samples by determining the presence and level of inflammation, granulation tissue, and fibrosis formation. Data were statistically analyzed by Kruskal Wallis and Mann-Whitney U tests. RESULTS: Histological features of the samples showed that PVDF and plain catgut suture materials produced more fibrous tissue (favorable response) on the fourth day in comparison with silk suture (P=0.02). Also, in the 7-day samples PVDF sutures produced the mildest inflammation when compared with the silk sutures (P=0.015). CONCLUSION: According to the results of this study, it can be convey that PVDF suture materials created mild tissue reactions and can be a reasonable candidate for suturing oral tissues.