Mandana Naseri - Academia.edu (original) (raw)
Papers by Mandana Naseri
Objectives Dental anxiety often leads to avoidance of patients which may result in significant de... more Objectives Dental anxiety often leads to avoidance of patients which may result in significant deterioration of oral health. Non-pharmacological interventions such as music are increasingly used in dental care. The purpose of this study was to investigate the effect of relaxing music on the stress and anxiety level of dental patients. Methods In this study, 40 adult patients were randomly divided into two groups of music and control (no intervention). Each group included 10 females and 10 males. Subjects in the music group listened to relaxation music throughout their dental procedure while the control group did not. Pre-and post-tests were performed using the Spielberger's State-Trait Anxiety Inventory (STAI) and Hari's stress questionnaire in both groups. Results There were no significant differences between the two groups for baseline data. The mean age of patients in the music and control groups was 37.70±9.29 years and 39.05±5.36 years, respectively. Comparison of moderated means in the intervention and control groups showed that listening to relaxation music caused a reduction in the mean scores of STAI (x=7.746, SE=416, P<0.05) and stress (x=7.746, SE=2.103, P<0.01) in the intervention compared with the control group. Conclusion This study indicated that relaxing music can decrease the state anxiety and stress of dental patients.
Objectives Canine teeth are supposed to have one single root canal, but they may have some anatom... more Objectives Canine teeth are supposed to have one single root canal, but they may have some anatomical variations. This study aimed to investigate the morphology of root canals of maxillary and mandibular canines regarding gender and age in an Iranian population using cone-beam computed tomography (CBCT). Methods Using CBCT images, 126 maxillary and 125 mandibular canines were evaluated. Root anatomy was assessed regarding root length, root curvature, number of roots and canals, and pattern of root canal system. The data were analyzed by the Kruskal Wallis and Mann-Whitney tests and multinomial regression model. Results The mean root length of male patients was significantly higher than females (p=0.0001). The most frequent root curvatures were towards the distal and buccal. Mandibular teeth (p=0.020) and females (p=0.012) had higher frequency of root curvature. All maxillary canines had one root; whereas 1.6% of mandibular canines had two roots. High prevalence of two canals was reported (34.9% of maxillary and 18.4% of mandibular canines). The most prevalent canal patterns included type I (65.1%) followed by type III (34.9%) in maxillary canines and types I (81.6%), III (16.8%) and V (1.6%) in mandibular canines. Higher frequency of type III canal configuration was reported in maxillary teeth (p=0.001) and male patients (p=0.008). No significant difference was found in any parameter between different age groups (p>0.05). Conclusion A high percentage of type III canal configuration in canine teeth especially maxillary canines and male patients was reported. Mandibular teeth and females had higher frequency of root curvature.
PubMed, 2023
Endodontic therapy of dens invaginatus (DI) anomalies is challenging due to difficult access, ina... more Endodontic therapy of dens invaginatus (DI) anomalies is challenging due to difficult access, inadequate cleaning and shaping, and incomplete disinfection of its complicated root canal system. The present case report describes the treatment of tooth #10 with tooth discomfort, intermittent pus discharge, and localized swelling. Sinus tract, mobility, and probing grade 1 were observed. The tooth was tender on palpation and percussion with negative responses to pulp sensibility tests. Radiographic assessments revealed an atypical structure of pulpal anatomy, probably dens invaginatus, associated with a large periapical lesion and severe root curvature. Cone-beam computed tomography confirmed the presence of DI type II. Finally, the diagnosis of pulp necrosis with chronic apical abscess of tooth #10 was made. Combining antimicrobial photodynamic therapy as an adjunctive treatment with different irrigation techniques were effective in nonsurgical endodontic management of the complicated DI type II in a maxillary lateral incisor with a large periradicular lesion and severe root curvature. Six-month and one-year recall radiographic images revealed asymptomatic tooth and progressive osseous healing.
PubMed, Nov 1, 2016
Objectives: It is essential for clinicians to have adequate knowledge about root canal configurat... more Objectives: It is essential for clinicians to have adequate knowledge about root canal configurations; although its morphology varies largely in different ethnicities and even in different individuals with the same ethnic background. The current study aims to review the root canal configurations of mesiobuccal roots of maxillary first molars in an Iranian population based on different epidemiological studies. Materials and methods: A comprehensive search was conducted to retrieve articles related to root canal configuration and prevalence of each type of root canal based on Vertucci's classification for the mesiobuccal root of maxillary first molars. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. The articles were evaluated and methods, population, number of teeth and percentage of each root canal type evaluated in each study were summarized in the data table. Websites such as http://www.magiran.com/ , http://health.barakatkns.com/journal-internal-list and www.sid.ir were used to search all related studies published in Persian. Results: Totally, out of nine studies conducted on the Iranian populations in nine provinces of Iran and 798 teeth, the Vertucci's type I was the most common type (35.70%), followed by type II (30.37%), type IV (16.66%), type III (7.93%) and type V (2.61%). Conclusions: From this review article, it is concluded that the root canal morphology of mesiobuccal roots of maxillary first molars in the Iranian population predominantly has more than one canal. Therefore, careful evaluation of radiographs and anatomy of the pulp chamber is essential in order to achieve a successful root canal therapy.
PubMed, 2016
Introduction: The conventional method of teaching endodontics has some drawbacks. Due to the smal... more Introduction: The conventional method of teaching endodontics has some drawbacks. Due to the small size of the oral cavity, students cannot closely observe the clinical procedure. Use of new teaching modalities such as the intraoral camera may obviate this problem. This study assessed the effect of video-assisted clinical instruction in dentistry (VACID) on dental student's knowledge and performance in access cavity preparation during endodontic treatment. Methods and materials: In this interventional study, twenty six undergraduate students were equally divided into two groups and received instructions on access cavity preparation via conventional demonstration (CD) or VACID using intraoral camera plus conventional demonstration. Students' knowledge was assessed before and after the demonstration. The scores obtained by students were compared between the two groups. Data were analyzed using the Mann Whitney U test. Results: No significant difference was found between the two groups in knowledge and performance scores of students about pulp chamber removal, under-extension, over-extension, gouging, perforation or finding the main and extra canals. However, use of intraoral camera significantly reduced the number of student visits to instructors for problem solving (P=0.001). Conclusion: VACID is an effective educational method and as efficient as conventional demonstration in endodontics; as a result it can be used in combination with conventional teaching.
PubMed, 2017
Introduction: The purpose of this study was to assess the accuracy of sensibility tests by correl... more Introduction: The purpose of this study was to assess the accuracy of sensibility tests by correlating it with histologic pulp condition. Methods and materials: Assessment of clinical signs and symptoms were performed on 65 permanent teeth that were scheduled to be extracted for periodontal, prosthodontic or orthodontic reasons. The normal pulp and reversible pulpitis were considered as treatable tooth conditions while irreversible pulpitis and necrosis were considered as untreatable conditions. The teeth were then extracted and sectioned for histological analysis of dental pulp. Histologic status and classification corresponded to the treatable or untreatable pulp condition. Comparisons between histological treatable and untreatable pulp condition were performed with chi-square analysis for sensibility test responses. The positive predictive value (PPV), negative predictive value (NPV) and accuracy to detect untreatable from treatable pulp condition were calculated for each test. Results: A significant difference was detected in the normal and a sharp lingered response to heat and cold tests. There was significant difference in the negative response to EPT between histological groups. The kappa agreement coefficient between clinical and histological diagnosis of pulp condition was about 0.843 (P<0.001). The accuracy of cold and heat tests and EPT to detect treatable pulp or untreatable pulp states were 78, 74 and 62%, respectively. The sensibility tests diagnosed untreatable pulpitis with a higher probability (NPV=63%-67% -54%, PPV=83%-91% -95% for heat, cold and EPT, respectively). Conclusion: Sensibility test results were more likely to diagnose pulpal disease or untreatable pulp conditions. However, to increase the diagnostic accuracy patient history, clinical signs and symptoms and also radiographic findings in conjunction with sensibility tests must be used. The result of this small study demonstrated a good agreement between clinical and histological pulp diagnosis.
PubMed, 2018
Introduction: This study sought to assess root canal morphology of maxillary second molars regard... more Introduction: This study sought to assess root canal morphology of maxillary second molars regarding age and gender in an Iranian population using cone-beam computed tomography (CBCT). Methods and materials: Totally, 157 maxillary second molars of patients presenting to a radiology clinic were evaluated on CBCT scans. Tooth length, number of roots, root fusion, coronal and sagittal root deviation, number of canals per root, prevalence of second mesiobuccal canal, root canal morphology according to the Vertucci's classification and the correlation of these variables with age and gender were evaluated. Data were analyzed using the Mann Whitney U, Kruskal Wallis and Fisher's exact tests. Results: Of 157 teeth, 98 belonged to females and 59 to males. The mean tooth length was significantly greater in males than in females (P=0.002) and it was shorter in 50-60 years old group. The rate of root fusion was 18.6%. Distobuccal and palatal roots were mainly straight in both sagittal and coronal planes while mesiobuccal roots mostly had a distal-buccal deviation; 67.5% of the teeth had four canals. Number of canals was significantly correlated with gender and was higher in males (P<0.05). The most prevalent canal type was type VI in second mesiobuccal, and type V in palatal and distobuccal canals. The most common types in mesiobuccal canal were types I, VI and II, respectively. In the remaining two roots, type I was the most common. Conclusion: Root and canal morphology of the maxillary second molars in Iranian population showed features different from those in other populations.
PubMed, 2013
Introduction: One of the key factors in successful endodontic therapy is to adequately fill the r... more Introduction: One of the key factors in successful endodontic therapy is to adequately fill the root canals. The aim of this in vitro study was to compare the quality of four different root canal obturation techniques: cold lateral condensation (CLC), warm vertical condensation (WVC), Obtura II (OII) and Gutta Flow (GF) by using micro-computed tomography (micro CT). Materials and methods: A total of 20 extracted maxillary first molars prepared with ProTaper files, were randomly divided into four groups. Micro CT was used to measure the internal volume of root canals. Following application of AH26 sealer to canal obturation, new micro-CT images were taken and the volume percentage (VP) of voids, gutta-percha and sealer at different levels were calculated with CT software. Data was statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests. Results: The highest percentage of filling material was observed in GF group followed by OII with no statistically significant difference (P>0.05). These two groups had a significantly more acceptable filling than WVC and CLC groups (P<0.05). Voids were detected in all samples. There was a significant difference between the highest and the lowest percentage of voids in CLC (19.6%) and GF groups (6.7%), respectively. In the apical third, CLC and OII showed the highest and the lowest percentage of voids (5.5% and 2.6%) and the lowest and highest percentage of gutta-percha (76.52% and 94.26%), respectively. These differences were statistically significant (P<0.05). Conclusion: None of the root canal filled teeth were gap-free. GF and CLC techniques showed the highest and lowest VP of obturation materials, respectively.
PubMed, 2016
Introduction: The purpose of this study was to investigate the root and canal morphology of maxil... more Introduction: The purpose of this study was to investigate the root and canal morphology of maxillary first molars with regards to patients' age and gender with cone-beam computed tomography (CBCT). Methods and materials: A total of 149 CBCT scans from 92 (67.1%) female and 57 (31.3%) male patients with mean age of 40.5 years were evaluated. Tooth length, presence of root fusion, number of the roots and canals, canal types based on Vertucci's classification, deviation of root and apical foramen in coronal and sagittal planes and the correlation of all items with gender and age were recorded. The Mann Whitney U, Kruskal Wallis and Fisher's exact tests were used to analyze these items. Results: The rate of root fusion was 1.3%. Multiple canals were present in the following frequencies: four canals 78.5%, five canals 11.4% and three canals 10.1%. Additional canal was detected in 86.6% of mesiobuccal roots in which Vertucci's type VI configuration was the most prevalent followed by type II and I. Type I was the most common one in distobuccal and palatal roots. There was no statistically significant difference in the canal configurations in relation to gender and age as well as the incidence root or canal numbers (P>0.05). The mean tooth length was 19.3 and 20.3 mm in female and male patients, respectively which was statistically significant (P<0.05). Evaluation of root deviation showed that most commonly, a general pattern of straight-distal in the mesiobuccal and straight-straight for distobuccal and palatal roots occurred. In mesiobuccal roots, straight and distal deviations were more dominant in male and female, respectively (P<0.05). The prevalence of apical foramen deviation in mesiobuccal and palatal roots statistically differed with gender. Conclusion: The root and canal configuration of Iranian population showed different features from those of other populations.
Journal of Endodontics, Sep 1, 2019
INTRODUCTION Calcium hydroxide (CH) and nano-calcium hydroxide (NCH) as intracanal medicaments ma... more INTRODUCTION Calcium hydroxide (CH) and nano-calcium hydroxide (NCH) as intracanal medicaments may affect the physical and chemical properties of dentin. The aim of this investigation was to evaluate the effects of CH and NCH on the microhardness and superficial chemical structure of radicular dentin. METHODS In this in vitro trial, 80 dentin discs were randomly assigned into 2 control and 2 treatment groups (n = 20). CH and NCH pastes were used in the treatment groups. In the control groups, the samples were washed with either normal saline or 2.5% sodium hypochlorite. After 1 and 4 weeks, dentin microhardness was assessed by the Vickers test, and the phosphate/amide I ratio was evaluated by the Fourier-transform infrared spectrometry test. The data were subjected to 1-way and 2-way analyses of variance, the Tukey multiple comparison test, and the Student t test. RESULTS A significant reduction in the mean microhardness was observed in the CH group after 4 weeks, whereas the differences were not significant in the NCH and control groups. The amount of reduction induced by NCH was comparable with hypochlorite. A significant increase in the mean phosphate/amide I ratio was observed in the CH and NCH groups compared with the sodium hypochlorite and intact control groups after 1 week, which did not change significantly during the observation period. CONCLUSIONS The use of CH as an intracanal medicament for 4 weeks reduced dentin microhardness, whereas NCH did not result in any change in the microhardness value. However, a change in the superficial chemical structure was observed earlier after 1 week and in both the CH and NCH groups.
Journal of lasers in medical sciences, Jun 21, 2019
Effect of low-level laser therapy with different locations of irradiation on postoperative endodo... more Effect of low-level laser therapy with different locations of irradiation on postoperative endodontic pain in patients with symptomatic irreversible pulpitis: a double-blind randomized controlled trial.
DOAJ (DOAJ: Directory of Open Access Journals), 2016
Objective: Pulp regeneration within the root canal of necrotic teeth is considered an ideal treat... more Objective: Pulp regeneration within the root canal of necrotic teeth is considered an ideal treatment to allow for continued root development and recover teeth vitality. This study aims to evaluate the inductive effect of platelet-rich plasma (PRP) on expression of angiogenesis factors and pulpal revascularization of immature necrotic teeth. Materials and Methods: In this experimental animal study, we randomly divided 28 immature premolars from two mixed breed dogs into four groups, two experimental, negative and a positive control. Premolars in negative control group were left intact to develop normally. In the positive control and experimental groups, we removed the pulps and induced pulp necrosis, after which the chambers were sealed. Then, we applied the revascularization protocol in the experimental teeth located in the right quadrant. Two months later, the same protocol was applied to the left quadrant. The root canals were disinfected by irrigation with sodium hypochlorite (NaOCl) solution and application a triple antibiotic past. Following the induction of a blood clot (BC) inside the canal space, the coronal portion of the canals was assigned to either of two experimental groups: group 1 [BC+PRP+ mineral trioxide aggregate (MTA)], group 2 (BC+MTA). Access cavities were sealed with a Glass Ionomer. The jaws that held the teeth were processed for histologic analysis of newly formed tissue and immunohistochemical evaluation according to vascular endothelial growth factor (VEGF) and factor VIII expressions in the canals. Results: Histological analysis demonstrated no significant difference in the formation of new vital tissue inside the root canals between groups1 (42.8%) and 2 (43.5%, P>0.05). Based on immunohistochemical evaluation, micro-vessel density (MVD) of the granulation tissues in both groups were similar and were higher compared with the normal pulp. We observed strongly positive expressions of VEGF and factor VIII in the stromal and endothelial cells, with severe intensity after one month. Both factors showed downregulation at three months postoperative. Conclusion: PRP could not increase the formation of new vital tissue. The immunohistochemical results showed that VEGF and factor VIII played a pivotal role in the formation of new vessels inside the root canals of immature, non-vital teeth.
Dental research journal, 2012
Background: Enterococcus faecalis has been widely used as a valuable microbiological pathogen for... more Background: Enterococcus faecalis has been widely used as a valuable microbiological pathogen for in vitro studies due to its ability to successfully colonize the root canal in a biofi lm-like style, invade dentinal tubules, and resist endodontic treatment procedures.The aim of this study was to compare the bactericidal effi cacy of photodynamic therapy (PDT), 2% chlorhexidine, 2.5% NaOCl, and combination of PDT and 2.5% NaOCl against E. faecalis. Materials and Methods: Sixty single-rooted teeth had their canals contaminated with E. faecalis in brain heart infusion broth and were incubated for 48 hours.The canals were then subjected to 2% chlorhexidine, 2.5% NaOCl, PDT (red light emitting diode 625 nm+ Toludine Blue) and PDT + 2.5% NaOCl. Controls consisted of no treatment (positive control) and without inoculation of bacterium (negative control). Following treatment, the canal contents were sampled with sterile paper points. The samples were dispersed in transport medium, serially diluted, and cultured on blood agar to determine the number of colony forming units (CFU). Data were analyzed by Mann-Whitney U test at 5% signifi cance level. The signifi cance level for all analyses was set at P <.05. Results: Combination of PDT and 2.5% NaOCl achieved maximum reduction in recovered viable bacteria, no viable bacteria was observed after treatment of PDT + 2.5% NaOCl. Conclusion: Combination of PDT and 2.5% NaOCl simultaneously is effective in the elimination of E. faecalis from dentinal tubules under the conditions of this study.
iranian endodontic journal, 2017
The purpose of this study was to assess the accuracy of sensibility tests by correlating it with ... more The purpose of this study was to assess the accuracy of sensibility tests by correlating it with histologic pulp condition. Methods and Materials: Assessment of clinical signs and symptoms were performed on 65 permanent teeth that were scheduled to be extracted for periodontal, prosthodontic or orthodontic reasons. The normal pulp and reversible pulpitis were considered as treatable tooth conditions while irreversible pulpitis and necrosis were considered as untreatable conditions. The teeth were then extracted and sectioned for histological analysis of dental pulp. Histologic status and classification corresponded to the treatable or untreatable pulp condition. Comparisons between histological treatable and untreatable pulp condition were performed with chi-square analysis for sensibility test responses. The positive predictive value (PPV), negative predictive value (NPV) and accuracy to detect untreatable from treatable pulp condition were calculated for each test. Results: A significant difference was detected in the normal and a sharp lingered response to heat and cold tests. There was significant difference in the negative response to EPT between histological groups. The kappa agreement coefficient between clinical and histological diagnosis of pulp condition was about 0.843 (P<0.001). The accuracy of cold and heat tests and EPT to detect treatable pulp or untreatable pulp states were 78, 74 and 62%, respectively. The sensibility tests diagnosed untreatable pulpitis with a higher probability (NPV=63%-67%-54%, PPV=83%-91%-95% for heat, cold and EPT, respectively). Conclusion: Sensibility test results were more likely to diagnose pulpal disease or untreatable pulp conditions. However, to increase the diagnostic accuracy patient history, clinical signs and symptoms and also radiographic findings in conjunction with sensibility tests must be used. The result of this small study demonstrated a good agreement between clinical and histological pulp diagnosis.
DOAJ (DOAJ: Directory of Open Access Journals), 2013
Because of the great challenges in the diagnosis and treatment of "C" configuration and lack of a... more Because of the great challenges in the diagnosis and treatment of "C" configuration and lack of any systematic information about its occurrence, the purpose of the present study is to determine the prevalence of C shaped root canals in Iranian population. Methodology: An exhaustive search was undertaken to identify published and unpublished researches related to the C-shaped canals by using key words. The search of the MEDLINE database included all publications from 1966 to May 2012.Then selected articles were obtained and reviewed. Data evaluated and summarized in the data sheet included methodology, population, number of teeth per study (power), number of root canals, type of root canal configuration, and cshaped canals. Results: Six studies were included with total of 1062 teeth, all in mandibular second molars. The total incidence of C-shaped canals in Iranian population was obtained 6.96%. Conclusions: The incidence of C-shaped canals in Iranian population is 6.96%, which seems much less than Asian populations but nearer to Middle East countries.
Journal of lasers in medical sciences, Oct 9, 2021
Introduction: This study assessed the effect of apical size and taper on the efficacy of root can... more Introduction: This study assessed the effect of apical size and taper on the efficacy of root canal disinfection with LED photodynamic therapy (PDT) as an adjunct to irrigation with sodium hypochlorite. Methods: A total of 126 extracted human mandibular molars were divided into 4 groups. The mesiobuccal canal was prepared to size 25/4% in group 1, 25/6% in group 2, 30/4% in group 3, and 30/6% in group 4 using the iRaCe rotary system. A 21-day Enterococcus faecalis biofilm was prepared and used for inoculation of the canals. Each group was randomly divided into 3 subgroups for canal disinfection with 2.5% sodium hypochlorite, sodium hypochlorite plus LED PDT and saline (positive control). Samples from the root canals were obtained with rotary files and cultured. Microbiologic data were analyzed using the Poisson regression test. Results: The bacterial count significantly decreased following disinfection with sodium hypochlorite with/without PDT in all sizes and tapers of preparation compared with the control group (P < 0.05). Increasing the apical taper or apical size and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count (P > 0.05). However, the apical size and PDT had a significant effect on the number of residual bacteria (P < 0.05), and increasing the apical size and conduction of PDT significantly decreased the number of residual bacteria. Conclusion: The apical size and taper and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count. However, increasing the apical size and conduction of PDT as an adjunct to sodium hypochlorite irrigation significantly decreased the number of residual bacteria in the root canal system.
iranian endodontic journal, 2022
Shahid Beheshti University Dental Journal, 2013
Objective: Antibacterial properties of silver nanoparticles have recently come into the spotlight... more Objective: Antibacterial properties of silver nanoparticles have recently come into the spotlight in endodontic therapy. This study was conducted aiming at comparing the antimicrobial activity of a new irrigation solution containing nanosilver particles with that of sodium hypochlorite and chlorhexidine against Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans with direct culture technique. Methods: In this in vitro experimental study, Mueller Hinton agarmedium was prepared for cultivation of E. coli, C. albicans and P. aeruginosa species and Bile-Esculin agar culture medium was used for E. faecalis. Understudy irrigation solutions were chlorhexidine 2%, chlorhexidine 0.2%, sodium hypochlorite 5.25%, sodium hypochlorite 2.5%, sodium hypochlorite 1.125% and nanosilver solutions of 25, 50, 100, 150, 200, 400 and 4000 ppm. After preparation, the bacteria were exposed to these solutions and the culture media were stored in an incubator at 37C for 24 h...
Shahid Beheshti University Dental Journal, 2019
Objectives Adequate knowledge about canal anatomy is necessary for clinicians to prevent any dama... more Objectives Adequate knowledge about canal anatomy is necessary for clinicians to prevent any damage to the periodontium. The aim of this study was to evaluate the canal and apical complexities of the mandibular first and second premolars in an Iranian population. Methods One-hundred mandibular first (n=50) and second (n=50) premolars were collected. After access cavity preparation, 2% methylene blue was injected into the canals, and they were sealed with Coltosol and nail varnish. Next, demineralization and clearing with 5% nitric acid and methyl salicylate were performed. Apical morphology including the presence of accessory canals, apical delta, anastomoses and canal configurations was evaluated under a stereomicroscope at x16 magnification. Descriptive statistics (including tables, central tendency and dispersion tests) were used for data analysis. Results The most prevalent form of canal type was Vertucci’s type I in first and second premolars. The mean distance between the apic...
Objectives Dental anxiety often leads to avoidance of patients which may result in significant de... more Objectives Dental anxiety often leads to avoidance of patients which may result in significant deterioration of oral health. Non-pharmacological interventions such as music are increasingly used in dental care. The purpose of this study was to investigate the effect of relaxing music on the stress and anxiety level of dental patients. Methods In this study, 40 adult patients were randomly divided into two groups of music and control (no intervention). Each group included 10 females and 10 males. Subjects in the music group listened to relaxation music throughout their dental procedure while the control group did not. Pre-and post-tests were performed using the Spielberger's State-Trait Anxiety Inventory (STAI) and Hari's stress questionnaire in both groups. Results There were no significant differences between the two groups for baseline data. The mean age of patients in the music and control groups was 37.70±9.29 years and 39.05±5.36 years, respectively. Comparison of moderated means in the intervention and control groups showed that listening to relaxation music caused a reduction in the mean scores of STAI (x=7.746, SE=416, P<0.05) and stress (x=7.746, SE=2.103, P<0.01) in the intervention compared with the control group. Conclusion This study indicated that relaxing music can decrease the state anxiety and stress of dental patients.
Objectives Canine teeth are supposed to have one single root canal, but they may have some anatom... more Objectives Canine teeth are supposed to have one single root canal, but they may have some anatomical variations. This study aimed to investigate the morphology of root canals of maxillary and mandibular canines regarding gender and age in an Iranian population using cone-beam computed tomography (CBCT). Methods Using CBCT images, 126 maxillary and 125 mandibular canines were evaluated. Root anatomy was assessed regarding root length, root curvature, number of roots and canals, and pattern of root canal system. The data were analyzed by the Kruskal Wallis and Mann-Whitney tests and multinomial regression model. Results The mean root length of male patients was significantly higher than females (p=0.0001). The most frequent root curvatures were towards the distal and buccal. Mandibular teeth (p=0.020) and females (p=0.012) had higher frequency of root curvature. All maxillary canines had one root; whereas 1.6% of mandibular canines had two roots. High prevalence of two canals was reported (34.9% of maxillary and 18.4% of mandibular canines). The most prevalent canal patterns included type I (65.1%) followed by type III (34.9%) in maxillary canines and types I (81.6%), III (16.8%) and V (1.6%) in mandibular canines. Higher frequency of type III canal configuration was reported in maxillary teeth (p=0.001) and male patients (p=0.008). No significant difference was found in any parameter between different age groups (p>0.05). Conclusion A high percentage of type III canal configuration in canine teeth especially maxillary canines and male patients was reported. Mandibular teeth and females had higher frequency of root curvature.
PubMed, 2023
Endodontic therapy of dens invaginatus (DI) anomalies is challenging due to difficult access, ina... more Endodontic therapy of dens invaginatus (DI) anomalies is challenging due to difficult access, inadequate cleaning and shaping, and incomplete disinfection of its complicated root canal system. The present case report describes the treatment of tooth #10 with tooth discomfort, intermittent pus discharge, and localized swelling. Sinus tract, mobility, and probing grade 1 were observed. The tooth was tender on palpation and percussion with negative responses to pulp sensibility tests. Radiographic assessments revealed an atypical structure of pulpal anatomy, probably dens invaginatus, associated with a large periapical lesion and severe root curvature. Cone-beam computed tomography confirmed the presence of DI type II. Finally, the diagnosis of pulp necrosis with chronic apical abscess of tooth #10 was made. Combining antimicrobial photodynamic therapy as an adjunctive treatment with different irrigation techniques were effective in nonsurgical endodontic management of the complicated DI type II in a maxillary lateral incisor with a large periradicular lesion and severe root curvature. Six-month and one-year recall radiographic images revealed asymptomatic tooth and progressive osseous healing.
PubMed, Nov 1, 2016
Objectives: It is essential for clinicians to have adequate knowledge about root canal configurat... more Objectives: It is essential for clinicians to have adequate knowledge about root canal configurations; although its morphology varies largely in different ethnicities and even in different individuals with the same ethnic background. The current study aims to review the root canal configurations of mesiobuccal roots of maxillary first molars in an Iranian population based on different epidemiological studies. Materials and methods: A comprehensive search was conducted to retrieve articles related to root canal configuration and prevalence of each type of root canal based on Vertucci's classification for the mesiobuccal root of maxillary first molars. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. The articles were evaluated and methods, population, number of teeth and percentage of each root canal type evaluated in each study were summarized in the data table. Websites such as http://www.magiran.com/ , http://health.barakatkns.com/journal-internal-list and www.sid.ir were used to search all related studies published in Persian. Results: Totally, out of nine studies conducted on the Iranian populations in nine provinces of Iran and 798 teeth, the Vertucci's type I was the most common type (35.70%), followed by type II (30.37%), type IV (16.66%), type III (7.93%) and type V (2.61%). Conclusions: From this review article, it is concluded that the root canal morphology of mesiobuccal roots of maxillary first molars in the Iranian population predominantly has more than one canal. Therefore, careful evaluation of radiographs and anatomy of the pulp chamber is essential in order to achieve a successful root canal therapy.
PubMed, 2016
Introduction: The conventional method of teaching endodontics has some drawbacks. Due to the smal... more Introduction: The conventional method of teaching endodontics has some drawbacks. Due to the small size of the oral cavity, students cannot closely observe the clinical procedure. Use of new teaching modalities such as the intraoral camera may obviate this problem. This study assessed the effect of video-assisted clinical instruction in dentistry (VACID) on dental student's knowledge and performance in access cavity preparation during endodontic treatment. Methods and materials: In this interventional study, twenty six undergraduate students were equally divided into two groups and received instructions on access cavity preparation via conventional demonstration (CD) or VACID using intraoral camera plus conventional demonstration. Students' knowledge was assessed before and after the demonstration. The scores obtained by students were compared between the two groups. Data were analyzed using the Mann Whitney U test. Results: No significant difference was found between the two groups in knowledge and performance scores of students about pulp chamber removal, under-extension, over-extension, gouging, perforation or finding the main and extra canals. However, use of intraoral camera significantly reduced the number of student visits to instructors for problem solving (P=0.001). Conclusion: VACID is an effective educational method and as efficient as conventional demonstration in endodontics; as a result it can be used in combination with conventional teaching.
PubMed, 2017
Introduction: The purpose of this study was to assess the accuracy of sensibility tests by correl... more Introduction: The purpose of this study was to assess the accuracy of sensibility tests by correlating it with histologic pulp condition. Methods and materials: Assessment of clinical signs and symptoms were performed on 65 permanent teeth that were scheduled to be extracted for periodontal, prosthodontic or orthodontic reasons. The normal pulp and reversible pulpitis were considered as treatable tooth conditions while irreversible pulpitis and necrosis were considered as untreatable conditions. The teeth were then extracted and sectioned for histological analysis of dental pulp. Histologic status and classification corresponded to the treatable or untreatable pulp condition. Comparisons between histological treatable and untreatable pulp condition were performed with chi-square analysis for sensibility test responses. The positive predictive value (PPV), negative predictive value (NPV) and accuracy to detect untreatable from treatable pulp condition were calculated for each test. Results: A significant difference was detected in the normal and a sharp lingered response to heat and cold tests. There was significant difference in the negative response to EPT between histological groups. The kappa agreement coefficient between clinical and histological diagnosis of pulp condition was about 0.843 (P<0.001). The accuracy of cold and heat tests and EPT to detect treatable pulp or untreatable pulp states were 78, 74 and 62%, respectively. The sensibility tests diagnosed untreatable pulpitis with a higher probability (NPV=63%-67% -54%, PPV=83%-91% -95% for heat, cold and EPT, respectively). Conclusion: Sensibility test results were more likely to diagnose pulpal disease or untreatable pulp conditions. However, to increase the diagnostic accuracy patient history, clinical signs and symptoms and also radiographic findings in conjunction with sensibility tests must be used. The result of this small study demonstrated a good agreement between clinical and histological pulp diagnosis.
PubMed, 2018
Introduction: This study sought to assess root canal morphology of maxillary second molars regard... more Introduction: This study sought to assess root canal morphology of maxillary second molars regarding age and gender in an Iranian population using cone-beam computed tomography (CBCT). Methods and materials: Totally, 157 maxillary second molars of patients presenting to a radiology clinic were evaluated on CBCT scans. Tooth length, number of roots, root fusion, coronal and sagittal root deviation, number of canals per root, prevalence of second mesiobuccal canal, root canal morphology according to the Vertucci's classification and the correlation of these variables with age and gender were evaluated. Data were analyzed using the Mann Whitney U, Kruskal Wallis and Fisher's exact tests. Results: Of 157 teeth, 98 belonged to females and 59 to males. The mean tooth length was significantly greater in males than in females (P=0.002) and it was shorter in 50-60 years old group. The rate of root fusion was 18.6%. Distobuccal and palatal roots were mainly straight in both sagittal and coronal planes while mesiobuccal roots mostly had a distal-buccal deviation; 67.5% of the teeth had four canals. Number of canals was significantly correlated with gender and was higher in males (P<0.05). The most prevalent canal type was type VI in second mesiobuccal, and type V in palatal and distobuccal canals. The most common types in mesiobuccal canal were types I, VI and II, respectively. In the remaining two roots, type I was the most common. Conclusion: Root and canal morphology of the maxillary second molars in Iranian population showed features different from those in other populations.
PubMed, 2013
Introduction: One of the key factors in successful endodontic therapy is to adequately fill the r... more Introduction: One of the key factors in successful endodontic therapy is to adequately fill the root canals. The aim of this in vitro study was to compare the quality of four different root canal obturation techniques: cold lateral condensation (CLC), warm vertical condensation (WVC), Obtura II (OII) and Gutta Flow (GF) by using micro-computed tomography (micro CT). Materials and methods: A total of 20 extracted maxillary first molars prepared with ProTaper files, were randomly divided into four groups. Micro CT was used to measure the internal volume of root canals. Following application of AH26 sealer to canal obturation, new micro-CT images were taken and the volume percentage (VP) of voids, gutta-percha and sealer at different levels were calculated with CT software. Data was statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests. Results: The highest percentage of filling material was observed in GF group followed by OII with no statistically significant difference (P>0.05). These two groups had a significantly more acceptable filling than WVC and CLC groups (P<0.05). Voids were detected in all samples. There was a significant difference between the highest and the lowest percentage of voids in CLC (19.6%) and GF groups (6.7%), respectively. In the apical third, CLC and OII showed the highest and the lowest percentage of voids (5.5% and 2.6%) and the lowest and highest percentage of gutta-percha (76.52% and 94.26%), respectively. These differences were statistically significant (P<0.05). Conclusion: None of the root canal filled teeth were gap-free. GF and CLC techniques showed the highest and lowest VP of obturation materials, respectively.
PubMed, 2016
Introduction: The purpose of this study was to investigate the root and canal morphology of maxil... more Introduction: The purpose of this study was to investigate the root and canal morphology of maxillary first molars with regards to patients' age and gender with cone-beam computed tomography (CBCT). Methods and materials: A total of 149 CBCT scans from 92 (67.1%) female and 57 (31.3%) male patients with mean age of 40.5 years were evaluated. Tooth length, presence of root fusion, number of the roots and canals, canal types based on Vertucci's classification, deviation of root and apical foramen in coronal and sagittal planes and the correlation of all items with gender and age were recorded. The Mann Whitney U, Kruskal Wallis and Fisher's exact tests were used to analyze these items. Results: The rate of root fusion was 1.3%. Multiple canals were present in the following frequencies: four canals 78.5%, five canals 11.4% and three canals 10.1%. Additional canal was detected in 86.6% of mesiobuccal roots in which Vertucci's type VI configuration was the most prevalent followed by type II and I. Type I was the most common one in distobuccal and palatal roots. There was no statistically significant difference in the canal configurations in relation to gender and age as well as the incidence root or canal numbers (P>0.05). The mean tooth length was 19.3 and 20.3 mm in female and male patients, respectively which was statistically significant (P<0.05). Evaluation of root deviation showed that most commonly, a general pattern of straight-distal in the mesiobuccal and straight-straight for distobuccal and palatal roots occurred. In mesiobuccal roots, straight and distal deviations were more dominant in male and female, respectively (P<0.05). The prevalence of apical foramen deviation in mesiobuccal and palatal roots statistically differed with gender. Conclusion: The root and canal configuration of Iranian population showed different features from those of other populations.
Journal of Endodontics, Sep 1, 2019
INTRODUCTION Calcium hydroxide (CH) and nano-calcium hydroxide (NCH) as intracanal medicaments ma... more INTRODUCTION Calcium hydroxide (CH) and nano-calcium hydroxide (NCH) as intracanal medicaments may affect the physical and chemical properties of dentin. The aim of this investigation was to evaluate the effects of CH and NCH on the microhardness and superficial chemical structure of radicular dentin. METHODS In this in vitro trial, 80 dentin discs were randomly assigned into 2 control and 2 treatment groups (n = 20). CH and NCH pastes were used in the treatment groups. In the control groups, the samples were washed with either normal saline or 2.5% sodium hypochlorite. After 1 and 4 weeks, dentin microhardness was assessed by the Vickers test, and the phosphate/amide I ratio was evaluated by the Fourier-transform infrared spectrometry test. The data were subjected to 1-way and 2-way analyses of variance, the Tukey multiple comparison test, and the Student t test. RESULTS A significant reduction in the mean microhardness was observed in the CH group after 4 weeks, whereas the differences were not significant in the NCH and control groups. The amount of reduction induced by NCH was comparable with hypochlorite. A significant increase in the mean phosphate/amide I ratio was observed in the CH and NCH groups compared with the sodium hypochlorite and intact control groups after 1 week, which did not change significantly during the observation period. CONCLUSIONS The use of CH as an intracanal medicament for 4 weeks reduced dentin microhardness, whereas NCH did not result in any change in the microhardness value. However, a change in the superficial chemical structure was observed earlier after 1 week and in both the CH and NCH groups.
Journal of lasers in medical sciences, Jun 21, 2019
Effect of low-level laser therapy with different locations of irradiation on postoperative endodo... more Effect of low-level laser therapy with different locations of irradiation on postoperative endodontic pain in patients with symptomatic irreversible pulpitis: a double-blind randomized controlled trial.
DOAJ (DOAJ: Directory of Open Access Journals), 2016
Objective: Pulp regeneration within the root canal of necrotic teeth is considered an ideal treat... more Objective: Pulp regeneration within the root canal of necrotic teeth is considered an ideal treatment to allow for continued root development and recover teeth vitality. This study aims to evaluate the inductive effect of platelet-rich plasma (PRP) on expression of angiogenesis factors and pulpal revascularization of immature necrotic teeth. Materials and Methods: In this experimental animal study, we randomly divided 28 immature premolars from two mixed breed dogs into four groups, two experimental, negative and a positive control. Premolars in negative control group were left intact to develop normally. In the positive control and experimental groups, we removed the pulps and induced pulp necrosis, after which the chambers were sealed. Then, we applied the revascularization protocol in the experimental teeth located in the right quadrant. Two months later, the same protocol was applied to the left quadrant. The root canals were disinfected by irrigation with sodium hypochlorite (NaOCl) solution and application a triple antibiotic past. Following the induction of a blood clot (BC) inside the canal space, the coronal portion of the canals was assigned to either of two experimental groups: group 1 [BC+PRP+ mineral trioxide aggregate (MTA)], group 2 (BC+MTA). Access cavities were sealed with a Glass Ionomer. The jaws that held the teeth were processed for histologic analysis of newly formed tissue and immunohistochemical evaluation according to vascular endothelial growth factor (VEGF) and factor VIII expressions in the canals. Results: Histological analysis demonstrated no significant difference in the formation of new vital tissue inside the root canals between groups1 (42.8%) and 2 (43.5%, P>0.05). Based on immunohistochemical evaluation, micro-vessel density (MVD) of the granulation tissues in both groups were similar and were higher compared with the normal pulp. We observed strongly positive expressions of VEGF and factor VIII in the stromal and endothelial cells, with severe intensity after one month. Both factors showed downregulation at three months postoperative. Conclusion: PRP could not increase the formation of new vital tissue. The immunohistochemical results showed that VEGF and factor VIII played a pivotal role in the formation of new vessels inside the root canals of immature, non-vital teeth.
Dental research journal, 2012
Background: Enterococcus faecalis has been widely used as a valuable microbiological pathogen for... more Background: Enterococcus faecalis has been widely used as a valuable microbiological pathogen for in vitro studies due to its ability to successfully colonize the root canal in a biofi lm-like style, invade dentinal tubules, and resist endodontic treatment procedures.The aim of this study was to compare the bactericidal effi cacy of photodynamic therapy (PDT), 2% chlorhexidine, 2.5% NaOCl, and combination of PDT and 2.5% NaOCl against E. faecalis. Materials and Methods: Sixty single-rooted teeth had their canals contaminated with E. faecalis in brain heart infusion broth and were incubated for 48 hours.The canals were then subjected to 2% chlorhexidine, 2.5% NaOCl, PDT (red light emitting diode 625 nm+ Toludine Blue) and PDT + 2.5% NaOCl. Controls consisted of no treatment (positive control) and without inoculation of bacterium (negative control). Following treatment, the canal contents were sampled with sterile paper points. The samples were dispersed in transport medium, serially diluted, and cultured on blood agar to determine the number of colony forming units (CFU). Data were analyzed by Mann-Whitney U test at 5% signifi cance level. The signifi cance level for all analyses was set at P <.05. Results: Combination of PDT and 2.5% NaOCl achieved maximum reduction in recovered viable bacteria, no viable bacteria was observed after treatment of PDT + 2.5% NaOCl. Conclusion: Combination of PDT and 2.5% NaOCl simultaneously is effective in the elimination of E. faecalis from dentinal tubules under the conditions of this study.
iranian endodontic journal, 2017
The purpose of this study was to assess the accuracy of sensibility tests by correlating it with ... more The purpose of this study was to assess the accuracy of sensibility tests by correlating it with histologic pulp condition. Methods and Materials: Assessment of clinical signs and symptoms were performed on 65 permanent teeth that were scheduled to be extracted for periodontal, prosthodontic or orthodontic reasons. The normal pulp and reversible pulpitis were considered as treatable tooth conditions while irreversible pulpitis and necrosis were considered as untreatable conditions. The teeth were then extracted and sectioned for histological analysis of dental pulp. Histologic status and classification corresponded to the treatable or untreatable pulp condition. Comparisons between histological treatable and untreatable pulp condition were performed with chi-square analysis for sensibility test responses. The positive predictive value (PPV), negative predictive value (NPV) and accuracy to detect untreatable from treatable pulp condition were calculated for each test. Results: A significant difference was detected in the normal and a sharp lingered response to heat and cold tests. There was significant difference in the negative response to EPT between histological groups. The kappa agreement coefficient between clinical and histological diagnosis of pulp condition was about 0.843 (P<0.001). The accuracy of cold and heat tests and EPT to detect treatable pulp or untreatable pulp states were 78, 74 and 62%, respectively. The sensibility tests diagnosed untreatable pulpitis with a higher probability (NPV=63%-67%-54%, PPV=83%-91%-95% for heat, cold and EPT, respectively). Conclusion: Sensibility test results were more likely to diagnose pulpal disease or untreatable pulp conditions. However, to increase the diagnostic accuracy patient history, clinical signs and symptoms and also radiographic findings in conjunction with sensibility tests must be used. The result of this small study demonstrated a good agreement between clinical and histological pulp diagnosis.
DOAJ (DOAJ: Directory of Open Access Journals), 2013
Because of the great challenges in the diagnosis and treatment of "C" configuration and lack of a... more Because of the great challenges in the diagnosis and treatment of "C" configuration and lack of any systematic information about its occurrence, the purpose of the present study is to determine the prevalence of C shaped root canals in Iranian population. Methodology: An exhaustive search was undertaken to identify published and unpublished researches related to the C-shaped canals by using key words. The search of the MEDLINE database included all publications from 1966 to May 2012.Then selected articles were obtained and reviewed. Data evaluated and summarized in the data sheet included methodology, population, number of teeth per study (power), number of root canals, type of root canal configuration, and cshaped canals. Results: Six studies were included with total of 1062 teeth, all in mandibular second molars. The total incidence of C-shaped canals in Iranian population was obtained 6.96%. Conclusions: The incidence of C-shaped canals in Iranian population is 6.96%, which seems much less than Asian populations but nearer to Middle East countries.
Journal of lasers in medical sciences, Oct 9, 2021
Introduction: This study assessed the effect of apical size and taper on the efficacy of root can... more Introduction: This study assessed the effect of apical size and taper on the efficacy of root canal disinfection with LED photodynamic therapy (PDT) as an adjunct to irrigation with sodium hypochlorite. Methods: A total of 126 extracted human mandibular molars were divided into 4 groups. The mesiobuccal canal was prepared to size 25/4% in group 1, 25/6% in group 2, 30/4% in group 3, and 30/6% in group 4 using the iRaCe rotary system. A 21-day Enterococcus faecalis biofilm was prepared and used for inoculation of the canals. Each group was randomly divided into 3 subgroups for canal disinfection with 2.5% sodium hypochlorite, sodium hypochlorite plus LED PDT and saline (positive control). Samples from the root canals were obtained with rotary files and cultured. Microbiologic data were analyzed using the Poisson regression test. Results: The bacterial count significantly decreased following disinfection with sodium hypochlorite with/without PDT in all sizes and tapers of preparation compared with the control group (P < 0.05). Increasing the apical taper or apical size and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count (P > 0.05). However, the apical size and PDT had a significant effect on the number of residual bacteria (P < 0.05), and increasing the apical size and conduction of PDT significantly decreased the number of residual bacteria. Conclusion: The apical size and taper and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count. However, increasing the apical size and conduction of PDT as an adjunct to sodium hypochlorite irrigation significantly decreased the number of residual bacteria in the root canal system.
iranian endodontic journal, 2022
Shahid Beheshti University Dental Journal, 2013
Objective: Antibacterial properties of silver nanoparticles have recently come into the spotlight... more Objective: Antibacterial properties of silver nanoparticles have recently come into the spotlight in endodontic therapy. This study was conducted aiming at comparing the antimicrobial activity of a new irrigation solution containing nanosilver particles with that of sodium hypochlorite and chlorhexidine against Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans with direct culture technique. Methods: In this in vitro experimental study, Mueller Hinton agarmedium was prepared for cultivation of E. coli, C. albicans and P. aeruginosa species and Bile-Esculin agar culture medium was used for E. faecalis. Understudy irrigation solutions were chlorhexidine 2%, chlorhexidine 0.2%, sodium hypochlorite 5.25%, sodium hypochlorite 2.5%, sodium hypochlorite 1.125% and nanosilver solutions of 25, 50, 100, 150, 200, 400 and 4000 ppm. After preparation, the bacteria were exposed to these solutions and the culture media were stored in an incubator at 37C for 24 h...
Shahid Beheshti University Dental Journal, 2019
Objectives Adequate knowledge about canal anatomy is necessary for clinicians to prevent any dama... more Objectives Adequate knowledge about canal anatomy is necessary for clinicians to prevent any damage to the periodontium. The aim of this study was to evaluate the canal and apical complexities of the mandibular first and second premolars in an Iranian population. Methods One-hundred mandibular first (n=50) and second (n=50) premolars were collected. After access cavity preparation, 2% methylene blue was injected into the canals, and they were sealed with Coltosol and nail varnish. Next, demineralization and clearing with 5% nitric acid and methyl salicylate were performed. Apical morphology including the presence of accessory canals, apical delta, anastomoses and canal configurations was evaluated under a stereomicroscope at x16 magnification. Descriptive statistics (including tables, central tendency and dispersion tests) were used for data analysis. Results The most prevalent form of canal type was Vertucci’s type I in first and second premolars. The mean distance between the apic...