Journal of Baghdad College of Dentistry

Background: Oxidative stress may contribute to the etiology of hypertension in humans. Oxidative stress is an imbalance between reactive oxygen species (ROS) and antioxidant defense mechanisms, causing damage to biological macromolecules and dysregulation of normal metabolism and physiology. Amlodipine as an antihypertensive agent is a long-acting calcium channel blocker that dilates blood vessels and improves blood flow.
The aim of this study was to assess the oxidative stress in hypertensive patients on Amlodipine treatment through the assessment of salivary Malondialdehyde (MDA) and superoxide dismutase (SOD) as a marker of oxidative stress. Material and method: 60 individuals were included in this study, divided into two groups; the first group composed of 30 hypertensive patients on Amlodipine antihypertensive agent. The second group, the control group, composed of 30 healthy subjects without any systemic disease and with almost healthy oral hygiene. Intraoral examination was done for each individual and salivary samples were collected with the salivary flow rate (F/R) which was calculated in ml per minute and pH was measured by pH meter. Salivary MDA and SOD were analyzed by using ELISA kit based on the principle of competitive enzyme immunoassay technique; the concentrations of markers were measured by spectrophotometer at 450nm in a microplate reader. Results: Salivary MDA was significantly higher in hypertensive patients compared to control, while salivary SOD was significantly lower in patients than control group. Salivary flow rate and pH was significantly lower in patients as compared to the control group.
Conclusions: There is a relation between oxidative stress and hypertension. Salivary MDA and SOD can be used as potential marker for monitoring patients with Hypertension.

Background: Vibration decreases the viscosity of composite, making it flow and readily fit the walls of the cavity. This study is initiated to see how this improved adaptation of the composite resin to the cavity walls will affect microleakage using different curing modes
Materials and methods: Standard Class V cavities were prepared on the buccal surface of sixty extracted premolars. Teeth were randomly assigned into two groups (n=30) according to the composite condensation (vibration and conventional) technique, then subdivided into three subgroups (n=10) according to light curing modes (LED-Ramp, LED-Fast and Halogen Continuous modes). Cavities were etched and bonded with Single Bond Universal then restored with Filtek® Z350 (3M ESPE, USA). In the vibration group, condensation was done using CompothixoTM (Kerr, Switzerland). In the conventional group, condensation was done with hand plugger. Curing modes for all groups were LED-Ramp, LED-Fast and halogen continuous modes, respectively. Samples stored in distilled water at 37°C for seven days, and painted completely with two layers of nail varnish with only 1 mm around the composite restoration left. Samples were thermocycled, immersed in 2% methylene blue solution for 3 hours, and sectioned longitudinally. Dye penetration was assessed under a stereomicroscope. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests with p <0.05 considered significant.
Results: Vibration group showed less microleakage (P=0.028). In the conventional group there were no differences by using different curing modes (P=0.277). In the vibration group no differences were found between LED-Ramp and LED-Fast mode (P=0.989). However, there were significant differences between LED-Fast and halogen (P=0.05) and between LED-Ramp and halogen group (P=0.001). Microleakage scores of all cervical walls were higher than the occlusal walls (P=0.001). Occlusal walls leakage for conventional and vibration groups were not different (P=0.475), while there were significant differences between them at cervical walls (P=0.001).
Conclusion: Vibration with LED-Ramp curing mode may decrease marginal leakage of composite restoration placed in Standard Class V tooth preparations.

Background: This study aims to assess the prevalence of malposed canines among students of College of Dentistry/ University of Baghdad and evaluate the relation between canine malposition and occlusal features.
Material and method: The prevalence of buccally malposed canines was estimated by intra-oral visual examination of 250 young adult subjects (106 males and 144 females), their ages were between 19-24 years.
Results: The prevalence of the mandibular malposed canine (12%) was higher than the maxillary buccally malposed canine (10%). Generally, malposed canines were found higher in females than in males and mostly seen in class l Angle’s classification and buccally more than lingually.
Conclusion: A relationship exists between canine malposition and other occlusal features.

Background and objective: Considering the antioxidant, anti-inflammatory, and antimicrobial properties of green tea, this study aimed to evaluate the histopathological effect of the sulcular irrigation of green tea extract in the treatment of experimental gingivitis in rabbit.
Materials and methods: For this experimental study, 45 male rabbits, separated in two groups, control non- irrigated group (5rabbits) and study group (40 rabbits), gingivitis induced by ligatures was packed subgingivally in the lower right central incisors of the experimental group for seven days. Then, the animals were randomly designated to two irrigated groups (20 rabbits for each) with 50μl/kg of distilled water and 5% green tea extract once daily for seven days starting from the day of ligature removal respectively. Specimens have taken at 1, 3, 7, and 14 days for light microscopical evaluation of inflammatory cellular infiltration.
Results: Regarding study group (5% of green tea extract), results demonstrated a significant reduction in the mean values of inflammatory cell counts within three days (P≤ 0.05) to reach the amount of control group within seven days (P˃ 0.05). A highly significant difference was detected between control group and study group sprayed with distilled water during all healing periods (P≤ 0.05). Histological examination showed that the resolution of gingival inflammation, re-epithelization, and tissue healing were achieved much quicker in the group of gingival sulcular irrigation with 5% green tea extract.
Conclusions: In this experimental study, the histopathological analysis demonstrated that the use of 5% extract of green tea as gingival sulcular irrigation might fasten healing after the induction of gingivitis.

Background: smoking is the major environmental risk factor that has been associated with the pathogenesis and progression of periodontal diseases. Interleukin-8 (IL-8), has been associated with the immunopathology of periodontitis.
Objectives: To determine the influence of smoking on salivary Interleukin-8 level from smokers and non-smokers with periodontitis and periodontally healthy control subjects.
Materials and Methods: Un-stimulated saliva samples were collected of 90 participants: 30 smokers and 30 non-smokers with chronic periodontitis, as well as 30 periodontally healthy control subjects. The clinical parameters such as the pocket depth, clinical attachment loss, plaque index, and gingival index were measured. IL-8 level in the saliva was measured by Enzyme Linked Immunosorbent Assay (ELISA) kit.
Results: It was found that the mean value of salivary IL-8 levels was significantly higher in smokers (461.76 ± 329.66 ng/L) than in non-smokers periodontitis (257.83 ± 247.19 ng/L) and the controls (96.55 ± 62.35 ng/L) (p < 0.001). Moreover, salivary IL-8 levels were significantly higher in smokers compared with non-smokers periodontitis (p< 0.001).
Conclusion: Smoking subjects showed increased level of salivary IL-8 and a worse periodontal condition than non-smoking subjects. Our results suggest that smoking alters an immune response which may contribute to an increased susceptibility to periodontal disease among smokers

Background: Several pathologies of the oral cavity have been associated with stress. Dental students need to gain assorted proficiencies as theoretical knowledge, clinical proficiencies, and interpersonal dexterity which is accompanied with high level of stress. Uric acid is the major antioxidant in saliva. The aim of this study is to assess the dental caries experience among dental students with different levels of dental environment stress in relation to physicochemical characteristics of whole unstimulated saliva.
Materials and Methods: the total sample is composed of 300 dental students (73 males, 227 female) aged 22-23 years old, from collage of dentistry / university of Baghdad, from the 4th and 5th grade. The total sample was classified into three categories (mild stress, moderate stress and severe stress) according to Dental environment stress questionnaire (DESQ); Diagnosis and recording of dental caries were assessed according to Decay, Missed, Filled surface and teeth index (DMFS, DMFT) of WHO criteria in 1987. Unstimulated salivary samples were collected from the 95 dental students from the mild stress group (27 male, 28 female) and from the severe stress group (11 male, 29 female). Then, salivary flow rate was measured and chemically analyzed to determine salivary uric acid concentration. All data were analyzed using statistical package for social science (SPSS) version 21.
Results: The mean value of the DMFT and DS fraction was higher among severe stress group of dental environment stress scale with no significant differences (P≥ 0.05), while DMFS, FS and MS fractions were higher among moderate stress group of dental environment stress scale with no significant differences (P≥ 0.05). The data from salivary analysis showed that the mean value of salivary flow rate was lower among severe dental environment stress category than mild dental environment stress category but the difference was statistically not significant, while the mean value of uric acid was higher among students with severe dental environment stress than students with mild dental environment stress with statistically significant difference. The flow rate was negatively correlated with caries experience among both mild and severe stress groups except for the DS was positively correlated with flow rate among students with mild stress. The correlation of uric acid with DMFT was negative among students with mild stress while among severe stress group was positive; however all these correlations were not statistically significant.
Conclusion: Dental environment stress appears to affect oral health, shown by higher caries prevalence among dental students with moderate and severe dental environment stress level by affecting the normal level of salivary flow rate and uric acid.

Background: Recurrent aphthous ulceration (RAU) is an inflammatory condition of unknown etiology characterized by painful recurrent (single or multiple) ulcerations of the oral mucosa. It is one of the most common and poorly understood mucosal disorders. It occurs more frequently in times of stress. Local and systemic conditions, genetic, immunologic, microbial factors, and oxidative stress may play a role in the pathogenesis of RAU. The objective of this study was to evaluate the free radical metabolism and antioxidant activity of RAU patients treated by lavender or flax oil paint.
Methods: Sixty-six RAU patients were enrolled in this prospective randomized double-blind placebo-controlled study. Analysis of the plasma levels of malondialdehyde (MDA), glutathione (GSH), Nitric oxide (NO), myeloperoxidase (MPO), Vit. E, Vit. C, and Trolox equivalent antioxidant capacity (TEAC) were determined. The ulcer size, healing time, and healing process were correlated to the plasma levels of the studied parameters for the assessment of the antioxidant mechanism of action of lavender and flax oil paint in the treatment of RAU.
Results: Statistical analysis showed that lavender antioxidant action was higher than flax oil paint compared to placebo. The decreased oxidative stress and the damage caused by free radicals was significant in the lavender group than both flax group and placebo (P<0.001).
Conclusion: This study proves the significant antioxidant mechanism of both lavender and flax in the treatment of RAU patients.

Background: Celiac disease is an autoimmune chronic disease that affects the human’s intestine and subsequently reflects its effect on the entire body health by retardation the absorption and immune mediated complications cause the involvement of oral health. The present study intended to evaluate the impact of the histopathological disease activity upon dental enamel defects and dental caries.
Subjects and methods: Forty celiac-diseased patients aged 7-11 years were collected from 3 different teaching hospitals in Baghdad classified by means of the histopathological activity of the intestinal disease according to modified Marsh-Rostami classification. Dental enamel defects were measured by Aine’s classification, while dental caries experience and severity were measured using d1-4mfs/t and D1-4MFS/T.
Results: The majority of the sample came with partial villous atrophy of the small intestine (Marsh III-a) and almost half of the sample were with no celiac disease specific dental enamel defects (Aine’s 0), while Aine’s I was the most predominant than Aine’s II. Most missed surfaces due to dental caries in permanent teeth came with Marsh II.
Conclusion: The more the severity of celiac disease histopathological activity the more the severity of celiac specific dental enamel defects and the less experienced dental caries.

Background: The evaluation of the chronological age is a practical method in crime investigation field that assists in identifying individuals to treat them as underage or adult. This study aimed to assess the stages of third molars mineralization in relation to chronological age of Iraqi individuals, determine the gender differences and arches (maxillary/mandibular) differences.
Materials and Methods: A total of 300 orthopantomograms of orthodontic patients were collected according to specific criteria and evaluated visually. The developmental stages of maxillary and mandibular third molars were determined according to Demirjian method. The chronological age was recorded according to the particular mineralization stages at which it reached considering genders, sides and jaws. Comparisons were done using paired sample and independent sample t-tests.
Results: Results showed that there was no statistically significant difference (P>0.05) between maxillary and mandibular third molars. The maxillary third molars reached earlier than mandibular one in stages F and G. There was no significant difference between the mean ages of males and females at each given developmental stage in the maxillary and mandibular third molars except for the stage D in the maxilla and stages D and E in the mandible. The development of third molar teeth on the right and left sides was similar except for the maxillary arch in males when there was a significant difference in stage C and D and stage E in the mandibular arch.
Conclusion: The Demirjian method is an excellent approach for age assessment using Orthopantomogram. All of the differences between the current study and other studies could be because of the difference in the populations who were chosen from different geographical areas.