Journal of Baghdad College of Dentistry

Background: Molars and premolars are considered as the most vulnerable teeth of caries attack, which is related to the morphology of their occlusal surfaces along with the difficulty of plaque removal. different methods were used for early caries detection that provide sensitive, accurate preoperative diagnosis of caries depths in order to institute suitable protective procedures and avoid early tooth management by restoration. The aim of the present study was to evaluate the clinical sensitivity and specificity rates of DIAGNOdent and visual inspection as opposed to the ICDAS for detection of initial occlusal carious lesions in noncavitated first permanent molars.Materials and Methods : the present study examined 139 occlusal surface of the first permanent molar pooled from fifty patients aged 8-9 years by three methods. The selected criteria include one occlusal site per tooth (first permanent molars) with carious lesions range from 0 to 3 according to ICDASII (gold standard) visual criteria then the clinical sensitivity and specificity of visual inspection according to Ekstrand et al.in 1997 and DIAGNOdent were performed. .Results: the highest correlation was found between the ICDASII and DIAGNOdent. The sensitivity of the DIAGNOdent for the enamel caries detection (D1) was better than that of visual inspection. The sensitivity and the specificity for the DIAGNOdent at D3 threshold were better than the D1 threshold and the visual inspection method.Conclusion: DIAGNOden pen can be used as a tool for early caries detection in cases of difficult diagnosis that provide good additional sensitivity to the visual inspection.

Background: changing in lifestyle like displacing place could cause depression which is a common mental disorder that change general health that affect dental caries incidence and severity. The aims of this study were to assess the relation of depression status on prevalence and severity of dental caries among internally displaced people.
Material and Method: The sample include 121 internally displaced people aged from 13-17 years. Method for depression measuring is by using Children Depression Inventory (CDI2) questionnaire. Dental caries is measured by using caries experience (DMFs) and caries severity D1-4.
Result: the mean value for decayed and missing surfaces were higher in high depression grade as compering with low and medium depression grade, while filled surfaces were with higher mean value in low grade than high grade of depression and absent in medium grade. While when measuring caries severity (D 1-4), the highest mean value for D1, D3 were in medium depressed group while D2, D4 were with highest value in high depressed group.
Conclusion: depression among internally displaced people had an effect on caries severity.

Background: Dental calculus is mineralized dental plaque formed on teeth and dental prosthesis surfaces in the oral cavity. Urinary stone is a crystal aggregation formed in urinary system due to minerals saturation present in urine. The structure of dental calculus is similar to that of urinary stone.
Objective: To assess oral hygiene and gingival status in patients with urinary stone. And compared with healthy subjects.
Patients and Methods: Sixty participants, 25-40 years, were involved in this study who were divided into study and control group. The study group involved patients with urinary stone while the control group involved healthy subjects. Clinical parameters including plaque, calculus and gingival indices were recorded for all participants. The correlation between the recorded clinical parameters was estimated.
Results: The study group mean (±SD) plaque (1.435±0.499), gingival (0.995±0.288) and calculus (1.28 ±0.66) indices were found to be significantly high compared with control group(0.868±0.265), (0.602±0.265) (0.501±0.457 ) respectively. The formed calculus was positively associated with accumulated plaque (r: 0.608, p < 0.05) and gingival inflammation(r: 0.612, p < 0.05).
Conclusion: Urinary stone patients were associated with more plaque and calculus accumulation, and had worse gingival inflammation compared to healthy participants. Thus, they need to be more aware of their gingival health status and improved preventive care of oral health.

Background and aim: Pomegranate is a medicinal herb that can promote healing of periodontal tissue through differentiation of mesenchymal cells both in vivo and in vitro. Therefore, this study is to investigate the effect of oral supplementation of Punicagranatum L. peel extract on bone defect in rabbit.
Methods: Forty five male rabbits were divided into 3 groups; group 1; baseline group(5 rabbits) left without bone defect. Group 2; study group (20 rabbits) with bone defect model that received daily 1ml of oral supplementation of pomegranate peel extract (PoPx). Group 3; control group (20 rabbits) with bone defect model that received distilled water. Bone defect was done into facial plate of lower right central incisor. Blood biopsies by cardiocentesis at times (base line, 3h, 1, 3 and 7days) for estimation of serum calcium, phosphorous, and vitamin D levels.
Results: The results showed a significant increase in serum calcium and phosphorous levels only after 3 hours and 1 day of bone defect, in rabbits receiving water and rabbits receiving pomegranate peel extraction. Serum vitamin D level shows significant increase in all time intervals reaching maximum value after three days in rabbits receiving pomegranate peel extract, while no significant change was observed in rabbits receiving water.
Conclusions: Supplementation of pomegranate peel extract can increase vitamin D absorption, thus it may promote the bone healing process.

Background: Dental implant is one of the most important options for teeth replacement. In two stage implant surgery, a few options could be used for uncovering implants, scalpel and laser are both considered as effective methods for this purpose.
The Aim of the study: To compare soft tissue laser and scalpel for exposing implant in 2nd stage surgery in terms of the need for anesthesia, duration of procedure and pain level assessment at day 1 and day 7 post operatively using visual analogue scale .
Materials and methods: Ten patients who received bilateral implants participated after healing period completed, gingival depth over each implant was recorded and then implant(s) were exposed by either scalpel or laser with determination for the need of anesthesia. Duration of the procedure was calculated in each case and post-operative pain was assessed by Visual analogue scale at day 1 and day 7.
Results: Statistically significant difference in the need of anesthesia was found. A non-significant difference in the duration of the operation was found between the two methods. Non-significant difference was found between the two methods regarding post-operative pain at day 1, with the day 7 scores "no pain or zero pain score" in all the cases by the two methods. A directional significant correlation was found between depth of the gingival tissue over the implants and duration of the procedures regardless of the method used.
Conclusion: diode laser can be used effectively for uncovering implants, providing both the dentist and the patient with additional advantages over the conventional methods. Although there was insignificant difference in pain scoring, however implant exposure by laser was more preferred by the patients.

Background: Gingival recession is well-defined by means of the apical movement of the gingival margin below the cementoenamel junction (CEJ), causing in exposure of the root surface and it remains the foremost esthetic complaints of patients. The treatment of gingival recession is depend on a full assessment of the etiological factors and the amount of tissue envelopment.

Background: Nutritional Rickets is a condition produced by an absence of Vitamin D, calcium or phosphate. It clues to relaxing and fading of the bones. Dental expression of children with rickets contains enamel hypoplasia and delayed tooth eruption. This study was conducted in order to assess caries experience (dmfs) and enamel defects among study and control groups, and to evaluate and compare the levels of selected salivary biomarkers between children with nutritional rickets and apparently healthy children.
Material and methods: Assessment of caries according to WHO in 1987, and assessment of enamel defects according to enamel defect index EDI of WHO in 1997. In addition a stimulated saliva samples were collected according to Palone et al from 30 children diagnosed with nutritional rickets and 30 control children as control group. Salivary vitamin D, calcium, phosphate and alkaline phosphtase were analyzed.
Results: Caries experience represented by dmfs was significantly higher among control group compared to study group, while enamel hypoplasia was higher in study group than control group. Salivary inorganic component (Ca, PO4 ALP) revealed obvious variations between study and control group. Salivary vitamin D concentration was lower in study group compared with control group.
Conclusion: Based on the results, it can be concluded that nutritional rickets impact on certain salivary biomarkers which can be considered for evaluating the diagnosis and prognosis of caries experience and enamel defects in nutritional rickets children.

Background: Knowledge is considered to be essential for developing healthy practices and preventing the main oral diseases. In some developing countries, women were at higher risk to develop these diseases. This study was conducted to evaluate women’s dental knowledge and practices through a specific questionnaire and the relationship with patient’s educational level and the number of their children.
Subjects and method: Women, aged from 25-35 years old, were selected to participate in the current study. They were attending dental clinics in the teaching hospital of Baghdad University. Each participant was instructed to answer questionnaire sheet which is previously prepared in Arabic language by the authors. The total number of women was divided into three groups according to women’s educational level and the number of their children.
Results: The number of women that participated in the study was 150. Higher percent of them (58.7%) have received instruction on the use of dental floss but 60.0% had no information about fluoride. Dental floss was used by only 24.7% of women. Higher percent of women eat candies, chocolate bars and cookies in between meals. Significant association was reported between educational level and oral health information. Educational level didn’t influence patients’ health practices. Frequency of follow-up appointments and toothbrushes changes were higher among women with less number of children.
Conclusion: The study revealed important gaps in oral health practices especially in diet control and the use of dental floss. There is a need for frequent dental educational programmes among women to promote the proper practices and to achieve good oral hygiene.

Background: The microorganisms can impend the life of health care professional and particularly the dental practitioners. They can be transmitted by different ways like airborne and droplet transmission. The current study was carried out to identify whether the arch wires that received from the manufactures are free from microbial contamination and to determine the bacterial species attached to the arch wires.
Materials and Methods: This study involved eighty samples, consisted of two types of arch wires (nitinol and stainless-steel) from four companies (3M, G&H, Jiscop, OrthoTechnology). These wires inserted in a plane tube that contains 10 -ml of (Tris [tris(hydroxymethyl)aminomethane] and EDTA (ethylenediaminetetraacetic acid) tris-EDTA and brain heart infusion (BHI) broth. A 0.1 ml was withdrawn from the tube and spread on agar plates. The control groups consist of 16 plane tube (8 tubes with tris-EDTA and other 8 tubes with (BHI).
Results: Microbial sampling yielded growth from 5 of the 80 arch wires. The predominant bacteria that isolated were Bacillus spp. No growth was recovered from 75 of the samples and from controls. The bacteria were isolated by BHI reagent and no growth was observed by tris-EDTA reagent with statistically significant difference (P<0.05). The Bacillus spp. found only in the G&H and Jiscop companies, however, no statistically significant difference was found among them (P>0.05). With regard to the presence and distribution of bacteria according to the types of wires, the present results clarified that cases of contamination with Bacillus spp. were found in the nitinol arch wires with statistically significant difference (P<0.05).
Conclusions: The results of the current study revealed low count of bacterial contamination in the two types of companies (G&H and Jiscop). Not all materials that received from the manufactures are free from contamination and an effective sterilization regimen is needed to avoid cross-contamination.

Background: Dental caries is a localized, progressive destructive, largely irreversible microbial based disease of multifactorial nature; these factors include (host, microbes and food) they influence differently on the initiation and progression of dental caries.
The aims of the study: was to evaluate the effect of smoking on salivary flow rate, secretory immunoglobulin (SIgA) level and viable count of mutans streptococci (M.S) bacteria in oral cavity and their relation to dental caries experience.
Material and method: The samples were collected from 80 male students ranging in ages from 18-22 years old. Where they divided in to two groups, 40 non-smokers (control group) and 40 smokers (study group). Unstimulated salivary samples were collected. Salivary flow rate was estimated and viable count (CFU/ml) of mutans streptococci was determined. The diagnosis and recording of dental caries were done according to WHO, 1987 criteria and the level of SIgA was determined by ELISA.
Result: the result revealed that the salivary flow rate and SIgA level were lower in smoker group than non-smoker, while the means value of dental caries experience Decay, Missing and Filling tooth (DMFT) and (CFU/ml)of M.S were higher in oral cavity of smoker group than non-smoker group.
Conclusion: the smoking has negative effect on salivary flow rate, SIgA and increase the viable bacterial count of M.S and dental caries in smoker patients.

Background: lip lengthening procedure is one of the surgical options for the correction of gummy smile in patients with short upper lip.
Methods: A comparative clinical study was conducted on 15 patients requiring lip lengthening procedure for the esthetic correction of excessive gingival exposure with gummy smile. Scalpel was used in seven patients and diode laser in the remaining eight patients. Under infiltration anesthesia, about one cm strip of mucosa was excised at the vestibular depth and the mucosa of the lip was sutured to the alveolar mucosa.
Results: The diode laser group demonstrated less postoperative pain and swelling. Regarding postoperative ecchymosis, three patients in the scalpel group developed ecchymosis and no cases were noted in the laser group, the difference was statistically significant. No patient in the laser group developed wound dehiscence and only one patient in the scalpel group had wound dehiscence at third postoperative day. Observed at one month postoperatively, the laser treated groups had less obvious scar than the scalpel group.
Conclusion: Diode laser is a valuable tool in performing lip lengthening for gummy smile.