Common risk factors for postoperative pain following the extraction of wisdom teeth

Vahid Rakhshan 대한구강악안면외과학회 2015 대한구강악안면외과학회지 Vol.41 No.2

The extraction of third molars is a common task carried out at dental/surgery clinics. Postoperative pain is one of the two most common complications of this surgery, along with dry socket. Knowledge of the frequent risk factors of this complication is useful in determining high-risk patients, planning treatment, and preparing the patients mentally. Since the risk factors for postoperative pain have never been summarized before while the risk factors for dry socket have been highly debated, this report summarizes the literature regarding the common predictors of postextraction pain. Except for sur- gical difficulty and the surgeon’s experience, the influences of other risk factors (age, gender and oral contraceptive use) were rather inconclusive. The case of a female gender or oral contraceptive effect might mainly be associated with estrogen levels (when it comes to dry socket), which can differ considerably from case to case. Improvement in and unification of statistical and diagnostic methods seem necessary. In addition, each risk factor was actually a combination of various independent variables, which should instead be targeted in more comprehensive studies.

Variations in surface roughness of seven orthodontic archwires

Fariborz Amini,Vahid Rakhshan,Maryam Pousti,Hajir Rahimi,Mahsa Shariati,Bahareh Aghamohamadi 대한치과교정학회 2012 대한치과교정학회지 Vol.42 No.3

Objective: The purpose of this study was to evaluate the surface roughness (SR) of 2 types of orthodontic archwires made by 4 different manufacturers. Methods: This in vitro experimental study was conducted on 35 specimens of 7 different orthodontic archwires, namely, 1 nickel-titanium (NiTi) archwire each from the manufacturers American Orthodontics, OrthoTechnology, All-Star Orthodontics, and Smart Technology, and 1 stainless steel (SS) archwire each from the manufacturers American Orthodontics, OrthoTechnology, and All-Star Orthodontics. After analyzing the composition of each wire by energydispersive X-ray analysis, the SR of each wire was determined by scanning electron microscopy (SEM) and surface profilometry. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests (α < 0.05). Results: The average SR of NiTi wires manufactured by Smart Technology, American Orthodontics, OrthoTechnology, and All-Star Orthodontics were 1,289 ± 915 A˚, 1,378 ± 372 A˚, 2,444 ± 369 A˚, and 5,242 ± 2,832 A˚, respectively. The average SR of SS wires manufactured by All-Star Orthodontics, OrthoTechnology, and American Orthodontics were 710 ± 210 A˚, 1,831 ± 1,156 A˚, and 4,018 ± 2,214 A˚, respectively. Similar to the results of profilometry, the SEM images showed more defects and cracks on the SS wire made by American Orthodontics and the NiTi wire made by All-Star Orthodontics than others. Conclusions: The NiTi wire manufactured by All-Star Orthodontics and the SS wire made by American Orthodontics were the roughest wires.

Preoperative imaging of the inferior alveolar nerve canal by cone-beam computed tomography and 1-year neurosensory recovery following mandibular setback through bilateral sagittal split ramus osteotomy: a randomized clinical trial

Ali Hassani,Vahid Rakhshan,Mohammad Hassani,Hamidreza Mahaseni Aghdam 대한구강악안면외과학회 2020 대한구강악안면외과학회지 Vol.46 No.1

Objectives: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. Materials and Methods: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher’s test, Spearman’s test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01). Results: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122). Conclusion: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

Two-year survival analysis of twisted wire fixed retainer versus spiral wire and fiber-reinforced composite retainers

Farhad Sobouti,Vahid Rakhshan,Mahdi Gholamrezaei Saravi,Ali Zamanian,Mahsa Shariati 대한치과교정학회 2016 대한치과교정학회지 Vol.46 No.2

Objective: Traditional retainers (both metal and fiber-reinforced composite [FRC]) have limitations, and a retainer made from more flexible ligature wires might be advantageous. We aimed to compare an experimental design with two traditional retainers. Methods: In this prospective preliminary clinical trial, 150 post-treatment patients were enrolled and randomly divided into three groups of 50 patients each to receive mandibular canine-to-canine retainers made of FRC, flexible spiral wire (FSW), and twisted wire (TW). The patients were monitored monthly. The time at which the first signs of breakage/debonding were detected was recorded. The success rates of the retainers were compared using chi-squared, Kaplan-Meier, and Cox proportional-hazard regression analyses (α = 0.05). Results: In total, 42 patients in the FRC group, 41 in the FSW group, and 45 in the TW group completed the study. The 2-year failure rates were 35.7% in the FRC group, 26.8% in the FSW group, and 17.8% in the TW group. These rates differed insignificantly (chi-squared p = 0.167). According to the Kaplan-Meier analysis, failure occurred at 19.95 months in the FRC group, 21.37 months in the FSW group, and 22.36 months in the TW group. The differences between the survival rates in the three groups were not significant (Cox regression p = 0.146). Conclusions: Although the failure rate of the experimental retainer was two times lower than that of the FRC retainer, the difference was not statistically significant. The experimental TW retainer was successful, and larger studies are warranted to verify these results.

Variations in surface roughness of seven orthodontic archwires: an SEM-profilometry study

Amini, Fariborz,Rakhshan, Vahid,Pousti, Maryam,Rahimi, Hajir,Shariati, Mahsa,Aghamohamadi, Bahareh The Korean Association Of Orthodontists 2012 대한치과교정학회지 Vol.42 No.3

Objective: The purpose of this study was to evaluate the surface roughness (SR) of 2 types of orthodontic archwires made by 4 different manufacturers. Methods: This in vitro experimental study was conducted on 35 specimens of 7 different orthodontic archwires, namely, 1 nickel-titanium (NiTi) archwire each from the manufacturers American Orthodontics, OrthoTechnology, All-Star Orthodontics, and Smart Technology, and 1 stainless steel (SS) archwire each from the manufacturers American Orthodontics, OrthoTechnology, and All-Star Orthodontics. Aft er analyzing the composition of each wire by energy-dispersive X-ray analysis, the SR of each wire was determined by scanning electron microscopy (SEM) and surface profilometry. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests (${\alpha}$ < 0.05). Results: The average SR of NiTi wires manufactured by Smart Technology, American Orthodontics, OrthoTechnology, and All-Star Orthodontics were $1,289{\pm}915A^{\circ}$, $1,378{\pm}372A^{\circ}$, $2,444{\pm}369A^{\circ}$, and $5,242{\pm}2,832A^{\circ}$, respectively. The average SR of SS wires manufactured by All-Star Orthodontics, OrthoTechnology, and American Orthodontics were $710{\pm}210A^{\circ}$, $1,831{\pm}1,156A^{\circ}$, and $4,018{\pm}2,214A^{\circ}$, respectively. Similar to the results of profilometry, the SEM images showed more defects and cracks on the SS wire made by American Orthodontics and the NiTi wire made by All-Star Orthodontics than others. Conclusions: The NiTi wire manufactured by All-Star Orthodontics and the SS wire made by American Orthodontics were the roughest wires.

Isthmuses, accessory canals, and the direction of root curvature in permanent mandibular first molars: an in vivo computed tomography study

Dastgerdi, Aria Chuppani,Navabi, Manizheh,Rakhshan, Vahid The Korean Academy of Conservative Dentistry 2020 Restorative Dentistry & Endodontics Vol.45 No.1

Objectives: This study was performed to assess the anatomy of mandibular first molars. Materials and Methods: In this in vivo study, cone-beam computed tomography (CBCT) volumes of 312 bilateral intact first mandibular molars from 156 patients (79 men and 77 women; average age, 35.6 ± 11.2 years) were investigated in terms of the direction of each canal's curvature in the buccolingual and mesiodistal dimensions (direction of the position of the apex in relation to the longitudinal axis of the root), the presence of an isthmus (a narrow, ribbon-shaped communication between 2 root canals) in 3 segments (0-2, 2-4, and 4-6 mm) from the apex), and the presence and number of accessory canals (smaller canals besides the main root canals, connecting the pulp to the periodontium). Data were analyzed statistically (α = 0.05). Results: Mesiolingual canals were mostly buccally and distally inclined, while mesiobuccal and distolingual canals were mostly distally curved. Isthmuses were more common in younger patients (χ<SUP>2</SUP> test, p < 0.05). The average numbers of accessory canals in the apical, middle, and coronal segments were 9.9 ± 4.2, 6.9 ± 2.9, and 9.3 ± 3.0 canals per segment, respectively (analysis of variance, p < 0.001). Age and sex were not associated with the number of accessory canals (p > 0.05). Conclusions: The complex anatomy of these teeth deserves attention during non-surgical or surgical endodontic treatment. Around the apex, isthmuses might be more prevalent in younger and female individuals.

Isthmuses, accessory canals, and the direction of root curvature in permanent mandibular first molars: an in vivo computed tomography study

Aria Chuppani Dastgerdi,Manizheh Navabi,Vahid Rakhshan 대한치과보존학회 2020 Restorative Dentistry & Endodontics Vol.45 No.1

Objectives: This study was performed to assess the anatomy of mandibular first molars. Materials and Methods: In this in vivo study, cone-beam computed tomography (CBCT) volumes of 312 bilateral intact first mandibular molars from 156 patients (79 men and 77 women; average age, 35.6 ± 11.2 years) were investigated in terms of the direction of each canal's curvature in the buccolingual and mesiodistal dimensions (direction of the position of the apex in relation to the longitudinal axis of the root), the presence of an isthmus (a narrow, ribbon-shaped communication between 2 root canals) in 3 segments (0–2, 2–4, and 4–6 mm) from the apex), and the presence and number of accessory canals (smaller canals besides the main root canals, connecting the pulp to the periodontium). Data were analyzed statistically (α = 0.05). Results: Mesiolingual canals were mostly buccally and distally inclined, while mesiobuccal and distolingual canals were mostly distally curved. Isthmuses were more common in younger patients (χ2 test, p < 0.05). The average numbers of accessory canals in the apical, middle, and coronal segments were 9.9 ± 4.2, 6.9 ± 2.9, and 9.3 ± 3.0 canals per segment, respectively (analysis of variance, p < 0.001). Age and sex were not associated with the number of accessory canals (p > 0.05). Conclusions: The complex anatomy of these teeth deserves attention during non-surgical or surgical endodontic treatment. Around the apex, isthmuses might be more prevalent in younger and female individuals.

Efficacy of hyaluronic acid, absorbable collagen sponge, and their combination in minimizing bisphosphonate-related osteonecrosis of the jaws (BRONJ) after dental extraction: a preliminary animal histomorphometric study

Farzin Sarkarat,Alireza Modarresi,Arefeh Riyahi,Pejman Mortazavi,Fatemeh Tabandeh,Vahid Rakhshan 대한악안면성형재건외과학회 2022 Maxillofacial Plastic Reconstructive Surgery Vol.44 No.-

Introduction: There is no study on the effectiveness of hyaluronic acid (HA) placement either with or without absorbable collagen sponge (ACS) in reducing or preventing bisphosphonate-related osteonecrosis of the jaws (BRONJ). This preliminary animal study examined the efficacy of this clinically important treatment. Methods: For simulating BRONJ, zoledronic acid was administered to 40 rats for 5 weeks. Two weeks later, a right first molar was extracted from each rat. The rats were randomized into four groups of socket treatments: control (empty extraction socket) or with sockets filled with ACS, HA, or HA+ACS (n=4×10). After 2 weeks, 5 rats in each group were sacrificed and subjected to histopathologic and histomorphometric evaluation. Eight weeks postsurgically, the rest of rats were euthanized and histologically examined. The Kruskal-Wallis test was used to compare the four treatments at each time point (α=0.05).

The effects of dentin bonding agent formulas on their polymerization quality, and together with tooth tissues on their microleakage and shear bond strength: an explorative 3-step experiment

Mohmmad Erfan,Tahereh Sadat Jafarzadeh-Kashi,Malihe Ghadiri,Vahid Rakhshan 대한치과보철학회 2014 The Journal of Advanced Prosthodontics Vol.6 No.5

PURPOSE Bonding agents (BA) are the crucial weak link of composite restorations. Since the commercial materials' compositions are not disclosed, studies to formulize the optimum ratios of different components are of value. The aim of this study was to find a proper formula of BAs. MATERIALS AND METHODS This explorative experimental in vitro study was composed of 4 different sets of extensive experiments. A commercial BA and 7 experimental formulas were compared in terms of degree of conversion (5 experimental formulas), shear bond strength, mode of failure, and microleakage (3 experimental formulas). Statistical analyses were performed (α=.05). The DC of selected formula was tested one year later. RESULTS The two-way ANOVA indicated a significant difference between the shear bond strength (SBS) of two tissues (dentin vs. enamel, P=.0001) in a way that dentinal bonds were weaker. However, there was no difference between the four materials (P=.283). The adhesive mode of failure was predominant in all groups. No differences between the microleakage of the four materials at occlusal (P=.788) or gingival (P=.508) sites were detected (Kruskal-Wallis). The Mann-Whitney U test showed a significant difference between the microleakage of all materials (3 experimental formulas and a commercial material) together at the occlusal site versus the gingival site (P=.041). CONCLUSION A formula with 62% bisphenol A-glycidyl methacrylate (Bis-GMA), 37% hydroxy ethyl methacrylate (HEMA), 0.3% camphorquinone (CQ), and 0.7% dimethyl-para-toluidine (DMPT) seems a proper formula for mass production. The microleakage and SBS might be respectively higher and lower on dentin compared to enamel.

Polymerization behavior and thermal characteristics of two new composites at five temperatures : Refrigeration to preheating

Tahereh Sadat Jafarzadeh-Kashi,Marzieh Mirzaii,Mohmmad Erfan,Akbar Fazel,Solmaz Eskandarion,Vahid Rakhshan 대한치과보철학회 2011 The Journal of Advanced Prosthodontics Vol.3 No.4

PURPOSE Heat of composite polymerization (HP) indicates setting efficacy and temperature increase of composite in clinical procedures. The purpose of this in vitro experimental study was to evaluate the effects of 5 temperatures on HP of two new composites. MATERIALS AND METHODS From each material (Core Max II [CM] and King Dental [KD]), 5 groups of 5 specimens each were prepared and their total HPs (J/gr) were measured and recorded, at one of the constant temperatures 0℃, 15℃, 23℃, 37℃ and 60℃ (2 × 5 × 5 specimens) using a differential scanning calorimetry (DSC) analyzer. The data were analyzed using a two-way ANOVA, a Tukey's test, an independent-samples t-test, and a linear regression analysis (α=0.05). RESULTS No polymerization reactions occurred at 0℃; then this temperature was excluded from statistical analyses. The mean HP of the remaining 20 KD specimens was 20.5 ± 14.9 J/gr, while it was 40.7 ± 12.9 J/gr for CM. The independent-samples t-test showed that there were significant differences between the HP of the two materials at the temperatures 15℃ (P=.0001), 23℃ (P=.0163), 37℃ (P=.0039), and 60℃ (P=.0106). Linear regression analysis showed statistically significant correlations between environment temperatures and HP of CM (R2=0.777). CONCLUSION Using CM is advantageous over conventional composite because of its better polymerization capacity. However due to its high HP, further studies should assess its temperature increase in vivo. Preheating KD is recommended. Refrigerating composites can negatively affect their polymerization potential.