Journal of

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Introduction: Fat body mass and body mass index (BMI) are important determinants of bone mineral density (BMD). Although the mechanism involved in this relation is uncertain, it seems that aromatization of androgens to esteradiol in adipose tissue is the most important explanatory mechanism. Materials & Methods: The purpose of this study is to evaluate the correlation between BMI and BMD among 63 women aged 45 to 55 36(57.1%) postmenopausal and 27(42.9%) premenopausal referred to Imam Khomeini hospital. We measured BMD at the lumbar spine (L1-L4), hip (femoral neck, trochanter, and intertrochanter), and Ward's triangle by dual energy X-ray absorptiometry (DEXA). Additionally, body composition was measured in this group. Results: Using WHO BMD T-score criteria, 28.8% of these women had osteoporosis in the lumbar spine and/or the femoral neck. As expected, relative positive linear correlations were found between BMI and BMD at L1-L4 (r=0.315 p = 0.026) and femoral neck (r=0.297 p=0.036), but these correlations were not significant in premenstrual women. Between the age, postmenopausal duration and BMI in relation with BMD, using multiple regression analyses, only BMI remained significant predictor for BMD. The correlation between BMI and BMD was improved after adjustment for age and postmenopausal period (R=0.402, p=0.034 for L1-L4 R=0.376, p=0.049 for femoral neck). Conclusion: The present results, confirming the results of other studies, have revealed a significant correlation between BMD and BMI in perimenopausal women. Our findings suggest that maintenance of adequate body mass (prevention for leanness) is important for prevention of postmenopausal bone loss.

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Introduction: The height of the alveolar bone, is normally maintained by equilibrium between bone formation and bone resorption, but in periodontal disease more destruction or lack of bone formation will reduce the alveolar bone height. However the radiography is important in diagnosis, treatment plan and detection of quality and quantity of the alveolar bone although the type of radiography is more important. The purpose of this study is the comparison between panaromic, P.A (Parallel), Bite Wing radiographs in diagnosis of periodontitis. Methods: This study was descriptive cross-Sectional study Periapical (PA), Bitewing (B.W) & Panoramic radiographic images in 32 pationent 13 male and 19 female with moderate to advanced periodontitis (mean age 38 year) were taken before surgical treatment. Actual hight of defect were measured by a William's probe during surgery, the distance between cemento enamel junction (CEJ) and alveolar crest were measured on radiographs using a digital vernie scale as will as. Actual measurements were compared with values taken from panoramic PA, B.W radiographs. For Data analysis Paired t test was used. Results: A total of 314 linear distances from the panoramic PA , B.W, and CEJ/BL were measured. The mean difference between panoramic and actual Measurements (0.115 and 0.28) P=(0.24-0.07), were not satistically significant (P> 0.05). The mean difference between P.A and actual measurements (0.279-0.498) P=(0.0001-0.004) showed a satistically significant difference (P< 0.05). The mean deference between BW and actual Measurements (0.576-0.613) P=(0.24-0.07) were satistically significant (P<0.05). Conclusion: Although, all forms of radiographic images showed agreement in detection of periodontal bone loss, the accuracy of panoramic radiographs was more than PA & BW radiographs'. Specially when the magnification was adjusted in panoramic radiography.

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Introduction: Rheumatoid arthritis (RA) is the most common autoimmune joint disease. Osteoporosis is a well-known consequence of RA. Objective: The aim of the present study was to determine the interrelationship between radiographic findings and bone mineral density (BMD) in patients with RA. Methods: 70 patients with established RA (according to 1987 ACR criteria) were included in a cross-sectional study. BMD at lumbar vertebrae and hip were measured using DEXA machine. Plain radiographs of both hands of all patients were examined and scored according to the Larsen scoring system. Results: Sixty-five females (92.9%) and five males (7.1%) enrolled in the study. Mean of T-score in these patients was -1.06 in femoral region and -1.56 in lumbar regions. According to lumbar T-score, 50% of patients who were graded in group C Larson score (grade 4, 5) had osteoporosis and 3.33% of patients in this group had osteopenia. A high radiologic Larson score was associated with low BMD at hip and lumbar regions. Age was positively associated with low BMD. Conclusion: Higher radiologic Larson score was associated with reduced BMD in our RA patients. Because of high prevalence of osteopenia in group B (grade 2, 3 Larson score), we suggest routine bone densitometry in this group and taking into consideration anti-resorptive therapy. However, more studies are required to establish and confirm the results.

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Introduction: Bone marrow transplantation is one of the treatment modalities in many hematologic disorders. In recent years, bone marrow transplantation is increasingly being delivered in the outpatient setting. Some studies suggest that outpatient transplantation has many advantages. The aim of this study was to compare the quality of life in outpatient and inpatient multiple myeloma patients after bone marrow transplantation. Methods: This research was a descriptive, comparative study. The quality of life of 35 multiple myeloma patients who had undergone bone marrow transplantation (20 outpatient and 15 inpatient) was assessed. An EORTC QLQ_C30 questionnaire was used for data collection. The questionnaire was completed on three occasions (before transplantation, 45 day after BMT and 90 day after BMT). Descriptive (mean, SD) and inferential statistics (Paired T Test, ANOVA Repeated Measures) were used for data analysis. Results: Comparison of quality of life between inpatient and outpatient settings indicated that quality of life of outpatient group was significantly better than inpatient group in certain aspects including all functional scales, all symptom scales, physical functioning, nausea and vomiting, fatigue, role functioning and appetite loss, and after a period of 90 days after transplantation, there was a significant increase in quality of life of the members of the inpatient group with regards to social functioning (p=0.001), dyspnoea( p=0.05), insomnia(p<0.001) and diarrhea (p=0.07). Conclusion: Although both transplantation methods have their own advantages, but considering the point that outpatient setting results in betterment of quality of life in certain aspects, it is advisable that patients should undergo bone marrow transplantation in an outpatient setting.

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Introduction: Increasing hematological diseases along with increased use of microwaves in different systems proposed possible correlation between them. Age of exposure to wave is also an important factor. This study was conducted to evaluate the effect of radiation leakaged from microwave oven on hemopoitic bone marrow cells at pre and post pubertal. Methods: Fourteen male mature (2 months old) and 14 male immature rats(one month old) were randomly divided in to four groups (control and test). Test groups were exposed, three times a day each time 30 min for 60 days, to microwaves produced by microwave oven. After sixty days, animals were sacrified and bone marrow samples were collected from femural bones. Percent of variose cells type and their morphology were evaluated in 500 cells of each smear. Results: exposure to microwave did not exert visible morphological alteration. In the immature experimental group significant decrease in percent of basophilic rubricyte, polychromatic rubricyte, meta rubricyte and all the erythroid cell types observed(P<0.05), whereas, meta myelocyte, notrophilic band, total myeloid cell types and prolifrative cells, other cell types and the myeloid/erythroid ratio significantly increased(P<0.05). In the mature group, however, a significant decrease in percent of meta rubricyte and myelocyte cells observed(P<0.05), although prolifrative cells and all other cell types were significantly increasing in this group. Conclusion: In conclusion, the radiation leaked from microwave oven in the experimental conditions had no effect on the morphology of hemopoitic bone marrow cells, though the number of these cells was altered especially in immature group.

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Introduction: Ghrelin hormone is a polypeptide with 28 amino acids that is secreted along the gastrointestinal tract, mainly in fundus of stomach. Some physiological functions of ghrelin include increase of appetite and food intake, energy balance, stimulation of growth hormone secretion and heart output and decrease in blood pressure. Recently, relation of ghrelin and bone mineral density has been considered. Methods: This descriptive study included 33 adult persons above 20 years of age. Bone mineral density was determined with dual energy x-ray absorptiometry in femur and lumbar regions. T-score over than -1 was considered as normal case. Ghrelin levels were determined by ELISA method. Results: The mean of age, body mass index and serum ghrelin were 40±10.6years, 27±3.6 kg/m² and 100.5±128 pg/ml, respectively. Correlation of ghrelin and variables was not statistically significant except weight (p=0.05). Conclusion: Range of serum ghrelin levels varies with age. In the present research, there was no relationship between ghrelin levels and bone mineral density in femur and lumbar regions. More studies with larger number of samples are proposed.

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Introduction: Ankyloglossia is an anatomic developmental anomaly determined with thick and short fibrotic ferenum. Hyoid bone plays an important role in tongue physiology and tongue changes, in turn, have sever effects on malocclusion. Taking in to account the effects of tongue position on oropharyngeal structures and relation of hyoid position with different types of malocclusion, this study aimed to investigate the hyoid position in children aged 7-11 years with ankyloglossia in lateral cephalometric radiographs. Methods: 30 radiographs of children with ankyloglossia with mean age of 9.8 were chosen. In addition, 30 other radiographs were selected as the control group and were matched with the experimental (study)group in regard with age, sex, class of malocclusion and growth pattern. The measurements of hyoid position were (C3-RGN, C3-H, H-RGN, HP) analysed via the paired t-test. Results: The means of C3-RGN, C3-H, H-RGN, HP were respectively 66.2, 30.9, 33.4, 3.2 in ankyloglossia group (study), whereas those of control group were 7.45, 36.8, 34.1, 68.6 respectively. A statistically significant decrease was observed in all measurements (p-value<0.05). Conclusion: Size and position of hyoid in the study group demonstrated more posterior- superior position than the controls.

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Introduction: Vitamin E as a strong antioxidant plays an important role in inhibiting free radicals. Therefore, this study aimed to investigate the effect of vitamin E on the viability, morphology and osteogenic differentiation in bone marrow mesenchymal stem cells of an adult rat. Methods: The bone marrow mesenchymal stem cells were extracted using the flashing-out method. At the end of the third passage, cells were divided into groups of control and experimental. Experimental cells were treated withVitamin E (5,10,15,25,50,100,150μM) for a period of 21 days in the osteogenic media containing 10% of fetal bovine serum. The cell viability, bone matrix mineralization, intercellular and extracellular calcium deposition, alkaline phosphatase activity, expression of genes and synthesis of proteins of osteopontin and osteocalcin as well as morphological changes of the cells were investigated. The study data was analyzed using one-way ANOVA and T-Test setting the significant P value at P<0.05. Results: Within vitamin- E treated cells, the mean viability, mean bone matrix mineralization, calcium deposition, alkaline phosphatase activity, expression and synthesis of osteopontin and osteocalcin of the mesenchymal stem cells treated with vitamin E significantly increased in a dose dependent manner. Also cytoplasm extensions were observed in the cells treated with vitamin E. Conclusion: Since vitamin E caused a significant increase in cell viability and osteogenic differentiation in the mesenchymal stem cells, therefore it can be utilized in order to increase cell differentiation and cell survival.

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Introduction: Dental caries and periodontal disease are probably the most common oral chronic diseases in worldwide, and their prevalence is progressively increasing from day to day. Therefore, this study was conducted to investigate the relationship between caries and periodontal disease. Methods: In this cross sectional study, 237 panoramic radiographies of patients aged 10 to 65 years (110males and 127 females) were selected utilizing convenience sampling. In order to measure the variables, a graduate caliper with 0/2 mm accuracy and Negatoscope with optimum light were used. Moreover, in order to diagnose the caries and minimize the errors, “calibration” method was selected. Results: There was no significant relationship between crown caries and mean of alveolar bone loss. (p=0/19). As the age increased in patients, the mean of alveolar bone loss also increased and a significant association was detected between the severity of caries, alveolar bone loss and male gender. Conclusion: Generally, no relationship was observed between dental caries and periodontal disease in this study.

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Introduction: Gelatin and Chitosan are known as biodegradable and biocompatible biopolymers. These biopolymers have recently received increasingly more attention for tissue engineering. The aim of this study was to survey of effects of Gelatin-Chitosan film in viability, proliferation, apoptosis and differentiation on bone marrow stromal cell (BMSCs) culture in rat. Methods: Fist, gelatin- chitosan composites film were prepared by solution mixing , of both biopolymer in %75 acetic acid. After two passage of BMSCs culture, cells in the four groups including control, gelatin, chitosan and chitosan-gelatin were grown. The cells viability during the second, fourth and sixth days by tripanblue, proliferation by cell account and cell apoptosis by Acridin Orange were examined. Also cell differentiation during the second, fourth and sixth day were evaluated by immunocytochemistry . Results: The results showed significant reduction in cell proliferation in chitosan alone group (P<0.05). But the gelatin and chitosan-gelatin groups were similar to the control group as the cell proliferation was increased. Also all groups had no cell differentiation. Conclusion: Results of proliferation,differentiation and apoptosis cultured BMSCs on a gelatin-chitosan film showed that gelatin-chitosan film can be used as a good model of a biodegradable scaffold in tissue engineering and cell therapy.

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Introduction: Oral mucositis is one of the most important side effects of chemotherapy. Bone marrow transplantation is one of the common ways to rescue many patients’ life, therefore, this study intended to investigate the prevalence of oral mucositis and its related factors (age-gender-type of transplantation –site of involvement-smoking-medication except chemotherapy drugs-history of chemotherapy-allergy-oral hygiene) in patients undergoing bone marrow transplantation in Tehran Shariaty hospital during 1 year. Methods: This descriptive cross-sectional study was conducted on 80 patients with BMT. The sampling method was sequential and the study data were gleaned via inspection, clinical examination, questionnaire, medical record examinations in Tehran Shariaty hospital. After collecting the data, SPSS statistic software (version 11/5) was utilized via applying chi-square test in order to analyze the study data. Results: Out of 80 patients (50 men and 30 women), 65 persons (81/25 %) were reported to have oral mucositis. Most of the patients revealed more than 2 involved regions. Among related factors, a significant relationship was found between history of chemotherapy and mucositis. Conclusion: According to high prevalence of oral mucositis in patients undergoing BMT (81/25 %), oral mucositis is supposed to be one of the most serious side effects of chemotherapy drugs, which requires more effective solutions to be controlled so as patients’ quality of life could be improved.

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Introduction: Dental abscesses and periodontal disease can be regarded as the common causes of odontogenic sinusitis. Apical periodontitis, periodontal disease, implant treatment and teeth extraction lead to the increase risk of maxillary sinus mucositis. The maxillary sinuses are usually well visualized on panoramic images. Therefore, this study aimed to explore the association between mucosal thickening of the sinuses and periodontal bone loss(PBL) on the digital panoramic images. Methods: In this cross-sectional descriptive study, a total of 200 digital panoramic images related to patients at least suffering from mild periodontal bone loss were reviewed. Type and severity of PBL of posterior teeth were assessed, and the presence of mucosal thickening was recorded. The study data were analyzed via SPSS software ( version17) applying Chi-square test. Moreover, significant level of P –value of less than. 005 was determined . Results: Mucosal thickening was significantly correlated with the bone loss and pattern type of the bone loss. Moreover, the prevalence of sinus mucosal thickening was 12.10% in patients with mild bone loss, 27.45% in patients with moderate bone loss, 63.15% in patients with severe bone loss. No statistically significant relationship was detected between Maxillary sinus mucositis with patients’ age and sex (p =0.05). Conclusion: In patients suffering from the bone loss, increased severity of the bone loss can lead to an increase in the prevalence of sinus mucosal thickening. The maxillary sinus mucositis was reported to be more prevalent in the bone loss with a vertical pattern rather than the bone loss with a horizontal pattern. Moreover, based on the results of the present study, the periodontal disease may increase the risk of sinus mucosal thickening.

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Background and purpose: Adipose - drived stem cells are multipotent cells that capable to diffrentiate in to osteogenic cells. On the other hand, the scaffold of chitosan and gelatin are biodegradable and compatible used for tissue repair. This study evaluated the repair of femoral bone defect using adipose-derived stem cells on gelatin – chitosan membrane in adult Albino Wistar rats by radiographic and biomechanical tests. Materials and Methods: In this study, sixty male adult rats were equally divided into six groups. 1)Normal group) that received no treatment and bone intact and is only used to compare the biomechanics, 2(Normal Foramen group) femoral bone were removed from the animal body, and were then created bone defect similar to the experimental groups for biomechanic testing, 3 (control group) received no treatment after bone defect. 4 (sham group) after bone defect, the culture medium was injected at the site of bone defect. 5 (gelatin - chitosan group) that gelatin - chitosan membrane was used in to bone defect. Group 6 that transplanted ADSCs in to bone defect. Results: Radiograph bone opacity increased in chitosan – gelatin, cell and cell with chitosan - gelatin groups compared to control group but this difference was not significant. Biomechanical results of bone showed mean Fmax was increased in treatment groups compared to control group however the difference was not significant but compared with the normal foramen group significantly increased. Conclusion: It seems that scaffold of chitosan - gelatin membrane and ADSC cell transplantation appears to be effective in repair of bone defect.

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Introduction: Odontogenic infections are one of the common cause of maxillary sinusitis. This study aimed to evaluate the relationship between the teeth with periapical lesions or periodontal disease and sinus mucosal thickening using cone-beam computed tomography(CBCT). Methods: This was a retrospective and cross-sectional study. CBCT scans of 97 patients(188 sinuses) were evaluated retrospectively for the presence of periapical lesions and/or periodontal disease in posterior maxillary teeth and associated sinus mucosal thickening. Thickening >2 mm was considered pathological and was categorized by degree(normal, 0-2mm, 2–4 mm, 4–10 mm, and >10 mm). Periodontal bone loss was categorized in 25%, 25-50%, >50%. And for data analysis, Chi squre and Spearman correlation were performed. Results: Mucosal thickening>2 mm was observed in 109 sinuses(58%). Data analysis revealed significant associations between the mucosal thickening>2 mm and sex(males, p=0.001), and age(p<0.001). There was a close relationship between mucosal thickening and periodontal bone loss(p=0.057), also there was a significant association between mucosal thickening and periapical lesions(p=0.001). Conclusions: Sinus mucosal thickening was a common radiographic finding, which was more likely to be observed in males with older age and periapical lesions significantly increased the thickness of the maxillary sinus.

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Introduction: Dental implants are the choice of treatment for missing teeth. Despite the very good results, implant treatment is also associated with some failures and complications. The aim of this study was evaluation of survival rate and tissue health indexes around the Dio® SM dental implants placed in patients of dental school and a private office in Isfahan from 2005 until 2010.

Methods: In this cross sectional study, 94 Dio® SM dental implants in 72 patients via convenience sampling were selected. After that  demographic information and Gingival index, Gingival Bleeding index around Dio SM implants, plaque index, pocket depth, Bone loss were fulfilled for patients. Data analyzed using t-test, Chi-square test, Wilcoxon and Pearson test with SPSS Ver. 20 statistical software, at α =0.05.

Results: Among  94 implants, 55.6 % in maxilla, 44.4% in the mandible, 53.19% single and 46.81% were multi-unit. Survival rate of total implants was 80.6% and 19.4% were failed because of different
causes. Among indices Gingival index(p=0/001), plaque index(p=0/020),pocket depth(p<0/001) were
significantly lower than theeth. Periodontal indices except bleeding index were significantly higher
in maxilla (p<0.05) but bone loss was not significant(p=0.071).

Conclusions: The results of this study showed that survival rate of Dio® SM implants is lower than acceptable rate but needs to more studies.

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Introduction: Aging increases the probability of the concurrent incidence of osteoporosis and hypertension. It is demonstrated that antihypertensive drugs can affect bone metabolism. The object of this study was to evaluate the effects of antihypertensive medication on bone mineral density of maxilla and mandible in males over 50 years old using CBCT.

Methods: In this analytical cross-sectional study, 174 CBCT images belong to males over 50 years old were selected according to inclusion and exclusion criteria. According to the history of using antihypertensive drugs by the patients, these images set into three groups: control group who did not have any history of hypertension, beta blocker users group (at least 5 years) and calcium-channel blocker users group (at least 5 years). Bone mineral density in each jaw was obtained in four regions using CBCT and the mean of these four values in each jaw was taken as the mean mineral density of that jaw. One-way ANOVA analysis and Tukey post hoc test were used to compare the mean values.

Results: In beta blocker group, the mean of mineral density of all regions of maxilla except for incisor region was significantly greater than that for the control group. The difference between these two groups in mandible was statistically significant only at the mean of lower jaw. There was no statistically significant difference between the control group and the calcium-channel blocker group at all regions of maxilla and mandible.

Conclusion: It may be preferred to use beta blockers instead of calcium channel blockers to control hypertension in the patients at risk for osteoporosis.

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Title: Evaluation of Haller’s Cell in Panoramic Radiography in Selected Iranian Population.
Background and purpose: The purpose of this study was to evaluate Haller cells in panoramic radiography in Iranian population. Examining the Haller cells in this radiography can be helpful in the differential diagnosis of Orofacial Pain.
 Materials and Methods: This was a descriptive cross-sectional study. 300 panoramic radiographyes were selected including 151 women and 149 men, that they were 18-68 years old. Radiographies were studied by Ahmad et al. Data were analyzed using version 17 of the SPSS software and the Fisher test.
Results: The highest number of Haller cells (%33.33) was founded in the age group of 18- 28 years. The most common form was oval (%45/16) and the least, was cardiac (%1.5). The relationship between the shape and number of Haller cells was significant (P-value <0.001). The prevalence of single Haller cells was (%76.66) more than multiple cells (%23.33). The relationship between the shape and position were significant in Haller cells (P-value = 0.036). Most of the Haller cells were on the left side (%43.66) and the least were bilateral (%15.83).  There were no significant relationship between the shape of the Haller cells and gender (P-value = 0.3), and no presence or absence of cavity were found between the shape of the Haller cells (P-value=%13).
Conclusion: Haller cells have almost the same prevalence in both genders. The most common form of Haller cells was oval and one-sided, and left-handed. There was no significant difference in the existence of cavity in Haller cells.
 

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Introdution: Bisphenol A (BPA) disturbs the morphology, viability and differentiation of rat bone marrow mesenchymal stem cells (rMSCs) to osteoblast via the production of free radicals. Vitamin C (vit-C) is a potent antioxidant and protects cells against oxidative stress. The aim of this study was to investigate the effect of co-treatment of BPA and vitamin C as an antioxidant on the viability and osteogenic differentiation of rMSCs.
Methods: In this experimental study, rMSCs were divided into 4 groups; control, BPA (200nM), BPA (200nM) + vit-C (300µM) as well as vit- C (300µM) and treated for 21 days in the osteogenic media. Then, cell viability, osteogenic differentiation, morphological changes and DNA breakage in different groups of cells were evaluated. Data were analyzed using one-way ANOVA and Tukey‘s test and the means were considered significantly different at P<0.05.
Results: A significant reduction in the cell viability, bone matrix mineralization, alkalin phosphatase activity and intracellular calcium concentration (P<0.001) as well as a considerable increase in DNA breakage was seen in the BPA group compared to the control. The above parameters were compensated in the BPA + Vit-C group to the control level.
Conclusion: The results of this investigation showed that Vit-C can compensate the adverse effects of BPA on the viability and  osteogenic differentiation of rMSCs.

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Introduction: Bone is one of the tissues that have a true potential for regeneration. However, sometimes the bone defects are so outsized that there is no chance of bone self-repair and restoration or the damage is such that it is not possible to repair with medical or surgical interventions. In these situations, bone grafts are the treatment of choice, but due to several obstacles, including limitation in graft preparation and immunological incompatibility, bone grafts face some limitations. In these cases, with the help of regenerative medicine, the bone damages could be repaired. Regenerative medicine provides a new approach for large bone defects by cell therapy and tissue engineering. As, sometime the damaged tissues are so wide that there is no chance of self-repair, the engineered structures help to accelerate the tissue natural repairing. This review focuses on the importance of stem cells and scaffolding for bone tissue engineering. Also, the important characteristics of bone tissue engineered scaffolds like structure, porosity, stability, surface chemistry, bone induction and different met hods of scaffold fabrication are discussed. Up to now, various natural and synthet ic compounds were used for bone tissue engineering, including biopolymers, which are categorized to natural, synthet ic and ceramics. Bioceramics work as effective compound scaffolds in bone tissue engineering. From them bioglasses are one of the important materials which enhance the attachment, proliferation and differentiation of bone cells. Therefore, the current paper discussed biopolymers, as the effective compounds for regeneration of bone tissue.

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