Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201A 30-year Evaluation of the Agreement between Clinical and Histopathological Diagnoses of Peripheral Epithelial and Mesenchymal Lesions In Mashhad Dental School: 1976-200629129746291ENJ.SalehinejadDept. of Oral and Maxillofacial Pathology, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, IranN.SaghravanianDept. of Oral and Maxillofacial Pathology, Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, IranM.Afzal AghaieSocial Medicine Specialist, Medical School, Mashhad University of Medical Sciences, Mashhad, IranR.MohamadiyanGeneral Dentist, IranN.GhaziDept. of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20200215<strong>Statement of Problems:</strong> Sufficient knowledge, experience and careful examination usually lead to appropriate clinical diagnosis. However, lesions with similar clinical features present a diagnostic challenge. Therefore, a confirmatory histopathological examination can be helpful to reach the final diagnosis.
<strong>Purpose:</strong> The present study was conducted to evaluate the agreement between clinical and histopathological diagnoses of oral epithelial and mesenchymal lesions in a period of 30-years (1976-2006) at Mashhad Dental School.
<strong>Materials and Methods:</strong>The percentage of concurrence and discrepancy between clinical and histopathological diagnoses of 625 epithelial and 2480 mesenchymal lesions was compared. Clinical data including the patient’s gender and age and the lesion’s location were also evaluated in cases with discrepancy. Data were analyzed using Mann-Whitney, T-Test, Chi-Square, Likehood Ratio, Fisher’s Exact and Kappa tests.
<strong>Results: </strong>An overall agreement between clinical and histopathological diagnoses was seen in 71/4% of epithelial lesion cases, with maximum parity in squamous cell carcinoma and papilloma. In 57/1% of the mesenchymal cases, the diagnosis was in total agreement. Denture hyperplasia, epulis fissuratum, and pregnancy tumor showed the highest concurrence, respectively.
<strong>Conclusion: </strong>Although histopathological examination leads to final diagnosis, in some cases proper strategies and more attention to clinical features of the lesion are necessary to minimize the discrepancy, especially for those with non-specific clinical presentation.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201Comparison of Adherence of Candida Albicans on Amalgam, Light Cure Composite and Glass Ionomer: an In vitro Study29830546292ENArashAziziDept. of Oral Medicine, School of Dentistry, Islamic Azad University, Tehran, IRAN0000-0001-9219-1219M.FalahatiDept. of Mycology Department, Tehran University of Medical Sciences, Tehran, IranH.HeshmatDept. of Operative Dentistry, Islamic Azad University, Dental Branch, Tehran, IranN.EntezariGeneral Dentist, IranJournal Article20200215<strong>Statement of Problem:</strong> <em>Candidiasis</em> is the most common fungal infection in the human oral cavity. 85% of this infection is caused by <em>Candida albicans</em>. Although there is considerable information about the adhesion of <em>Candida albicans</em> to the epithelial cells and prosthetic materials, there are very few studies in regard to the adhesion of <em>Candida albicans</em> to various restorative dental materials.
<strong>Purpose:</strong> This study aimed to compare the adhesion of <em>Candida albicans</em> to three restorative materials, amalgam, light cure composite and glass ionomer.
<strong>Materials and Method: </strong>In this experimental study, 54 specimens of amalgam, light cure composite and glass ionomer (18 specimens from each group) were transferred to tubes containing suspensions of <em>Candida albicans </em>(1× 10<sup>6</sup> cell/ml). After 40, 80 and 120 minutes, the specimens of restorative materials were suspended in tubes containing 1ml of saline solution and then 100 microlitre of this suspension were plated in Sabouraud Dextrouse Agar. After 48 hours of incubation, the number of <em>candida</em> colonies was counted. Finally, the data were analyzed using kruskal wallis and Mann-Whitney tests.
<strong>Results: </strong>In the composites and amalgams specimens, the adhesion of <em>Candida albicans</em> increased with time and this differences was statistically significant ( <em>p</em> < 0.05). In glass ionomer specimens, no statistically significant difference was observed in different periods of time. The highest value of adhesion was related to composite at 120 minutes and the lowest was observed on a amalgam specimens at 40 minutes.
<strong>Conclusion: </strong>The results of this study show that glass ionomer is an appropriate choice as a dental restorative material especially in patients who are susceptible to <em>candidiasis</em> infections.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201Effect of Aaloe vera Gel Versus Local triamcinolone in Treatment of Oral Lichen Planus20621346294ENDaryoushAmanatDept. of Oral Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IRANR.Bahri NajafiDept. of Pharmacology, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.L.TazaeshDept. of Oral Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.Journal Article20200216<strong>Statement of Problem:</strong> Oral lichen planus (OLP) is a chronic inflammatory disorder which can specially be painful in atrophic, erosive and ulcerative forms. In this area, different treatment plans with different results have been evaluated
<strong>Purpose: </strong>The aim of this article is to compare the effect of aloe vera gel and local triamcinolone in treatment of oral lichen planus lesions.
<strong>Materials and Method</strong>: In this double blind research, 50 patients (13 males and 37 females) having oral lichen planus lesions were selected and randomly divided into two groups. The first group received 70% aloe vera gel and the second group, 0.1% local triamcinolone. Both groups used the drug locally 3 times a day for 8 weeks. All the patients were under follow up every 2 weeks. Clinical evaluation and pain reduction was evaluated by Thongprasom and VAS methods in both groups. Data were evaluated by repeated measure technique.
<strong>Results:</strong> 20 patients of the triamcinolone group showed good response to treatment and 3 patients had complete remission during the treatment period. In aloe vera group, 9 patients had good response and no one showed complete remission ( <em>p </em><0.001). No significant lesion was seen in both groups during the treatment period
<strong>Conclusion:</strong> Application of aloe vera gel is suggested in treatment of erosive and atrophic lichen planus lesions in comparison with steroids. However, according to the results of this study, the use of steroid instead of aloe vera in treating ulcerative lichen planus lesions is a better and more appropriate choice.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201Evaluation of Vessels Density and the Clinicopathological Features of Oral Pyogenic Granuloma and its Histopathologic Subtypes31432046332ENG.RezvaniDept. of Oral Pathology, School of Dentistry, Shahed University of Medical Sciences, Tehran, Iran0000-0002-4093-9827Z.Jafari AshkavandiDept. of Oral Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranSh.MusaviDept. of Oral Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranH.Khadibi BrujeniDentistJournal Article20200225<strong>Statement of Problem:</strong>Due to the clinicopathologic similarity of pyogenic granuloma to some neoplastic or hamartomatouse lesion, vascular density can represent some biological behaviors of this lesion.
<strong>Purpose: </strong>This study aimed to evaluate the density of the vessels and the clinicopathological features of oral pyogenic granuloma (PG) and its histopathologic subtypes.
<strong>Materials &Methods: </strong>Information about age, sex, site, size, duration and the presence of surface ulceration in total and in two histopathologic subtypes (lobular and non-lobular) were collected From 94 PG files in the archives and were compared. Vessel counting was performed on H&E slides and the density of the vessels was compared in two subtypes, two genders and ulcerated and non-ulcerated groups using Independent Samples T- test.
<strong>Results: </strong>Pyogenic granuloma comprised 4.5 percent of all the lesions. The male to female ratio was 1:1.7. The mean age of the patients was 27.99 years and the most frequent involved site was the gingiva (84%). The Non-LCH lesions were more than LCH. Post- mandibular gingiva in the LCH group and the anterior portion of the maxillary gingiva were the most locations of involvement. The mean duration of the presence of the lesion in Non-LCH was more than that in LCH. Surface ulceration in Non-LCH (89.4%) was more than LCH (78.6%). Although the mean density of the vessels was equal in both males and females; there was a significant difference in the lesions with or without surface ulcerations ( <em>p </em>=0.01). However there was no significant difference between the lobular and non-lobular groups.
<strong>Conclusion:</strong> The site of the lesion, duration, and the lower cases with surface ulceration in the LCH form can be in contrast with reactive nature of this subtype, showing similarity to tumoral or developmental lesions. Gender does not influence the density of blood vessels in PG but surface ulceration can influence it.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201Evaluation of the Influence of Resin Cement Thickness on the bond Strength of FRC Post32132646334ENGR.EsfahanizadehDept. of Prosthodontics, School of Dentistry, Islamic Azad University, Tehran, Iran0000-0000-0420-9528MH.SalariDept. of Prosthodontics, School of Dentistry, Islamic Azad University, Tehran, IranS.Zahedi RadGeneral Dentist, IranJournal Article20200225<strong>Statement of Problem:</strong> The increasing popularity and widespread use of fiber posts have changed the procedure of reconstructing endodontically treated teeth. A reinforced composite (FRC) post presents the advantage of having an elasticity modulus similar to the dentin, which reduces the risk of root fracture. Some factors like cement thickness may affect the bond strength of the posts.
<strong>Purpose:</strong> This study aimed to evaluate the influence of resin cement thickness on the bond strength of a FRC post system.
<strong>Materials and Method:</strong> In this experimental study, eighteen single-rooted human teeth were decoronated. (Length: 16 mm) The canals were prepared and the specimens were randomly allocated to two groups (n=9): Group 1, (low cement thickness) in which size 3 FRC posts and group 2 (high cement thickness) in which size 1 FRC posts were cemented. The specimens were sectioned, producing 2 samples (thickness: 4.5mm). For evaluation of the cement thickness, an optical microscope was used. Each sample was evaluated using push-out test and the data were statistically analyzed using T-test.
<strong>Result:</strong> Bond strengths of the 2 groups, low cement thickness and hight cement thickness, did not show a significant different ( <em>p</em> = 0.14).
<strong>Conclusion:</strong> The increase in cement thickness surrounding the FRC post did not impair the bond strength.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201A Comparison of Fracture Resistance of Zirconia Copings Made with CAD/CAM Technology and Slip Casting Technique32733346335ENK.TorabiDept. of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranAH.AhangariDept. of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranS.SalehiDept. of Prosthodontics, School of Dentistry, Ahwaz University of Medical Sciences, Ahwaz, IranM.MotamediProsthodontistJournal Article20200225<strong>Statement of Problem:</strong> Zirconia has been introduced as an appropriate structure for fabricating metal free copings. A major advantage of such restorations is esthetic concerns; however, due to its high strength, zirconia can also be used in posterior areas. One of the recent methods of making these restorations is CAD/CAM machines.
<strong>Purpose:</strong> This study aimed to evaluate the fracture resistance of zirconia copings fabricated by two methods, CAD/CAM and slip casting
<strong>Materials and Method:</strong> 32 brass dies were fabricated for this study and divided into two groups of 16 dies each. Zirconia copings were made by CAD/CAM machine for one group and by slip casting method for the other. The copings were cemented to dies by a resin-modified glass ionomer (GC plus). A hardened steel ball with a diameter of 5 mm was used to apply the load to the copings in the long axis of the dies at a crosshead speed of 0.5 mm/min. Then the amount of force needed to fracture each coping was recorded. Independent Sample T-test was used to compare the two groups.
<strong>Results:</strong> The average of fracture resistance for the CAD/CAM group was 1411± 424 N and for the slip cast group it was 1542±412 N, having no significant difference ( <em>p</em> > 0.05).
<strong>Conclusion:</strong> Zirconia copings made by CAD/CAM and slip casting methods have no significant difference in fracture resistance.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201Comparison of the Effects of Bupivacaine and Lidocaine as Local Anesthetics on the Incidence of Pain after Root Canal Therapy33434246338ENH.MirhadiDept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranS.SahebiDept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranF.MoazzamiDept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranZ.EmamiDept. of Periodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, IranS.SayafanDept. of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20200225<strong>Statement of Problem:</strong> Post-treatment endodontic pain is a concern of both patients and dentists. Several methods and drugs have been suggested to prevent the pain. In several studies, the use of long acting local anesthetics has been considered in the prevention of pain after some dental procedures.
<strong>Purpose:</strong> The purpose of this study was to compare the effect of Bupivacaine and Lidocaine as local anesthetics on the incidence of pain after root canal therapy.
<strong>Materials and Method:</strong> A total of 60 patients referring to 3 endodontists were invited to participate in this double blind clinical trial study. The patients had no history of cardiovascular disease, hypersensitivity to amide types of local anaesthetics, renal failure and hyperthyroidism. They were randomly assigned to one of the two groups: 0.5 percent Bupivacaine with 1.200000 Epinephrine or 2 percent Lidocaine with 1.100000 Epinephrine. After root canal therapy, the extent of postoperative pain was measured during 48 hours and categorized into 4 scores, 0 to 3. The results were analyzed using Mann-Whitney test for comparing the pain scores among the patients and Fischer’s Exact test for evaluating the correlation between, sex, jaw position, type of pulpal disease and preoperative pain with postoperative pain.
<strong>Results:</strong> Statistical analysis showed that Bupivacaine significantly reduced the incidence of flare-up after root canal therapy ( <em>p </em>=0.002) and the need for analgesics was significantly decreased using Bupivacaine ( <em>p </em>=0.01).
<strong>Conclusion:</strong> Long acting local anesthetics can be used in endodontic treatment especially for patients with high prediction of postoperative pain.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201Evaluation of Criteria for Successful Periodontal Therapies in the Posterior Teeth Using Delphi Technique in Iran34334946339ENJ.YaghiniDept. of Periodontology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranM.TavakoliDept. of Periodontology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranN.NaghshGeneral Dentist, IranA.Moghareh AbedGeneral Dentist, IranE.BateniDept. of Periodontology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranA.NazerGeneral Dentist, IranJournal Article20200225<strong>Statement of Problem: </strong>Periodontists use different criteria to assess the success of periodontal treatments so that there is no consistent approach regarding the important parameters to be used for successful treatment.
<strong>Purpose:</strong> The aim of this study was to determine success criteria of periodontal treatment using Delphi method based on the experience of expert panel of periodontists.
<strong>Materials and Method:</strong> In this cross-sectional study using Delphi method, 15 periodontitists in Iran determined the level of importance of attachment level, probing depth, furcation involvement, mobility, plaque, inflammation and patient satisfaction following periodontal treatment of the posterior teeth in a patient with moderate to severe chronic periodontitis. The periodontists were questioned concerning the relative importance of each outcome measure, a minimally acceptable level for success for each criterion and the length of time for these parameters to remain stable.
<strong>Results: </strong>Following two rounds of Delphi surveys, the periodontists considered the attachment level, bone loss and plaque to be a ''very important'' parameter for successful periodontal treatment. Probing depth, furcation involvement, inflammation, function, esthetics, mobility and patient satisfaction were considered to be" important" factors for successful periodontal treatment. The panelists agreed that a minimal of 1mm attachment gain, 1mm reduction in probing depth, Glickman grade I furcation involvement, Miller degree I mobility, and no change in the bone level are acceptable outcomes following 1 year of treatment. Finally, the periodontists considered that 1 year results of treatment should remain stable for a minimum of 5 years.
<strong>Conclusion:</strong> These studies suggest that Delphi method is a practical approach which can establish minimal standards for successful therapy of the posterior teeth based on the opinions of expert periodontists.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201Assessment of Radiologists' Agreement on Measurement of Alveolar Bone Dimension in Tomography before Implant Surgeries35035746340ENS.GoorangDept. of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Z.AziziDept. of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, IranM.RasuliDentistS.ValizadehDept. of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20200225<strong>Statement of Problem: </strong>Different imaging modalities are used for diagnostic objectives in implant treatment and the results are interpreted using individual subjective measurements. The significant differences among the observers' interpretation may result in various treatment outcomes.
<strong>Purpose:</strong> The present study was done to assess the radiologists' agreement on measurement of alveolar bone dimensions in tomographies before implant surgeries.
<strong>Materials and Method: </strong>In this observational diagnostic study, 30 digital conventional tomography images in a dental implant clinic were displayed on a monitor and four observers assessed them using "Digora for windows" software. The length and width of the alveolar bone in the implant recipient site were determined by the observers independently. The data were analyzed using paired T-Test and variance for repeated measures.
<strong>Results: </strong>The means of the predicted length of the alveolar bone were 30.33, 31.48, 30.63 and 30.8 mm and those for the width were 12.0, 11.63, 12.13 and 7.82 mm, as estimated by each observer. The mean predicted value for the width of the implant recipient site was significantly different among observers ( <em>p </em><0.0001), but no significant difference was found for length. The observers' agreement in width assessment with 1mm difference was 3.3% to 40% and 10% to 73.3% with 2mm difference. The observers' agreement in the length detection was 16.7% to 33.3% with 1 mm difference and 33.3% to 60% within 2 mm difference. A higher observer agreement was found in the prediction of the alveolar bone length compared to the width.
<strong>Conclusion: </strong>The results of the study show that the observers' agreement on detecting the alveolar bone length and width in the implant recipient site is not acceptable. However, a slightly higher agreement was estimated for the length of the alveolar bone as compared to the width. Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201The Effect of Dimension and Geometrical Shape of Prefabricated Post and the Material of Crown on the Stress Levels and Distributions in the Root of Restored Molar Tooth Using Finite Element Method35836646341ENM.MahmoudiDept. of Mechanical Engineering, School of Engineering, Shahid Bahonar University, Kerman, IranSA.Gandjalikhan NassabDept. of Mechanical Engineering, School of Engineering, Shahid Bahonar University, Kerman, IranA.SaidiDept. of Mechanical Engineering, School of Engineering, Shahid Bahonar University, Kerman, IranM.HashemipourDept. of Mechanical Engineering, School of Engineering, Shahid Bahonar University, Kerman, Iran0000-0002-1075-4020Journal Article20200225<strong>Statement of Problem:</strong> Researchers are often looking for appropriate treatments while considering esthetic aspects and health. In endodontically treated teeth afflicted with severe damage or complete loss of the coronal structure, a post is usually inserted in the root canal to provide intra-canal retention of the restorations. Therefore, it seemsthat it is necessary to investigate the stress distribution in the restored teeth with different post algorithms.
<strong>Purpose: </strong>In this study, the effects of post geometry and its dimensions on the stress distributions and levels in the root of molar teeth repaired by post-core crown (Ceramic, Alumina and Nickel-chrome) were studied using finite element method.
<strong>Materials and Method:</strong> An extracted intact mandibular second molar tooth was embedded in a cylindrical acrylic resin mould and then were sliced. The sections generated in this way were photographed and the images were transferred into the Solidworks software. After tooth modeling, Posts and crowns were designed. Then, the samples were exposed to a uniform distributed load of 240 N with the load angle of 45 degree which was applied over the occlusal area. In order to simulate the surrounding area of the tooth and also the periodontal ligament space, the bone was also modeled.
<strong>Results: </strong>Numerical results revealed that in the prefabricated post restoration, there was a stress concentration in the cervical region. The maximum value of normal stress (32.3 MPa) was seen in the parallel post with 1.4 diameter (D1.4), and the minimum value (26.7 MPa) was observed in the double tapered post (N0.1). It was observed that the increase in the modulus of elasticity from 100 to 300 causes an increase in normal stress from 69.5 to 38.5 MPa and in tensile stress from 69.5 to 38.5 MPa.
<strong>Conclusion:</strong> Numerical analysis showed that the maximum stress concentration in post core crown restoration increased when the posts with 1.4 mm diameter or post with double taper were used. The stress values decreased with the decrease in the post modulus of elasticity. The maximum stress in the residual dentin decreased by an increase in the post diameter. Besides, the maximum stress on the residual dentine changed irregularly by the change in the tapered post diameter. Also, it was found that crowns material did not have any considerable effect on the stress concentration.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201Shear Bond Strength of Two Self-etch adhesives to Permanent and Deciduous Dentin: Effect of Acid Preconditioning36737546342ENN.NourbakhshDept. of Operative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-2743-2631M.KhoroushiDept. of Operative Dentistry and Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.S.SharifDept. of Operative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20200225<strong>Statement of Problems:</strong> Enamel preconditioning using phosphoric acid has been recommended prior to applying self-etch adhesives. Meanwhile, there is the possibility for etching of the dentin.
<strong>Purpose:</strong> The aim of this study was to evaluate the shear bond strength (SBS) of two self-etch adhesives to the dentin of the primary and permanent teeth in case of phosphoric acid preconditioning.
<strong>Methods and Materials:</strong> In this experimental study, the buccal surfaces of 48 permanent molars and 48 primary molar teeth were prepared for bonding of two self-etch adhesives including Clearfil SE Bond (CSEB) and ACE All Bond SE (ABSE), to the dentin. Each of the permanent and primary teeth was randomly divided into 4 groups (n=12). According to the manufacturers’ instructions, CSEB and ABSE were applied on the dentin or etched dentin of both permanent and primary teeth, then, they were bonded with composite resin. The specimens were stored in water at 37<sup>o</sup>c for 24 hours and then were thermocycled for 500 cycles. SBS was performed at a crosshead speed of 1.0 mm/min using DARTEC universal machine. The results were statistically analyzed in SPSS 11.5 using Kruskal-Wallis and T-Test.
<strong>Results:</strong> The bond strength of CSEB was significantly higher than ABSE adhesive in both primary and permanent teeth ( <em>p </em>=0.001). Acid preconditioning significantly increased the dentin bond strengths of ABSE adhesive in the primary and permanent dentin ( <em>p </em>=0.001), and CSEB adhesive in primary dentin.
<strong>Conclusion:</strong> Bond strength of the studied adhesives was significantly different. While acid phosphoric preconditioning improved the bond strength of the both adhesives in primary teeth, it did not influence the bond strength of the studied two-step self-etch adhesive in the permanent dentin.Shiraz University of Medical SciencesJournal of Dentistry2345-648512420111201A Review of Bisphosphonates and Bisphosphonate-related Osteonecrosis of the Jaw37638746343ENM.ZargaranDept. of Oral and Maxillofacial Pathology, Dental Research Center, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, IranF.BaqhaeiDept. of Oral and Maxillofacial Pathology and Dental Research Center, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, IranJournal Article20200225<strong>Statement of Problems:</strong> Bisphosphonates are a class of agents used in treating a variety of bone diseases, including osteoporosis, multiple myeloma and hypocalcemia due to malignancy. Despite the benefits related to the use of these medications, in recent years, numerous cases of bisphosphonate-related osteonecrosis of the jaws (BRONJ) of patients treated with oral/IV bisphosphonates have been reported. The BRONJ phenomenon is a serious complication, presenting as an exposure of alveolar bone either spontaneously or secondary to invasive oral surgical procedures.
<strong>Purpose:</strong> This review aimed to warn dentists and dental specialists about BRONJ and propose guidelines for diagnosis, staging, management and treatment selection based on the available data and the authors’ experiences.
<strong>Conclusion:</strong> All the patients treated with oral or IV bisphosphonate therapyare are at risk of BRONJ. Suggested guidelines for these two applied forms of bisphosphonates vary. In IV bisphosphonate therapy, all dentoalveolar surgeries are contraindicated and should be avoided. However, the indications are more controversial in the cases of bisphosphonates administered via the oral route and are related to the duration of treatment.