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Focal forms of epilepsy can result from a wide range of insults and can vary from focal symptoms to generalized convulsions. Most drugs that have been developed for epilepsy focus on the prevention of seizures. On Electroencephalography (EEG), seizures are characterized by a repetitive buildup of epileptic waveforms that can spread across the brain. Brain regions that produce seizures generate far more frequent ‘interictal’ spikes seen between seizures, and in animal models, these spikes occur prior to the development of seizures. Interictal spiking by itself has been shown to have significant adverse clinical effects on cognition and behavior in both patients and animal models. While the exact relationships between interictal spiking and seizures are not well defined, interictal spikes serve as an important biomarker that, for some forms of epilepsy, can serve as a surrogate biomarker and as a druggable target. While there are many animal models of seizures for drug development, here we review models of interictal spiking, focusing on tetanus toxin, to study the relationship between interictal spiking, seizures, cognition, and behavior. Studies on human cortical regions with frequent interictal spiking have identified potential therapeutic targets; therefore, having a highly consistent model of spiking will be invaluable not only for unraveling the initial stages of the pathological cascade leading to seizure development but also for testing novel therapeutics. This review offers a succinct overview of the use of tetanus toxin animal models for studying and therapeutic development for interictal spiking.

Introduction: The leading cause of memory impairment is dementia-related disorders. Since current treatments for memory impairment target the neuroinflammatory pathways, we selected dapsone, an anti-inflammatory agent, to evaluate its effects on scopolamine-induced memory impairment in mice and the underlying role of nitric oxide (NO). Methods: Scopolamine (1 mg/kg, intraperitoneal [i.p.]) was used for induction of memory impairment. The animals received various doses of dapsone (0.1, 0.3, 1, 5, and 10 mg/kg, i.p.). Duration and number of arms visits in the Y-maze and step-through latency in the passive-avoidance were documented. To evaluate the underlying signaling pathway, N(ω)-nitro-L-arginine methyl ester (a nonspecific NO synthase [NOS] inhibitor), aminoguanidine (a specific inducible NOS inhibitor), and 7-nitroindazole (a specific neuronal NOS inhibitor) were administered 30 min after dapsone administration. Results: Dapsone (5 mg/kg) substantially improved memory acquisition in scopolamine-induced memory impairment. Additionally, NOS inhibitors considerably reversed the observed neuroprotective effects of dapsone, accompanied by the elevation of NO levels. Conclusion: Dapsone revealed a neuroprotective effect against scopolamine-induced memory impairment in mice, possibly through the nitrergic pathway.

Background: Mental health is a significant problem in developed and developing countries which influences all aspects of life. We aimed to evaluate the status of Iranian students’ mental health. Methods: This cross-sectional study was performed on 2052 elementary school students located in Tehran, Iran, in September 2018. We used the Census sampling method for sampling and the general health questionnaire comprising 28 items. For statistical analysis SPSS software, version 21 was used. Results: A total of 2052 elementary school students (1373 girls and 679 boys) participated in this study. The mean ± standard deviation (SD) ages of the girls and boys were 14.1±1.7 and 13.9±1.1 years, respectively. The mean ± SD of anxiety, social dysfunction, and depression scores were 7.42±4.92, 7.35±3.33, 6.83±2.26 in the girls and 5.65±3.89, 6.30±3.09, 4.61±1.74 in the boys, respectively. The mean ± SD total scores in boys and girls were 20.48±12.31 and 27.90±14.66, respectively. Conclusion: The mental health status of elementary school students was generally low, especially in male students.

Background and purpose: Status epilepticus is a severe neurological disorder that can be life-threatening. Thalidomide and its analogs have shown promising results to confront pentylenetetrazole-induced seizures. This study aimed to evaluate the potential effects of three synthesized thalidomide derivatives on lithium-pilocarpine-induced status epilepticus. Experimental approach: To induce status epilepticus, rats received lithium chloride (127 mg/kg, i.p.) and pilocarpine HCl (60 mg/kg, i.p.) 20 h after lithium chloride injection. Thirty min before pilocarpine HCl administration, rats received hyoscine N-butyl bromide (1 mg/kg, i.p.) and concurrently one of the test compounds (5B, 5C, and 5D), diazepam, thalidomide, or vehicle (4% DMSO) to evaluate their anti-epileptic effects. Epileptic seizures scores were assessed through the Racine scale. Twenty-four h after injection of pilocarpine, brain samples were extracted for further histopathological evaluation. Findings/Results: Results revealed that among tested compounds (5B, 5C, and 5D), only compound 5C (1 mg/kg) exhibited excellent anti-epileptic activity comparable to diazepam (10 mg/kg). Compound 5D (100 mg/kg) only demonstrated comparable anti-epileptic activity to thalidomide (1 mg/kg). Compound 5B did not have any anti-epileptic activity even at the dose of 100 mg/kg. The histopathological survey showed that compound 5C has more neuroprotective effects than diazepam and thalidomide in the cortex of the brain. In the cornu ammonis 1 region, thalidomide had higher protective properties and in the cornu ammonis 3 and dentate gyrus areas, diazepam had higher efficacy to prevent necrosis. Conclusion and implications: Compound 5C is a good candidate for further studies regarding its potency, compared to thalidomide and diazepam.

Background: Smile esthetics can be subjective. This study aims to assess the effect of culture/geographic location on judging smile esthetics by comparing the perception of smile characteristics between American laypersons (Western culture) and Iranians (Eastern). Materials and Methods: One hundred residents from each country were recruited for this analytical cross-sectional study. A frontal picture of a posed smile with standard norms which are mentioned in the Contemporary Orthodontics textbook by William R. Proffit was selected. Adobe Photoshop 7 was used to alter midline diastema, gingival display (GD), maxillary midline-to-face discrepancy, buccal corridor (BC), and smile arc. Images were given to groups to determine the most attractive and acceptable smile. Data were analyzed by Chi-square, Mann–Whitney, and Spearman correlation coefficient in SPSS-22 (α =0.05). Results: Americans were less critical in judging diastema (P < 0.001), GD (P = 0.013), and BC (P = 0.004) for smile attractiveness than Iranians. No difference was between the two groups in choosing the acceptability threshold and determining the most attractive smile except for BC (P = 0.002). Conclusion: Overall, Americans were more tolerant of variations in smile characteristics than Iranians. Both groups agreed on most smiles. Therefore, it seems that it is reasonable to use similar standards for smile characteristics while considering the small differences.

Abstract Background The timely and appropriate utilization of dental health care is essential to the prevention and accurate treatment of oral diseases. Therefore, it is crucial that managers, health professionals and healthcare providers be fully aware of the predictors encouraging the utilization of dental services and reduce social inequalities. In this scoping review, we aimed to analyze the published articles and reports to find out the factors associated with dental services utilization and the comprehensiveness of the applied models among general adult populations. Materials and methods This scoping study was based on the 5-steps of Arksey and O’Malley framework. Keywords were selected under two main concepts: determinants of dental care utilization and the concept of the applied models. Searches were conducted in some electronic databses including PubMed, Google Scholar and Scopus with variations, and a combination of the keywords under the two main afore-mentioned concepts. All the relevant articles reporting the utilization of dental care and its potential predictors among adult populations were chosen. No restrictions involving terms of study time, location or methodological aspects of oral health utilization were considered. Using tables and charts mapping, we tried to group the studies based on the year of their publication, geographic distribution, the range of included indices and the type of their measurement. Also, a directed content analysis method was used to investigate the comprehensiveness of the studies in regard to considering the determinant factors at different levels suggested by the Andesen model. Results Fifty-two articles were included in the analysis. Thirty-six (69%) had been published between 2016 and 2020. The United States had conducted the most research in this scope. About 30% of studies had mentioned all three domains of demographics, social structure and beliefs, simultaneously. To evaluate the enabling factors, in 84.61% and 59.61% of studies, the income levels and insurance feature were assessed, respectively. 57.69% of the retrieved studies considered the perceived need features and 38.46% referred to the evaluated ones. The dental services utilization, in terms of the last visit during the “past 12 months”, was assessed more commonly. Only 11.54% of studies did evaluate the contextual characteristics and about 71.15% of articles were relatively comprehensive. Conclusion Overall, it seems that in most of the studies, not all of the determinant factors at different levels of the Andersen model have been considered. In order to discover the conceptual linkages and feedback loops of the model, it is essential to conduct more comprehensive research in the future.

Background: Malocclusion is a common oral health problem and can affect the psychosocial well-being in the long term. Therefore, in the recent decades, demand for orthodontic treatment to correct malocclusion has greatly increased worldwide. This systematic review and meta-analysis was undertaken to assess existing evidence on the prevalence of orthodontic treatment need in Iran. Materials and Methods: National and international databases were searched for articles on the prevalence of orthodontic treatment need using index of orthodontic treatment need (IOTN) and dental aesthetic index (DAI). The required data were completed by hand-searching. After applying the inclusion and exclusion criteria, the quality of articles was checked by a professional checklist. Data extraction and meta-analysis were performed. A random effects model was employed, and publication bias was checked. Results: From a total of 443 articles that reported orthodontic treatment need in Iran, 24 articles were included in the meta-analysis process. Meta-analysis was performed on components of IOTN and DAI. The pooled prevalence of orthodontic treatment need based on Dental Health Component and Aesthetic Component of IOTN and DAI was 23.8% (19.5%–28.7%), 4.8% (3.3%–7%), and 16.1% (12.3%-20.8%). The results were found to be heterogeneous (P < 0.05). Conclusion: The results of this study revealed that orthodontic treatment need was not high in the Iranian population. Considering the differing prevalence of orthodontic treatment need based on normative index and self-perceived index, it is essential to improve the people's awareness of malocclusion and its side effects on their oral and general health.

BACKGROUND AND AIM: The aim of this study was to assess the level of dental care satisfaction among Iranian adult population and to identify socio-demographic factors and factors related to dental service that affect satisfaction. METHODS: A self-administrated valid and reliable 21-item questionnaire was designed and distributed among 1360 adult population living in Isfahan, Iran, using multi-stage proportional cluster sampling. It consisted of 5 main sections including demographic questions, perceived oral health status, oral health behaviors, barriers in receiving the demanded care and some 5-point Likert scale questions to assess the satisfaction level. Chi-square and analysis of variance were used to compare variables. People were classified as satisfied/dissatisfied based on their total score with score of 26 as the cut-off point. A logistic regression model was used to identify the factors affecting the level of satisfaction and to estimate their effect size. RESULTS: The mean age of participants was 31.2 ± 11.3 and they mostly reported to have dental visits during the last year. The mean satisfaction score was 3.34 out of 5 (53% were satisfied) and the least and the most satisfaction was in regard to waiting time and the convenience to access, respectively. Logistic regression showed that participants in lower age group [odds ratio (OR) = 0.7], those who reported their oral health status as poor (OR = 0.8) and those who had to spend more time to reach dental care setting (OR = 0.6) and those who had to wait more (OR = 0.5) were less satisfied. CONCLUSION: About 53% of participants were satisfied which was much lower than percentage of satisfied people in developed countries and the level of satisfaction was associated with socio-demographic, behavioral and also dental service.

Background: To determine patient orthodontic treatment need, appropriate self-perceived indices are required. The aim of this study was to assess the sensitivity and specificity of esthetic component (AC) of the index of orthodontic treatment need (IOTN), oral esthetic subjective index scale (OASIS), and visual analog scale (VAS) through dental health component (DHC) IOTN as a normative index to determine the more appropriate self-perceived index among young adults. Materials and Methods: In this cross-sectional study, a sample of 993 was randomly selected from freshman students of Isfahan University. Those with a history of orthodontic treatment or current treatment were excluded. DHC was evaluated by two inter- and intra-calibrated examiners. Data for AC, OASIS, and VAS were collected through a questionnaire completed by students. Descriptive statistics, Mann–Whitney U-test, and Spearman correlation test, were used for data analyses. Sensitivity, specificity, positive and negative predictive values of self-perceived indices were calculated through DHC. Results: Sensitivity of AC, OASIS, and VAS for evaluating definite orthodontic treatment need was calculated at 15.4%, 22.3%, and 44.6%, respectively. Specificity of these indices for evaluating definite orthodontic treatment need was calculated at 92.7%, 90.5%, and 76.2% percent, respectively. All self-perceived indices had a significant correlation with together and with DHC (P < 0.01). Among demographic factors, there was weak but significant correlation only between mother's educational level and VAS (P < 0.01). Conclusion: Due to the sensitivity and specificity of the three self-perceived indices, these indices are not recommended for population screening and should be used as adjuncts to a normative index for decision-making in orthodontic treatment planning.

Background: The aim of this study was systematic review and meta-analysis of prevalence in current and relevant literature about this developmental disorder to present the profile of malocclusion in Iran. Methods: This review study was carried out with systematically identified and critically assessed studies reporting malocclusion prevalence among Iranian population in permanent dentition. National and international databases were searched for articles about prevalence of malocclusion by Angle classification in different regions of Iran from 1994 to 2015. After applying inclusion and exclusion criteria, the quality of articles was checked by professional checklist. Data extraction and meta-analysis was performed. A random-effect model was employed. Publication bias was checked. Results: Of 2768 articles, 21 cases were included .The pooled prevalence of malocclusion was about 87% (95% CI: 78.3–92.2) in Iranian population; however, the prevalence of malocclusion across individual studies varied considerably (ranging from 23.7% to 99.7%). Prevalence of normal occlusion, class I, II and III malocclusion were reported as 13.3% (CI 95%: 7.8–21.7), 50.7% (CI 95%: 42.9-58.4), 21% (CI 95%: 17.5-25.1), 5.5% (CI 95%: 3-10); respectively. Maximum prevalence of malocclusion was in the East of Iran. Conclusion: The results showed a high prevalence of malocclusion in Iranian population. The baseline information could be appropriately utilized for the future planning to meet the orthodontic treatment need among the Iranian population.

The aim of this investigation was to determine the impact of orthognathic surgery on quality of life in patients with dentofacial deformities at immediate presurgery and at 3-week, 3-month, and 6-month intervals following the surgery. Subjects included forty-three 18–40-year-old Iranian orthognathic patients who were referred to private offices in Isfahan. Data collection was performed using the 22-item Orthognathic Quality of Life Questionnaire (OQLQ). Participants completed the questionnaire prior to surgery and 3 weeks, 3 months, and 6 months after it. Differences and correlations were calculated by the two-tailed t-test, ANOVA with Repeated Measure test, and the Pearson correlation coefficient. The results showed significant reduction returned to baseline in OQLQ mean scores and aesthetic, awareness, and social subdomains in all 3 intervals after surgery. However oral function domain showed an increase at T2 and then a decrease at next intervals. Maximum and minimum effect size were observed in aesthetic (ES = 0.7) and oral function (ES = 0.3) domain, respectively. Based on the finding of this study, in 6-month interval after surgery, orthognathic surgery causes significant improvements in quality of life in patients with dentofacial deformities as assessed in emotional, psychological, oral function, and social domains and maximum changes occurred in emotional domain.

Background: A comprehensive system of assessing orthodontic need requires the integration of normative clinical measures with patient-based indicators. This study sought to discover weather an oral health-related quality of life measure or Aesthetic Component of Index of Orthodontic Treatment Need (AC-IOTN) could be used as a predictor of orthodontic treatment need. Factors affecting the judgment of patient and dentist about this need are discussed. Materials and Methods: Oral examination on 597 Iranian students between 13 years and 18 years was done to reach the grade of Dental Health Component (DHC). The Child Oral Health Impact Profile (COHIP) and AC-IOTN were recorded. The diagnostic values of subjective tests were assessed. Multiple logistic regressions were applied to investigate the role of variables in the persons′ perceptions. Results: Half of the 570 eligible students did not need orthodontic treatment either on professional or self-assessment; 60% of patients with definite need had a distinct impact on their quality of life. The specificity of AC to detect the healthy persons was excellent (0.99) but its sensitivity was low (0.08). COHIP score gave a better sensitivity but its specificity was 50%. Caries experience, quality of life, father′s education, and brushing habits were the factors relating to the same judgment of persons and dentists (P < 0.02). Conclusion: Regarding the discrepancies between two assessment methods, present instruments did not meet the predictor′s competencies. The patient-based methods could not substitute the professional assessment, but by identification, the persons with higher impacts would benefit the prioritization process.

AbstractIntroduction: Considering the positive effect of health education on behavior change and health promotion, this study aimed at evaluating the effect of an educational program about fissure sealant therapy (FST) on behavior of mothers in relation to providing FST for their children.Materials and Methods: This randomized controlled trial evaluated 180 students with an age range of 6 to 9 years and their mothers in Isfahan. The participants were randomly divided to 3 groups: 2 intervention and one control group. The subjects were included if they had at least one sound first molar and excluded if they had any history of FST. One intervention group received the educational program through an oral presentation supplemented with a pamphlet and the other group was mailed only a pamphlet. The control group did not receive any instruction. After three months, the subjects' first molars were clinically examined for the presence of FST. Descriptive analysis and chi-squared test were used for data analysis at 95% confidence interval.Results: After three months, 11.7% of the subjects had FSTs, 66% of which were in the oral presentation group and 34% were in the pamphlet group. There were no teeth with FST in the control group. There were no significant differences between the intervention groups (p value < 0.08); however, there were significant differences between the intervention groups and the control group (p value = 0.001).Conclusion: Educational programs can effectively change the attitudes of mothers and encourage them to provide fissure sealant services for their children.Key words: Behavior, Education, Pit and fissure sealants, Prevention.

Background and Aims: Normative need assessments should be substituted or integrated by patient-based outcome measures regarding their shortages in health-oriented approach . This study aimed to assess and compare the ability of an index of oral health-related quality of life measured by Child Oral Health Impact Profile (COHIP) questionnaire and the Aesthetic Component of Index of Orthodontic Treatment Need (AC-IOTN) to identify the normative need to orthodontic treatment using Dental Health Component-IOTN in a sample of the Iranian adolescents.Materials and Methods: Target population of this cross-sectional analytic study was 597 of the 13 to 18 year-old schoolchildren enrolled in middle and high schools of the city of Isfahan, Iran. They completed the COHIP questionnaire and then were examined by two calibrated trained dentists (agreement coefficient:0.9) to record the DHC grading. The students scored their AC in according to the images of the scale. The association between subjective indicators and clinically defined need were evaluated by the correlation analysis and the statistics for the diagnostic validity of tests.Results: Of 568 examined students, 16.7% and 2.1% had definite need according to DHC and AC criteria, respectively. 10% of orthodontic patients had perceived distinct impact on their quality of life. The significant association (P=0.001) between the severity of malocclusion and quality of life was at moderate level by AC (R=0.37), but it was not convincing enough by DHC (R=0.16). The specificity of AC to detect the healthy ones showed to be excellent but its low sensitivity disabled the recognition of patients, precisely.Conclusion: The considered patient-based indices did not meet the competencies to define the orthodontic need in the adolescents, but it could be employed to identify the persons with impaired quality of life and it would probably benefit the process of prioritization.

Introduction: Clinical education has a remarkable importance in medical education. Awareness of dentistry students’ view from the educational setting, faculty and nurses will help on developing strategies for qualitative and quantitative improvement of clinical training. This study aimed to assess Isfahan Dental School students’ satisfaction and views or satisfaction of clinical setting, in order to gain insight about its strengths and weaknesses. Methods: In a cross-sectional study, all of students of Isfahan Dental School in one educational year (1388) were asked to fill a questionnaire with 16 standard questions. The questionnaire was about student’s satisfaction from teachers, nurses, equipments and facilities of clinical setting, student’s self-steams and satisfaction of their action in clinical practices. The data was analyzed by SPSS software using descriptive statistics, ANOVA and t-test. Results: There was a significant statistically difference between the mean score of satisfaction of different departments. Maximum satisfaction in all components was shown in periodontics and orthodontics departments and minimum satisfaction was shown in endodontic and prosthodontics departments. There was a negative correlation between their satisfactions and their final grades, but this correlation was not statistically significant. Conclusion: Results showed that despite significant differences between satisfaction of different clinical departments, students’ satisfaction from different departments is desirable. However, it is suggested to consider in future planning prosthodontics and endodontic departments as a priority.

Introduction: The current study aims to study people's access to oral and dental health-care services and their satisfaction with the services provided to them. Materials and Methods: A descriptive study with multi-stage sampling was conducted on 1360 people aged 16–64 years residing in Isfahan city, Iran. The required data were collected by a questionnaire which comprised of three main parts: demographic characteristics, patients' access to oral and dental health-care services and its barriers and participants' satisfaction with access to services. Data were analyzed by SPSS statistical software. Results: The results showed 40% of participants reported an average level for oral health, and 82% of them did not have any problems regarding access to dental care facilities. The main causes of their dissatisfaction were high cost of services (60%) and insufficient health insurance coverage (40%). About 73% reported that they had to spend 30 min or less to access to a dental health-care facility. In addition, 50% of participants were satisfied with the provided services. The main reported reasons for referring to dentists were oral and dental problems (69%) and regular check-ups (15%). There was no significant relationship between participants' gender, education level, insurance coverage, and access to dental health-care centers (P > 0.05). Conclusion: Most participants were satisfied with access to dental healthcare, but they were dissatisfied with the costs and inadequate insurance coverage. About half of the participants were satisfied with the services provided to them, and the highest level of satisfaction was reported for easy access to health-care centers.

Introduction: Graduated dentistry students ought to be competent in different fields of community dentistry such as health education, needs assessment, planning and policy making. The aim of this study was to assess the effect of community dentistry course on dental students' competencies in different fields of community dentistry through self-monitoring method in Isfahan School of dentistry. Methods: This quasi-experimental study was conducted on two groups using pre-test and post-test. Through census sampling method, 50 students were studied before and after passing the community dentistry course, as experiment group and 40 students who did not pass this course were studied as the control group at the time of graduation. The data gathering tool was a questionnaire which was completed by students as self-administered. The questionnaire assessed students' competencies in 6 determined areas with a scale ranging from unacceptable to excellent. The results were analyzed by SPSS software using Paired t-test and t-test. Results: The difference between the scores of experiment group's competencies in all six determined areas was significant, before and after passing the course. Comparing the scores of the experiment and control groups showed significant differences in all areas except in "preventive dentistry services". Conclusion: Community dentistry course has been successful in making the students competent in community dentistry fields. In order to improve these results, it is recommended to devote more time and facilities to the subjects such as needs assessment and course planning.