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Heck's disease or focal epithelial hyperplasia is a benign contagious disease caused by human papillomavirus types 13 or 32. It occurs with low frequency in the Iranian population. This condition is characterized by the occurrence of multiple, small papules or nodules in the oral cavity, especially on the labial and buccal mucosa and tongue. In some populations, up to 39% of children are affected. Conservative surgical excision of lesions may be performed for diagnostic or aesthetic purposes. The risk of recurrence after this therapy is minimal, and there seems to be no malignant transformation potential. In the present work, we presented the clinical case of a 12-year-old Iranian girl with oral lesions that clinically and histologically correspond to Heck's disease. [ABSTRACT FROM AUTHOR]

Aim : In this paper, the temperature and stress distributions in an exact 3D-model of a restored maxillary second premolar tooth are obtained with finite element approach. Objective : The carious teeth need to restore with appropriate restorative materials. There are too many restorative materials which can be used instead of tooth structures; since tooth structures are being replaced, the restorative materials should be similar to original structure as could as possible . Materials and Methods : In the present study, a Mesial Occlusal Distal (MOD) type of restoration is chosen and applied to a sound tooth model. Four cases of restoration are investigated: two cases in which base are used under restorative materials and two cases in which base is deleted. The restorative materials are amalgam and composite and glass-inomer is used as a base material. Modeling is done in the solid works ambient by means of an exact measuring of a typical human tooth dimensions. Tooth behavior under thermal load due to consuming hot liquids is analyzed by means of a three dimensional finite element method using ANSYS software. The highest values of tensile and compressive stresses are compared with tensile and compressive strength of the tooth and restorative materials and the value of shear stress on the tooth and restoration junctions is compared with the bond strength. Also, sound tooth under the same thermal load is analyzed and the results are compared with those obtained for restored models. Results : Temperature and stress distributions in the tooth are calculated for each case, with a special consideration in the vicinity of pulp and restoration region. Numerical results show that in two cases with amalgam, using the base material (Glass-ionomer) under the restorative material causes to decrease the maximum temperature in the restorative teeth . In the stress analysis, it is seen that the principal stress has its maximum values in composite restorations. Conclusion : The maximum temperatures are found in the restoration case of amalgam without base. Besides, it is found that restoration has not any influence on the stress values at DEJ, such that for all cases, these values are close to sound tooth results.

Introduction: Many patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems., Methods: The sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant's permission, no note-taking was done during the interviews, which allowed for greater focus on the participants' conversation. The obtained data was analyzed using the content analysis., Results: A total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient's perceptions of general practitioner(GP) and dental practitioner's scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs., Conclusion: Most participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient's consult behaviors regarding dental problems., (© 2024. The Author(s).)

Introduction: Fluoride is the main factor in reducing the prevalence of caries worldwide. However, there is insufficient knowledge about whether people in different age groups are aware of the benefits of fluoride toothpaste, as well as about people's daily oral care habits and whether they use fluoride. The purpose of this research is to investigate the knowledge and performance of Iranian students regarding the use of toothpaste containing fluoride., Method: This study was conducted on the first- and second-year high school students of Kerman city. Questionnaires containing personal questions, general questions, and questions related to students' knowledge and performance regarding the use of fluoride toothpaste were provided to them and then they were asked to complete and submit it. The results obtained from the survey were analyzed by T-test, Mann-Whitney test, and Chi-Square test in SPSS Version 24. The significance level in data analysis was P < 0.05., Results: In this research, 681 forms including 252 boys and 429 girls were examined. The average age of the participants was 14.1 ± 0.4. 91.2% declared that they use toothpaste and 77.8% of them used toothpaste containing fluoride. 521 people stated that the price of toothpaste is important in using the type of toothpaste. 621 people used regular toothbrush and 609 people evaluated their oral health as good. 621 of the participants stated that toothpaste makes the mouth healthy. The average knowledge score was 16.7 ± 2.1 out of 24, which indicates the average knowledge of students in this field., Conclusion: This study showed that students' knowledge and performance about using fluoride-containing toothpaste is average. There was no significant relationship between performance and knowledge with age and gender. There was also a positive correlation between knowledge and performance indicating that increasing knowledge leads to an increase in behavioral changes. Also, there was a positive correlation between knowledge and performance, and a correlation coefficient of 0.731 was obtained between knowledge and performance. It shows that increasing knowledge leads to increasing behavioral changes., (© 2024. The Author(s).)

Introduction: Oral Lichen Planus (OLP) is a chronic and relatively common mucocutaneous disease that often affects the oral mucosa. Although, OLP is generally not life-threatening, its consequences can significantly impact the quality of life in physical, psychological, and social aspects. Therefore, the aim of this research is to investigate the relationship between clinical symptoms of OLP and oral health-related quality of life in patients using the OHIP-14 (Oral Health Impact Profile-14) questionnaire., Materials and Methods: This descriptive-analytical study has a cross-sectional design, with case-control comparison. In this study, 56 individuals were examined as cases, and 68 individuals were included as controls. After recording demographic characteristics and clinical features by reviewing patients' records, the OHIP-14 questionnaire including clinical severity of lesions assessed using the Thongprasom scoring system, and pain assessed by the Visual Analog Scale (VAS) were completed. The ADD (Additive) and SC (Simple Count) methods were used for scoring, and data analysis was performed using the T-test, Mann-Whitney U test, Chi-Square, Spearman's Correlation Coefficient, and SPSS 24., Results: Nearly all patients (50 individuals, 89.3%) reported having pain, although the average pain intensity was mostly mild. This disease has affected the quality of life in 82% of the patients (46 individuals). The patient group, in comparison to the control group, significantly expressed a lower quality of life in terms of functional limitations and physical disability. There was a statistically significant positive correlation between clinical symptoms of OLP, gender, location (palate), and clinical presentation type (erosive, reticular, and bullous) of OLP lesions with OHIP-14 scores, although the number or bilaterality of lesions and patient age did not have any significant correlation with pain or OHIP scores., Conclusion: It appears that certain aspects of oral health-related quality of life decrease in patients with OLP, and that of the OLP patient group is significantly lower in terms of functional limitations and physical disability compared to the control group. Additionally, there was a significant correlation between clinical symptoms of OLP and pain as well as OHIP scores., (© 2024. The Author(s).)

Background: Nowadays, the adverse effects of smoking on general, oral, and dental health are reported time and again worldwide. However, evidence to quantify the effects of tobacco smoking and smoking cessation on health-related quality of life (HRQoL) and oral health-related quality of life (OHQoL) is inadequate. Accordingly, this study aimed to assess the effects of nicotine gum on HRQoL and OHQoL of cigarette smokers., Methods: This pilot study was conducted on 40 smokers, half of whom received nicotine gum. HRQoL and OHQoL were measured twice at the beginning of the study and after three months using standard versions of Short Form Health Survey (SF-12) and Oral Health Impact Profile (OHIP-5) questionnaires. T-test, Fischer's exact test, and Pearson's correlation coefficient were used to compare the participants' scores on the questionnaires., Findings: The mean age of the participants was 43.39±12.32 years. Using nicotine gum significantly increased the scores of general health ( P =0.046) and physical functioning ( P =0.021) domains of HRQoL in comparison with the cigarette smoking group. Moreover, using nicotine gum significantly increased the scores of the two questions about the reduced sense of taste ( P <0.001) and difficulty doing usual jobs ( P =0.071)., Conclusion: Using nicotine gum was associated with the improvement of HRQoL and OHQoL to some extent. To better understand the relationship between smoking cessation and improved OHQoL, it is necessary to conduct further studies in this field., Competing Interests: Competing Interests The authors declared no conflict of interest., (© 2024 Kerman University of Medical Sciences.)

Introduction: The journals must have an instruction for writers to observe the essential ethical principles like privacy-preserving, secrecy, and keeping the patients' identities hidden. Even though patient secrecy is an important ideology in medicine's ethics, most journals have a little guide on this topic for the authors. According to the absence of such studies in dentistry and limited studies in medicine, our goal in this article is to review the opinions of professors, Kerman dentistry students, and patients for publishing the patient images in the articles., Method: This research is an analytical, sectional, and descriptive study. The studied society includes the professors of the dentistry faculty (54 people), the 4th to 6th years dentistry students (122 people), and 129 patients who referred to the offices, the faculty, and other clinics in Kerman city base on simple random sampling method. A query including the personal questions, and questions related to the participants' opinions about publishing the images was given to contributors. Abundance, average tables, chi-square (χ 2) test, T-test, and SPSS 21 software were used for data description., Results: The contributors' attitudes were different in three groups of participants: more than half of the patients (58.91%), 39.5% of students, and 31.38% of professors believed that no permission is needed. While, 64.34% of the patients, 89.34% of students, and 83.3% of professors believed that written permission is needed for publishing., Conclusion: From the participants' viewpoints, more strict forms are needed by increasing identity recognizability. The professors are more eager than the patients to receive patients' permission for any kind of image. By reducing the level of identification, doctors and students are more eager than patients to receive approvals., (© 2023. The Author(s).)

Objective: There has been shown a relationship between "tongue coating" and "Simplified Oral Health Index, periodontal status, modified mallampati classification (MMC) of the oropharynx and oral malodor". The purpose of this study is to assess the frequency of tongue coating and relative factors (sex, age, smoking, systemic disease and oral health indices) among patients referred to Dental School of Kerman University., Methods: In this cross sectional study 250 patients referred to dental school of Kerman university of medical sciences were examined. The data collection form was included demographic data (gender, age, history of systemic disease and smoking) and Oral health indices such as TCI (Tongue coating index), OHI-S (Simplified Oral Hygiene Index), MGI (Modified Gingival Index), MMC and lost teeth. The analysis have been done using SPSS21, T-test, Pearson correlation coefficient and linear regression analysis (significance level was set at less than 0.05)., Results: Tongue coating has been shown in 96% of patients with the mean percent of 45.83 ± 19.16%. Men had higher percent of TCI though it was not statistically significant. Smoking was the strongest determinant factor in people with higher TCI scores (P = 0.013). There was a positive significant correlation between OHI-S and TCI [(Pearson's coefficient(r) = 0.134, P = 0.034)]., Conclusion: TCI appears to be related to smoking and Simplified Oral Health Index. The evaluation of tongue coating is necessary to assess its impact on oral health status and also to motivate patients to clean their tongue as a part of their oral health care routine., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction and Aims: Today, smoking is recognized as the biggest cause of preventable premature death. dentists can play a very important role in motivating and providing smoking cessation counseling and play this role of line requires gaining sufficient knowledge and education during the student period. Therefore, the purpose of this study is to determine the knowledge and attitude of dental students in Kerman in the field of smoking cessation counseling., Methods and Materials: This study was descriptive-analytical and crosssectional. The study population was fourth, fifth and sixth year dental students. A questionnaire was used to assess participants knowledge and attitude towards smoking cessation, using the 5 As of smoking cessation. Data were collected using a questionnaire and analyzed using SPSS 21, t-test and chi-square software., Results: This study showed that the mean score of students' knowledge was 2.13 ± 14.12. There was a significant relationship between knowledge score, gender (women more than men) and the presence of a smoker in the family (P = 0.01, 0.001, respectively). Also, the mean attitude score was 36.25 41 5.41. There was a significant relationship between attitude score, gender (women more than men) and the presence of a smoker in the family (P = 0.01, respectively)., Conclusion: Results of this study showed that the students have good knowledge of the 5As (Ask, Advice, Assess, Assist, Arrange) but that they did not have much information about some parameters under Assess. Also, they have a positive attitude in this regard. Moreover, students believed that time limitations in dental visits and concerns on the effectiveness of smoking cessation consultations are the major obstacle in implementing a smoking cessation plan., (© Association of Resident Doctors, UCH, Ibadan.)

Introduction: Recurrent aphthous stomatitis is a common lesion of the oral cavity, and many treatments have been introduced by researchers., Objective: This study aims to determine the effect of biosurfactant lipopeptide (Acinetobacter baumannii and Pseudomonas aeruginosa) adhesive mucus paste on the healing process of oral wounds., Materials and Methods: The studied population included 36 people (age range, 20-41 years). The volunteers had a history of oral ulcers and were randomly assigned to 3 groups: positive control (mouthwash chlorhexidine 0.2%), biosurfactant lipopeptide mucoadhesive (A baumannii and P aeruginosa), and base groups. In this analysis, the 2-paired sample t test, ANOVA, and Kruskal-Wallis test (Wilcoxon signed-rank test) were used., Results: On the second day of treatment, the efficacy index of the positive control group was higher than that of the mucoadhesive and the base groups (P = .04) and there was a significant difference between the mucoadhesive group and the positive control group compared with the base group (P = .001). On the sixth day of treatment, the positive control group was significantly different from the mucoadhesive and base groups in terms of wound size (P < .05)., Conclusions: This study showed that the use of mucoadhesive gel formation containing lipopeptide biosurfactant reduces pain and wound size compared to mucoadhesive without biosurfactant lipopeptide treatment, but it has less effect than routine treatment. Therefore, other studies should be done.

Background and Aim: Several research works show that anxiety is more common in women, low-income classes, and middle-aged and elderly populations. The present study aimed to investigate the role of positive and negative memories in patients' anxiety referred to the dental clinics, offices, and schools of Kerman, Iran, in 2018-2019., Materials and Methods: In this cross-sectional, descriptive, analytical study, the participants were selected among individuals referred to the dental offices, schools, and clinics of Kerman, Iran. In this study, 500 questionnaires were distributed among the participants (based on census method), and of these, 482 of which were reviewed (response rate = 96.4%). The questionnaire used in this study contained four categories of questions, including demographic information, general questions about dentistry, Corah's Dental Anxiety Scale, and Autobiographical Memory Questionnaire. Analysis of variance, t -test, and Chi-square test were used to analyze., Results: Overall, 281 participants were female, and 201 were male. Based on the findings, dental visits were enjoyable and pleasant experiences for 154 participants, and 165 patients were anxious while the dentist prepared for a restorative treatment. This study showed that people with negative memories had more anxiety. Anxiety was also significantly associated with positive memories, higher education, and gender (female) ( P < 0.05). Also, the most negative memories of dental treatments were associated with increased anxiety about dental treatments in adults ( P < 0.05), while positive memories did not have a relationship any with decreased anxiety ( P > 0.05)., Conclusion: The most negative memories of dental treatments were associated with increased anxiety about dental treatments in adults, while positive memories did not have any expected inverse relationship with anxiety., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

Purpose: Analgesics (painkillers) are one of the most widely used medications to reduce and control pain. The objective of this study was to investigate the self-medication with analgesics (narcotic or non-narcotic) in controlling odontogenic pain in patients visiting dental offices, dental clinics, and the dental school of Kerman., Materials and Methods: This was a descriptive-analytic study, conducted in 2018. The study sample included patients referring to dental offices, dental clinics and the dental school of Kerman. After obtaining informed consent, a questionnaire consisting of demographic data and questions regarding the consumption of different types of analgesics for relieving and controlling odontogenic pain and their impact on patients was given by the researcher to the respondents. The patients were asked to complete and return the forms. The questionnaire consisted of three categories of questions, including demographic data, pain characteristics (severity, aggravating factors, relieving factors, etc) and the drug used to relieve the pain. Pain severity was measured using a visual analogue scale (VAS). Mann-Whitney and chi-squared tests were used for statistical analysis in SPSS., Results: This study included 230 males and 351 females (male:female ratio = 0.66) in the age range of 18 to 71 years old (38.21 ± 7.45). 2.6% of respondents were illiterate and 11.3% of respondents were unemployed. The mean value of pain intensity was 6.21 ± 1.11 on a scale of 1 to 10. The types of drugs used for pain relief included 71.8% analgesics, 12.1% complementary medicines and 16.1% antibiotics. The most commonly used medication was NSAIDS, followed by acetaminophen codeine. In this study, the fourth most common medication consumed by patients as an analgesic was amoxicillin. Moreover, it showed that 44.3% (257 individuals) of study participants had used analgesics as self-medication to relieve odontogenic pain, of which 46.08% were males (N = 107) and 42.68% were females (N = 150). The gender of respondents, level of education, and occupation were significantly associated with the consumption of opioid drugs (p = 0.023, p = 0.041, p = 0.011, respectively). Consumption of opioid medications was not statistically significantly correlated with pain intensity (p = 0.115)., Conclusion: The factors affecting the appropriate use of medications are social, economic, cultural, and flaws in the health-care system of a society. This study showed that the medications used to reduce pain included analgesics, traditional drugs, and antibiotics. The rate of self-medication was higher among men and among those having a higher level of education.

Background: The goal of treating cancer patients is to cure the patients and improve their quality of life (QoL) during their illness. The aim of this research was to assess the QoL in Iranian patients with head-and-neck cancer by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35 (EORTC QLQ-H&N35) and University of Washington Quality of Life Questionnaire (UW-QoL)., Materials and Methods: In this cross-sectional study, Iranian variation of EORTC QLQ-H&N35 and UW-QoL questionnaires was administered to 210 patients with head-and-neck cancer. Patients who visited the Department of Oncology at Omid Hospital in Isfahan, Shafa Hospital in Kerman, and Emam Khomeini Hospital in Tehran were selected. Kruskal-Wallis test, general linear model multivariate of variance, multiple regression models, and SPSS version 21 were used for statistical analysis., Results: In the present research work, 210 patients with cancer in head and neck were under investigation, such that 128 patients (61%) were male and 82 patients (39%) were female. Only the patients with laryngeal cancer scored worse for dyspnea according to the scores from UW-QoL questionnaires. There were statistically significant differences for pain, swallowing, social eating, social contact, speech, taste/smell, and trismus based on the QLQ-H&N35. Lower QoL was observed in patients with advanced (Stage III + IV) tumors and treated with radiotherapy plus surgical method., Conclusion: The study showed that quality of life differs due to location of tumor, stage of cancer, and treatment type., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

One of the major and important challenges in dental composite resin and restoration is the mechanical performance and property of materials. Nanotechnology can produce nanoscale materials that are used in dentistry to help stabilize and strengthen the dentistry. In this work, we study the synthesis and characterization of PLA/Al 2 O 3 nanoscaffold in different conditions such as concentration, temperature, pH, microwave power and irradiation time. PLA/Al 2 O 3 nanoscaffolds were prepared by a micelle-assisted hydrothermal method. Durability, stability and biodegradable nature of nanopolymers have created the much-applied potential for using this structures in many fields such as dental resin composites. Products were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), transition electron microscopy (TEM), Fourier transformed infrared spectrum (FT-IR), Dynamic light scattering (DLS) and atomic force microscopy (AFM). The synthesis factors were designed by Taguchi technique to control the process systematically. It was found that the intermolecular crosslinks between PLA and Al 2 O 3 nanoparticles cause significant improves in the mechanical properties of PLA/Al 2 O 3 nanoscaffold as dental nanocomposites. The flexural strength (88.0 MPa), modulus (7.5 GPa) and compressive strength (157.2 MPa) were calculated for PLA/Al 2 O 3 nanoscaffolds loaded in Heliomolar Flow composite resins at 80 ppm (wt) concentration.

Conflict of interests is a situation when someone is in need of other people's trust on one the hand and has personal or general interests on the other hand, resulting in conflict with the given responsibility. In this research work, an attempt was made to find the relation between declarations of conflict of interests and reporting positive outcomes in the dental journals in Iran (2000-2016). In this analytical/cross-sectional study, first Health and Biomedical Information was searched and all the Persian and English dental journals published in Iran were collected. Then, all the papers published in the journals from December 2000 to December 2016 were collected and categorized in terms of the year of publication, author or authors' affiliations, Persian and English journal, type of the substance or the drug used (including the manufacturing company), declarations of conflict of interests and the positive or negative conclusion of the report. Data were analyzed with the Fisher's exact test and Chi squared test, using the program SPSS 18. In numerical analysis, the significance was set at P < 0.05. Seventeen dental journals in Persian and English were analyzed: 10 in English and 7 in Persian. Reviewing these studies showed that of 1021 articles in Persian, in 128 cases there was no mention of a declaration of conflict of interests and in 11 cases, the COI had been stated. In addition, from 1220 articles in English, in 825 cases there was no mention of declarations of conflict of interests and in 45 cases, the declarations of COI had been mentioned. There was no significant relation between the COI and 'no' COI and the reporting of positive outcomes in papers in Iranian dental journals in terms of the journal type, year of publication and the journals' guarantee form (P = 0.25, P = 0.41 and P = 0.09). A total of 83% of studies with declarations of COI had one positive outcome, with a significant relationship in this field; however, in 73% of studies with no COI, there was one positive outcome, too. In general, the society expects that doctors would not consider any incentives except the health of the patients in the efforts made by them. The severity of the consequences of COI is of higher value when the patients' health is endangered due to it. In addition, COI might change the attitude and approach of other doctors and peers.

Deep vein thrombosis (DVT) is caused primarily by obstruction of blood flow in the deep veins in the lower limbs. It is a form of thrombophlebitis and can be a major cause of morbidity and mortality in hospitalized patients. This report describes an unusual case of DVT in a 21-year-old woman with Class III malocclusion who underwent bimaxillary orthognathic surgery (bilateral sagittal split osteotomy and Le Fort I osteotomy) under general anesthesia. She developed DVT unexpectedly 1 week after surgery, with episodes of sweating and chills in addition to lower limb edema, tenderness, and rigidity. D-dimer laboratory testing and venous Doppler sonography were performed and the DVT diagnosis was confirmed; therefore, the patient was admitted to the intensive care unit for anticoagulant and supportive therapy. Although the incidence rate of thromboembolism in hospitalized patients undergoing oral and maxillofacial surgery is low, it is not an operation without risk of DVT. This complication can cause fatal acute pulmonary thromboembolism and death. This case study illustrates that pharmacologic treatment of menorrhagia with mefenamic acid combined with intraoperative use of tranexamic acid for control of blood loss might put the patient at increased risk of DVT. Hence, maxillofacial surgeons should assess all their patients preoperatively for thromboembolism risk; if they suspect any risk factors in the patient, prompt diagnostic tests and management should be ordered., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to evaluate the microbial contamination of cell phone in dental and engineering schools and also investigating the effect of an antibacterial spray., Method and Materials: A questionnaire was completed by participants, including the pattern of using mobile phones and their disinfection. The number of participants was 120 students and professors in each of dental and engineering schools. Swabs from mobile phones of the participants were taken and plated on culture medium. The t-test, Chi-Square with the SPSS 11.5 program were used in data analysis., Results: In total, 240 mobile phones were cultured for microorganisms, while 65.8% (n = 158) were culture-positive. One hundred percent of professors, 98% of students' dental school and 72% of professors and 62% of students of engineering, believe that mobile can serve as a source of pathogens., The most commonly cultured organisms were Staphylococcus Aureus, Escherichia coli, Enterococcus Faecalis , and Pseudomonas . The current study showed that none of the mobile phones of the professors and students of the engineering university was infected by Pseudomonas and Candida albicans ., Conclusion: The results of this study showed that mobile phones may act as an important source of nosocomial pathogens., Competing Interests: No conflicts of interest., (© Atlantis Press International B.V.)

Statement of the Problem: A significant proportion of patients undergoing chemotherapy or radiotherapy suffer from mucositis. The first symptom of oral mucositis is pain. Severe pain, burning sensation, and discomfort in the oral cavity make it difficult to continue treatment and even continue living in these patients., Purpose: The aim of this study was to evaluate and compare the effect of amitriptyline mouthwash (in two forms of simple and niosomal) as a local anesthetic agent with benzydamine HCl mouthwash in oral mucositis after radiotherapy or chemotherapy., Materials and Method: This double-blind study was performed on 60 patients with oral mucositis caused by radiotherapy and chemotherapy. The severity of mucositis was determined based on patient judgment; then dental examination was performed and recorded in a checklist. Three groups were assigned based on using either benzydamine HCL, amitriptyline, or niosomal form of amitriptyline. Pain and burning sensation were evaluated with VAS at different time intervals: before use and one, five, ten, and thirty minutes and one hour after using mouthwash. T-test was used to compare the intensity of pain between the two groups. ANOVA and Tukey test were used to compare the intensity of pain between groups., Results: Statistical analyses showed the maximum reduction in pain intensity at two different time intervals ( p = 0.04). Ten minutes after the use of niosomal form of amitriptyline, a 95% decrease in pain was observed. A 99% reduction in pain occurred after the use of simple form of amitriptyline ( p = 0.04)., Conclusion: Use of amitriptyline mouthwash had local anesthetic effects in oral mucositis without systemic side effects. Decrease in the severity of pain with the use of amitriptyline mouthwash was more than that of benzydamine HCL mouthwash., Competing Interests: Conflict of interests: The authors of this manuscript certify that they have no conflict of interest.

Background: Dynamic and static activities in dentistry cause musculoskeletal disorders, but dental students do not have sufficient awareness about the effects of ergonomic factors on their health. The aim of this study was to investigate ergonomic factors that cause pain muscle in dental students in Kerman Medical University, Iran., Methods: This cross-sectional analysis study was carried out on dental students of the 3 rd , 4 th , 5 th , and 6 th year, in clinical practice in the School of Dentistry, Kerman University of Medical Sciences. A convenient sample of 199 students who met the inclusion criteria was selected and those willing to participate signed an informed consent form. Data were collected by means of a structured questionnaire for ergonomic factors and the presence of pain. The variables evaluated were pain, affected zones, gender, postures, and work environment., Results: The present research work reveals that over 69% of the dental students complained of pain in at least one part of their body. Most individuals suffered from hand and elbow (23%) and head (19%) pain. The clinical areas where more pain was found were endodontics and pedodontics. Furthermore, it was found that a high percentage of students usually worked with their legs slightly separated, with the sole of the feet resting on the stool when working. The presence of muscular pain was higher in males in this study. Furthermore, there was a statistically significant relationship with the final Rapid Entire Body Assessment score in different body parts and the participants' demographic data (sex, age, weight, height, sports, and smoking)., Conclusions: The results of this study showed that the students' sitting positions and working environments need to be improved and it seems more training is necessary in this field., Competing Interests: There are no conflicts of interest.

In post-core crown restorations, the significant mismatch between stiffness of artificial crowns and dental tissues leads to stress concentration at the interfaces. The aim of the present study was to reduce the destructive stresses by using a class of inhomogeneous materials called functionally graded materials (FGMs). For the purpose of the study, a 3-dimentional computer model of a premolar tooth and its surrounding tissues were generated. A post-core crown restoration with various crown materials, homogenous and FGM materials, were simulated and analyzed by finite element method. Finite element and statistical analysis showed that, in case of oblique loading, a significant difference (p < 0.05) was found at the maximum von Mises stresses of the crown margin between FGM and homogeneous crowns. The maximum von Mises stresses of the crown margin generated by FGM crowns were lower than those generated by homogenous crowns (70.8 vs. 46.3 MPa) and alumina crown resulted in the highest von Mises stress at the crown margin (77.7 MPa). Crown materials of high modulus of elasticity produced high stresses at the cervical region. FGM crowns may reduce the stress concentration at the cervical margins and consequently reduce the possibility of fracture.

Statement of Problem: In post-and-core crown restorations, the use of flexible posts concentrates stresses at the dentin and the use of stiff posts concentrates stresses at the interfaces. A class of inhomogeneous materials (called functionally graded materials) has been proposed for posts to resolve the weaknesses of both flexible and rigid posts., Purpose: The purpose of this in vitro study was to design an inhomogeneous post and investigate its influence on the stress distribution of post-and-core crown restorations., Material and Methods: An extracted tooth was mounted, sectioned, and photographed to create a 3-dimensional model of the first premolar tooth. The post-and-core crown restoration was modeled with and without a ferrule. The surrounding tissues of the mandibular tooth, periodontal ligament, and cortical and trabecular bones were modeled. Fiber-reinforced composite (FRC), metallic, and inhomogeneous posts were investigated by finite element analysis and the stress distribution results compared., Results: FRC posts resulted in the highest maximum tensile stress (MTS) at the remaining dentin (90.4 to 93.2 MPa), while inhomogeneous posts graded by index n=10 (FGM10) caused the lowest MTS, both with and without a ferrule (72.3 to 74.8 MPa)., Conclusions: The use of FRC posts concentrated more MTS at the dentin and less MTS at the dentin-adhesive interface than metallic posts. Inhomogeneous posts (FGM10) resolved the weaknesses of both flexible and rigid posts by simultaneously reducing stresses at the dentin and interface. The ferrule effect resulted in fewer dentin and interface stresses., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: This double-blind randomized clinical trial evaluates the ef cacy and route of administration of omega-3 fatty acids for the prevention and treatment of oral mucositis in patients undergoing che- motherapy in Iranian hospitals., Materials and Methods: Sixty patients developing World Health Organization (WHO) grade 1 oral mucositis were randomized to the omega-3 fatty acid (n=30) or placebo (n=30) group. Mucositis was assessed according to the WHO, Western Consortium for Cancer Nursing Research, and Oral Mucositis Weekly Questionnaire cri- teria at baseline and rst, second, and third weeks of chemotherapy un- til mucositis resolved., Results: Differences in the severity of mucositis between the omega-3 and placebo groups in the rst, second, and third weeks of treatment based on the WHO criteria were noted. This study showed that patients in the omega-3 group experienced less pain during the rst, second, and third weeks of treatment., Conclusions: Omega-3 fatty acids are a safe, effective method for preventing and treating oral mucositis in patients receiving mucotoxic cancer chemotherapy.

Introduction: There are controversies in recent studies over the application of NSAIDs for controlling pain and swelling after implant surgeries for osseointegration. The aim of this study was to compare caffeine-containing versus codeine-containing analgesics in relation to their anti-inflammatory and analgesic effects after dental implant surgeries., Materials and Methods: 80 patients (40 in each group) were selected as the final sample size. Forty drug packs, which were formulated and made by the consultant pharmacist, each containing 10 capsules of acetaminophen caffeine (consisting of 300 mg of acetaminophen and 20 mg of caffeine), and another 40 packs, each containing 10 capsules of acetaminophen codeine (consisting of 300 mg acetaminophen and 20 mg codeine) were prepared. These drugs were administered randomly to patients 1 h before surgery and every 6 h afterward until 48 h, according to the protocol. The patients' pain severities were determined at 30-min, 3-h, 6-h, 12-h, 1-day, 2-day, and 1-week intervals. In addition, the swelling was evaluated after 1-day, 2-days, 3-days, and 1-week. Data were analyzed with Mann-Whitney, student's t, and chi-squared tests, using SPSS 11., Results: A total of 76 patients, including 38 males and 38 females, with a mean age of 41.06 ± 5 and an age range of 35-53 years, were studied. The pain severities in patients in the codeine group were significantly less than those in the caffeine group at 3-, 6-, and 12-h postoperative intervals (p = 0.001). However, the pain severities at the above intervals, even in caffeine group, were within the moderate pain severity range (VAS = 3-7). It is also interesting to note that the pain was at its maximum severity at the 6-h postoperative interval, and at its minimum at the 1-week interval. The severity of swelling was also evaluated in both groups, indicating that it was significantly less in the caffeine group at 1-, 2-, and 3-day postoperative intervals (p = 0.018)., Conclusion: According to this study, the codeine-containing analgesics are significantly more effective than caffeine-containing ones in reducing postoperative pain. It was also concluded that caffeine-containing analgesics are significantly more effective than codeine-containing ones in reducing postoperative swelling, which was reported to be significantly less within the first 3-days in the caffeine group. As a result, caffeine-containing analgesics are effective and acceptable in reducing both postoperative pain and swelling., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Introduction: Armored removable connector tubes are not always available in operating rooms for routine Altemir submental intubation (SMI) technique. The present study addresses a fiber-optic glidoscopy assisted 2-tubes modification of Green & Moore sequence for submandibular intubation., Methods: The sample was composed of 11 patients (8 males and 3 females) with panfacial fractures where neither the oral and nasal intubation techniques nor tracheostomy were feasible. The inter-operative procedure duration was recorded and a comparison was made between the present results with those obtained in similar studies. Moreover, postoperative complications were assessed over a duration of 6 months., Results: The average duration of this modified procedure was 8-13 min. (Mean, 10.54 ± 1.75 min). No perioperative or postoperative complications were observed. Based on the findings in this study, it is suggested that this new technique is safe, quick and reliable for submandibular intubation., Conclusion: This modification establishes a secure airway for treatment of maxillofacial panfacial fractures, where traditional methods are impossible due to non-detachable connector tubes. No perioperative or postoperative complications were observed. This study suggests that this new technique is safe, quick and reliable for submandibular intubation.

Introduction: Pain felt during dental injections is dependent on dental anxiety. Patients feel increased pain if anxiety in the treatment environment is high, and therefore it is important to reduce anxiety during treatment to reduce pain. The purpose of this study was to compare pain and anxiety levels experienced during injections using a newly invented telescopic-coated dental needle that covers the conventional needle and also has the capability of applying topical anesthesia through its unique design with the conventional dental injection needle., Methods: Dental injection anxiety questionnaires were completed by 60 adult patients who were randomly assigned to either the telescopic (a newly invented telescopic-coated dental needle that covers the needles) or the conventional group. Patients also completed visual analog scales to rate their pain perception during injection, their overall experience, and their future anticipated anxiety. Wilcoxon, Mann-Whitney, and Student t tests were used for statistical analysis. Statistical significance was defined as P < .05., Results: A total of 25 men and 35 women with an age range of 19-55 years (mean age of 38.7 ± 2.31 years) participated in this study. Pain levels reported during the injection using the telescopic-coated needle (4.13 ± 1.37) were significantly lower than those using the conventional needle (5.63 ± 1.57), with statistically significant differences between the 2 groups (P < .05). Patients experienced significantly lower overall postinjection anxiety (P < .05) and had more positive overall experience ratings with the telescopic-coated needles., Conclusions: A new telescopic-coated dental needle was superior to a conventional injection system in pain perception and in reducing postinjection dental anxiety., (Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Statement of the Problem: Use of traditional medicine to relieve human sufferings has a very long history. The effects of these plants in wound curing and subsequently making the best mucosa patch for treatment of oral ulcers is still under investigation., Purpose: The main goal of present research work is to assess the efficacy of Myrtus communis L., Camellia sinensis L. and Zataria multiflora Boiss . on oral ulcer recovery process in rats., Materials and Method: In this study, 60 healthy adult male rats in 5 groups were investigated. A wound with 2 mm diameter was punched into the hard palate of each rat. For topical application, a mucosa patch of materials or blank was packed into the wound. Histological samples were harvested on post injury days 2, 4, 6, and 8., Results: This study showed that there were no significant differences between groups in the reduction of weight. Comparison of clinical wound size showed that group Myrtus communis L had the greatest reduction in wound size on days 4, 6 and 8, which was significantly different from the other groups. The highest thickness of epithelium was observed in groups Myrtus communis L and Camellia sinensis L on days 6 and 8. Group Myrtus communis L showed the highest values on days 6 and 8. This study showed a lower mononuclear cell counts in group Myrtus communis L on days 6 and 8 compared to other groups which was statistically significant., Conclusion: The results of the present study showed that Myrtus communis L. has significant effects on oral wound healing processes. These favorable results might introduce a new group of material or medicine derived from this plant.

Statement of the Problem: Examinations have an important role in evaluating students' learning outcomes and their mastery of a subject. Passing or failing an examination can have far-reaching consequences for the students. Therefore, it is not surprising that international studies consistently show that dental students report examinations and grades among the highest ranking stressors in dental schools., Purpose: The aim of this research was to measure the levels of anxiety, self-perception of preparation and expectations for success using an objective structured clinical examination (OSCE), a written examination and a preclinical preparation test, and to examine the effects of the three predictive variables on the outcomes of assessments., Materials and Methods: The present research is a cross-sectional study. The population under consideration was students of Kerman Dental School in 2013. Examination anxiety was measured with Spielberger's state anxiety inventory. Preparation for the assessment (I am fully prepared = 4, I am prepared = 3, I'm not prepared = 2, I'm not fully prepared = 1) and expectation to succeed (I am quite successful = 4, I am successful = 3, I'm not successful = 2, I'm not quite successful = 1) were quantified with Likert scale. The questionnaire was completed during an OSCE, a written examination, a preclinical crown and bridge preparation test and a nonexamination situation., Results: The study population consisted of 138 4 th , 5 th , and 6 th year Kerman dental students (65 males and 73 females). The results showed that all the assessment methods induced a significant increase in state anxiety compared to baseline levels with the highest anxiety levels reported during an OSCE (62.4 ± 8.1, P = 0.04) and a written examination (48.8 ± 9.2, P = 0.04). The preparation levels in females were significantly higher than those in males in OSCE ( P = 0.03) and written ( P = 0.04)., Conclusion: State anxiety was high in all the three assessment methods. OSCE induced more anxiety than other assessment formats. However, anxiety was not predictive of performance outcomes in contrast to preparation and expectation to succeed, which were good predictors of the outcome scores. Also, this study showed that despite a better answer to the assessment of (I prepared myself well for the test), the students showed high levels of state anxiety., Competing Interests: There are no conflicts of interest.

Objectives: Oral cancer is a global health problem; however, many dentists lack the necessary skills, knowledge and capacity to diagnose oral cancers early. This study aimed to examine the validity and reliability of a Persian short-form version of a standardised questionnaire to assess dentists' knowledge, practice and attitudes towards oral cancer., Methods: This cross-sectional analytical study was carried out in May 2015 in Tehran, Iran. An original 39-item English-language questionnaire developed by Yellowitz et al . was translated into Persian using forward and backward translation methods. A total of 15 dental professionals were asked to assess the questionnaire for content validity. Based on their feedback, a 20-item short-form version was prepared, including six demographic, six knowledge, four attitude and four practice items. The translated short-form questionnaire was subsequently distributed to 973 general dental practitioners attending a dental conference in Tehran. Internal consistency and reliability were assessed with Cronbach's alpha coefficient and item-total correlation calculations., Results: A total of 13 professionals and 313 general dentists participated in the study (response rates: 86.7% and 32.2%, respectively). After the elimination of six items (two knowledge, two attitude and two practice items), the validity and reliability of the questionnaire was confirmed., Conclusion: The final Persian 14-item version of the questionnaire had acceptable validity and internal consistency. These results indicate that researchers can use this translated short-form version to evaluate oral cancer knowledge, attitudes and practices among Persian-speaking dentists; this will allow for a comparison of data between different populations., Competing Interests: CONFLICT OF INTEREST The authors declare no conflicts of interest.

Background: In cancers of prostate, breast, oropharynx, lung, hypopharynx and skin, human tissue kallikreins has been demonstrated as a main role in these problems. There are many research works in which some human tissue kallikreins are expressed in salivary glands. In the present study, the main goal was to determine expression of human tissue kallikreins 4, 8, 10, 11 and 13 in pleomorphic adenomas and mucoepidermoid carcinomas., Methods: Sixty-six specimens (45 cases of pleomorphic adenomas and 21 cases mucoepidermoid carcinomas) were selected for final analysis by immunohistochemistry. For doing association test, clinical parameters obtained from the patients' medical charts, which included age, gender were used and the nonparametric tests employed for statistical analyses., Results: The expression of human kallikreins 4, 8, 11 and 13 was more prominent in benign and malignant tumors compared to that in normal tissues and the difference was significant. In addition, the expression of human kallikreins 4, 8, 10 and 11 in malignant tumors was more than that in benign tumors, with statistically significant differences., Conclusion: The differences in the levels of human kallikreins 4, 8, 11 and 13 suggest that kallikreins may benefit in determining tumor behavior of salivary gland tumors.

Statement of the Problem: Use of cyclooxygenase inhibitors as chemotherapy agents has attracted the attention of a large number of investigators in recent years. Given the importance of cancer therapy, only a limited number of studies have been carried out to investigate the effects of cyclooxygenase inhibitors on specific cell lines., Purpose: This research aimed to determine the in vitro cytotoxic effects of cyclooxygenase inhibitors (COX-1 and COX-2 inhibitors) on KB, Saos-2, 1321N, U-87MG, SFBF-PI 39 cell lines., Materials and Method: Powders of celecoxib, mefenamic acid, aspirin and indometacin were dissolved in the appropriate solvent. The viability of cell lines was carried out by MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide) assay technique. Data gathered from four separate experiments were expressed as mean±SD. Statistical significance was defined at p< 0.05 by using analysis of variance. Significant treatment mean values were subjected to post-hoc Tukey's test., Results: Celecoxib showed marked cytotoxic effects on KB, Saos-2, and 1321N cells, which was significant in comparison with the control group. Celecoxib was not effective in killing U-87MG cell line. Mefenamic acid exerted cytotoxic effects on KB, Saos-2, and 1321N cells, where the viability was approximately 75%. U-87MG cells were resistant to mefenamic acid. Indometacin had the highest rate of activity on U-87MG cells, which was significant in comparison with the control group. Aspirin did not exhibit any activity on these cell lines and was not effective in killing U-87MG, KB, Saos-2, and 1321N cells., Conclusion: This research showed that celecoxib, indometacin, and mefenamic acid have the cytotoxic effects on KB, Saos-2, 1321N and U-87MG cell lines. Therefore, it appears that these drugs can be considered as anti-neoplastic agents in the experimental phase.

Objectives: Recognising causes of stress can help prevent associated adverse effects. This study aimed to investigate causes of occupational stress and coping behaviours among general dentists in Iran., Methods: This cross-sectional study was carried out from April to December 2014. A modified version of the Occupational Stress Indicator questionnaire was used to assess causes of stress and coping behaviours among 142 general dentists in Kerman, Iran., Results: A total of 93 dentists participated in the study (response rate: 65.5%). Of these, 58.9% reported often being stressed. The mean general stress score was 63.33 ± 19.99. The most common causes of stress were maintaining high levels of concentration while working (65.6%), time pressures (64.5%), concern over their ability to deliver dental services in future (60.2%) and rising costs (59.1%). No significant relationships between stress and gender, age, workplace or working hours per week were noted (P >0.05). However, there was a significant correlation between general stress scores and years of job experience (P = 0.05) and number of patients treated daily (P = 0.03). The most common methods for coping with stress were resting (71.0%), sports (45.2%) and entertainment (43.0%). Most dentists felt that stress management courses could help to reduce stress (89.7%)., Conclusion: General dentists in Kerman were subject to many sources of stress in their workplaces, with significant relationships between stress scores and years of work experience and number of patients treated daily. Dentists should be encouraged to participate in stress management courses to help alleviate stress.

Background: Today, the dental practitioners are finding many more medically compromised patients in their practice., Aims: The aim of this study was standardization of the European Medical Risk Related History (EMRRH) questionnaire for use among Persian population., Materials and Methods: The English original version of the EMRRH questionnaire was translated into Persian language by a forward-backward translation method. Then reliability was tested on 50 subjects. Also, the sensitivity, specificity, and validity of the questionnaire were assessed., Statistical Analysis Used: Cohen's kappa, a measure of agreement between observers that includes an adjustment for chance agreement, was likewise calculated., Results: The reliability coefficient (Cronbach's alpha) of the EMRRH was above the recommended 0.7 threshold and considered excellent (alpha 0.87). Specificity of the questions was 94% and of per EMRRH item was 93%. Sensitivity per question was 86.1% and of per EMRRH item was 94%. Cohen's kappa for the questionnaire was 0.89 and for subsequent questions was 0.82., Conclusions: The EMRRH (Persian version) has been shown to be valid in comparison with the gold standard (a medical history taken by a physician experienced) and this instrument would be an effectual method of history taking for the dentist.

The aim of the present study was to evaluate the relationship between BMI and tooth decay in a population of Iranian children. In this cross-sectional descriptive/analytical study, 1482 children were selected from kindergartens and preschool centers in Kerman, Iran. The children underwent examination of deciduous teeth (using the dmft index) after determination of height and weight for calculation of BMI. The relationship between BMI (after adjustment for age) and dmft was determined using Poisson's regression model. The mean of dmft in children with normal BMI was 1.5-fold that in subjects with extra body weight. Age had a significant effect on dmft. In addition, dmft was higher in boys compared to girls. The results of the present study showed that caries rate in the deciduous teeth of 3-6-year-old children decreases with an increase in body weight.

Objectives: The objective of this study was to assess the knowledge and use of evidence-based dentistry (EBD) among Iranian dentists., Methods: A cross-sectional survey was conducted by means of a questionnaire among dentists attending the 52(nd) National Annual Congress of the Iranian Dental Association in Tehran in April 2012. The questions covered the participants' level of knowledge and use of EBD., Results: The mean knowledge score of the 310 respondents was 3.66 ± 1.19 out of a maximum of 5. The majority of the dentists had little (56.1%) or no (20.7%) knowledge of EBD. The main reported barrier to the use of EBD was lack of time (44.1% of respondents) with 42.8% of dentists using the Internet less than one hour per week., Conclusion: EBD was not a familiar concept to these Iranian dentists; the majority of them preferred consultation with colleagues over seeking evidence from electronic databases.

Background: It is known that dental unit waterline can be a source of infection. The aim of this study was to evaluate the efficacy of a mouthwash, chlorhexidine, in controlling microbial and fungal contamination of dental unit waterlines., Materials and Methods: In the present experimental study, the water in high-speed handpieces and air/water syringes of 35 dental units in a dental school was investigated microbiologically. Five of the units and one tap water served as controls; 100-200-mL water samples were collected aseptically in sterile containers in the morning after a 2-min purge. Water reservoir bottles were emptied and 50 mL of 0.2% chlorhexidine mouthwash was introduced into the tank. Then the water syringe was used to flush the waterline until the pink-colored chlorhexidine was observed to flow from the water syringe. Before the next day's session and before the students used the unit, two water samples from the water syringe and water turbine was collected. The samples were transferred to the laboratory. After 48 h at 37°C, the microbial colonies were counted. The number of these colonies was evaluated using colony forming unit CFU. Data were analyzed with Mann - Whitney U test and SPSS 13.5 statistical program. The statistical significance was defined at P ≤ 0.05., Results: All 35 units were contaminated before chlorhexidine use; no contamination was detected after adding chlorhexidine to the waterlines of the units. After week 1, 28 of the 30 treated dental unit waterlines (DUWLs) had values of CFU/mL less than 200., Conclusion: The present study showed that the use of chlorhexidine could reduce microbial counts in dental unit waterlines.

Introduction: This study was designed to evaluate incidence and characteristics of acute referred orofacial pain caused by a posterior single tooth pulpitis in an Iranian population., Methods: In this cross-sectional study, 3,150 patients (1,400 males and 1,750 females) with pain in the orofacial region were evaluated via clinical and radiographic examination to determine their pain source. Patients completed a standardized clinical questionnaire consisting of a numerical rating scale for pain intensity and chose verbal descriptors from short form McGill questionnaire to describe the quality of their pain. Visual analog scale (VAS) was used to score pain intensity. In addition, patients indicated sites to which pain referred by drawing on an illustration of the head and neck. Data were analyzed using chi-square, fisher exact, and Mann-Whitney tests., Results: Two thousand and hundred twenty patients (67/3%) reported pain in sites that diagnostically differed from the pain source. According to statistical analysis, sex (P = 0.02), intensity of pain (0.04), and quality (P = 0.001) of pain influenced its referral nature, while age of patients and kind of stimulus had no considerable effect on pain referral (P > 0.05)., Conclusion: The results of the present study show the prevalence of referred pain in the head, face, and neck region is moderately high. Therefore, in patients with orofacial pain, it is essential to carefully examination before carrying out treatment that could be inappropriate., (© 2013 The Authors Pain Practice © 2013 World Institute of Pain.)

Introduction: Herpes simplex virus type 1 (HSV-1) belongs to the Herpesviridae family and genus simplex virus. This virus is usually acquired during childhood and is transmitted through direct mucocutaneous contact or droplet infection from infected secretions. The aim of the present study was to compare antiviral effects of honey, royal jelly, and acyclovir on herpes simplex virus-1 in an extra-somatic environment., Materials and Methods: Vero cells were cultured in the Dulbecco's Modified Eagle's Medium (DMEM) along with 10% fetal bovine serum (FBS) in 12-welled microplates. Various dilutions of honey, royal jelly, and acyclovir (5, 10, 50, 100, 2500, 500, and 800 μg/mL) were added to the Vero cells along with a 100-virus concentration of TCID50. The plaque assay technique was used to evaluate the antiviral activities., Results: The results showed that honey, royal jelly, and acyclovir have the highest inhibitory effects on HSV-1 at concentrations of 500, 250, and 100 μg/mL, respectively. In addition, honey, royal jelly, and acyclovir decreased the viral load from 70 795 to 43.3, 30, and 0 PFU/mL at a concentration of 100 μg/mL, respectively., Conclusion: The results of the present study showed that honey and royal jelly, which are natural products with no reports about their deleterious effect at least in laboratory conditions, can be considered alternatives to acyclovir in the treatment of herpetic lesions. However, it should be pointed out that further studies are necessary to substantiate their efficacy because hard evidence on their effectiveness is not available at present.

Background: The present study was conducted to evaluate keratinization as well as nuclear and cytoplasmic changes of oral epithelial cells among smokers, opium addicts and non-smokers through exfoliative cytology technique., Methods: Smears of buccal mucosa and mouth floor were collected from 300 males (100 smokers, 100 opium addicts and 100 non-smokers). The nucleus and cytoplasm sizes were determined using image analysis software. Data was analyzed with Mann-Whitney test and Student's t-test on SPSS version 13 statistical software. Statistical significance was defined as P < 0.05., Results: The results revealed statistically significant differences in cellular and nuclear size and the nuclear/cytoplasmic ratio between smokers, opium addicts and non-smokers in different age groups. The mean size of the nucleus compared to that of cytoplasm was significantly higher in smokers and opium addicts compared to non-smokers after correction for age., Conclusion: The results of this study indicate different rates of epithelial cell keratinization in oral cavity among smokers, opium addicts and non-smokers. Also, our results suggest a possible relationship between the number of cigarettes per day, daily opium consumption and an increase in the rate of cellular proliferation of oral mucosal cells. The present study indicated a decrease in cellular diameter as well as an increase in nuclear diameter and nuclear/cytoplasmic ratio in smears taken from both smokers and opium addicts compared to non-smokers.

Objectives: There is scant information regarding the multifactorial aetiology of denture stomatitis (DS) in the world and, despite its frequency, associated factors are not completely understood. The aim of this study was to investigate the risk factors that may be associated with this lesion., Methods: A total of 70 edentulous patients, all wearing removable dentures, were divided into two groups. The test group comprised 43 patients with DS and the control group comprised 27 subjects with clinically healthy palatal mucosa. A thorough history-taking and physical examination were carried out; the subjects also answered a questionnaire. The serum level of vitamin A for each subject was assayed from a blood sample taken after the examination., Results: THIS STUDY SHOWED A SIGNIFICANT RELATIONSHIP BETWEEN THE INCIDENCE OF DS AND THREE MAJOR FACTORS: denture age (in terms of years), the practitioner manufacturing the dentures (general dental practitioner versus dental hygienist), and the night-long wearing of dentures. Also, the vitamin A serum level was low in 94.29% of all subjects (cases and controls)., Conclusion: Although many predisposing conditions were related to this situation, the most important risk factor was the continuous use of the dentures.

Introduction: Dental practitioners, like other health-care professionals, might engage with legal claims and be sued if patients are not satisfied with the dental treatment. The aim of this study was to provide data on dental malpractice claims in Kerman, Iran, from 2000 to 2011., Materials and Methods: In the present descriptive cross-sectional research, a retrospective evaluation was carried out of dental malpractice claims in Kerman, Iran, during 2000-2011, based on the decisions of expert committees in medical malpractice cases by the Kerman Legal Medicine Organization and the Medical Council of the Islamic Republic of Iran. A valid and reliable questionnaire was designed in three sections, based on previous studies. The SPSS 18 software program was used for data analysis., Results: During the 11-year period, 64 decisions had been taken in relation to dental malpractices. The majority of complaints involved fixed prosthodontics and oral surgery usually by private practice and general dental practitioners. In 56.7% of clinical cases and 40% of non-clinical cases of malpractice claims, dental practitioners had been found guilty., Conclusions: Like all other medical staff, dental practitioners are under the obligation to comply with the laws of the country they practice. They also have to adhere to ethical principles as well as the acceptable standards and protocols of diagnosis and treatment. These data can alert them to the need for greater care and professionalism when treating their patients., (Copyright © 2013. Published by Elsevier Ltd.)

Background: Periodontitis and gingivitis are one of the most infectious diseases in human. Several studies have been carried out on dependence of periodontitis and stroke. The aim of this study was to investigate the gingivitis and periodontitis as a risk factor for stroke in Iranian population., Materials and Methods: A case-control study was conducted on 100 patients suffering from stroke as case group, and 100 hospitalized patients as control group. The case group included 42 males and 58 females, and in control group there were 44 males and 56 females. Using a University of North Carolina-15 manual probe, the clinical attachment level, the distance between the cemento-enamel junction and the probed base of the periodontal pocket, were recorded by gingival and periodontal indexes. The data were analyzed by multiple logistic regressions, Chi-square test, Fisher's test, t-test, Man Whitney, and SPSS11.5 software program. P > 0.05 was considered as significant., Results: The case group included 42 males and 58 females, and in control group 44 males and 56 females were included. In this investigation, the average of gingival index in men and women of case group was 1.22 ± 0.55 and 1.31 ± 0.55, respectively. This study showed that the average of gingival index in case group was more than control group. Periodontal index in both groups in men was more than women. The moderate and severe periodontitis in case group were more than that of control group (P = 0.003, P = 0.001)., Conclusion: The result of this study shows that there is a significant relation between stroke and periodontal index; however, there isn't any significant relation between stroke and gingival index.

Background: Dental students use extracted human teeth to learn practical and technical skills before they enter the clinical environment. In the present research, knowledge, performance, and attitudes toward sterilization/disinfection methods of extracted human teeth were evaluated in a selected group of Iranian dental students., Materials and Methods: In this descriptive cross-sectional study the subjects consisted of fourth-, fifth- and sixth-year dental students. Data were collected by questionnaires and analyzed by Fisher's exact test and Chi-squared test using SPSS 11.5., Results: In this study, 100 dental students participated. The average knowledge score was 15.9 ± 4.8. Based on the opinion of 81 students sodium hypochlorite was selected as suitable material for sterilization and 78 students believed that oven sterilization is a good way for the purpose. The average performance score was 4.1 ± 0.8, with 3.9 ± 1.7 and 4.3 ± 1.1 for males and females, respectively, with no significant differences between the two sexes. The maximum and minimum attitude scores were 60 and 25, with an average score of 53.1 ± 5.2., Conclusion: The results of this study indicated that knowledge, performance and attitude of dental students in relation to sterilization/disinfection methods of extracted human teeth were good. However, weaknesses were observed in relation to teaching and materials suitable for sterilization.

Introduction: Systemic conditions are considered limiting factors for surgical procedures under local anaesthesia in the oral cavity. All the pharmacological methods to control pain in patients have some disadvantages, such as side effects and extra costs for rehabilitation. Therefore, in such cases alternative treatment modalities are considered, such as hypnosis in dentistry. The aim of the present study was to evaluate the effect of hypnosis on haemorrhage, pain and anxiety during the extraction of third molars., Materials and Methods: In this case-control study, 24 female and male volunteers were included. The subjects had been referred to the Department of Oral and Maxillofacial Surgery, Kerman University of Medical Sciences, for extraction of third molars. Demographic data for all the subjects were recorded. Patients with chronic medical conditions were excluded. The patients were used as their own controls, with the third molars on one side being removed under hypnosis and on the opposite side under local anaesthetic. Hypnosis was induced by one of the two methods, either fixing the gaze on one point or Chiasson's technique; both these methods are appropriate for patients in the dental chair. The Spielberger State-Trait Anxiety Inventory was used to determine patient anxiety levels before hypnosis and anaesthesia. Pain was scored using VAS (visual analogue scale). After surgery the patient was asked to bite on a sterile gauze pad over the surgical site for 30 min when haemorrhage from the area was evaluated. If there was no haemorrhage the patient was discharged. If haemorrhage persisted, the gauze pad was left in place for another 30 min and the area was re-evaluated. Any active oozing from the area after 30 min was considered haemorrhage. Haemorrhage, anxiety and pain were compared between the two groups. Data was analyzed using the t-test, McNemar's test and Wilcoxon's signed rank test using SPSS 18 statistical software., Results: Twenty-four patients were evaluated; there were 14 males (58.3%) and 10 females (41.7%). The mean age of the subjects was 24.1 ± 2.7 years (age range = 18-30 years). A total of 48 third molars were extracted. In each patient, one-third molar was extracted under hypnosis and the other under local anaesthesia. All the patients were in the ASA 1 category (normal) with no significant medical history. Of the subjects who underwent hypnosis, only two subjects (8.3%) reported pain after induction of hypnosis. In the local anaesthetic group, 8 subjects (33.3%) reported pain. There was a significant difference between the two groups. The results of the study showed that patients in the hypnosis group had less pain during the first few hours post-operatively. Anxiety scores in the two groups were very close to each other and no statistically significant differences were observed in general and when each person was compared with himself or herself. Pain intensity in the two groups at 5- and 12-h post-operatively exhibited significant differences. In the hypnosis group, 10 patients (41.7%) took analgesic medication; in the local anaesthesia group, 22 patients (91.7%) took the analgesic medication (P = 0.0001). In other words, patients reported less pain when they were under hypnosis., Conclusion: The results of the study showed that hypnosis can effectively reduce anxiety, haemorrhage and pain. More studies are necessary to collect data on the effect of hypnosis on oral and maxillofacial surgeries., (Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study is to evaluate the position of impacted third molars based on the classifications of Pell & Gregory and Winter in a sample of Iranian patients., Study Design: In this retrospective study, up to 1020 orthopantomograms (OPG) of the patients who were referred to the radiology clinics from October 2007 to January 2011 were evaluated. Data including the age, gender, the angulation type, width and depth of impaction were evaluated by statistical tests., Results: Among 1020 patients, 380(27.3%) were male and 640(62.7%) were female with the sex ratio was 1:1.7. Of the 1020 OPGs, 585 cases showed at least one impacted third molar, with significant difference between males (205; 35.1%) and females (380; 64.9%) (P = 0.0311). Data analysis showed that impacted third molars were 1.9 times more likely to occur in the mandible than in the maxilla (P =0.000). The most common angulation of impaction in the mandible was mesioangular impaction (48.3%) and the most common angulation of impaction in the maxilla was the vertical (45.3%). Impaction in the level IIA was the most common in both maxilla and mandible. There was no significant difference between the right and left sides in both the maxilla and the mandible., Conclusion: The pattern of third molar impaction in the southeast region of Iran is characterized by a high prevalence of impaction, especially in the mandible. Female more than male have teeth impaction. The most common angulation was the mesioangular in the mandible, and the vertical angulation in the maxilla. The most common level of impaction was the A and there was no any significant difference between the right and left sides in both jaws.