Publications by authors named "Arash Shahravan"

39 Publications

Comparison of Dentinal Wall Thickness in the Furcation Area (Danger Zone) in the First and Second Mesiobuccal Canals in the Maxillary First and Second Molars Using Cone-Beam Computed Tomography.

Eur Endod J 2020 24;5(2):81-85. Epub 2020 Apr 24.

Department of Endodontics, Faculty of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.

Objective: Differences in the morphology of the root canal system might result in favorable or adverse treatment outcomes. The present study compared the thickness of the dentinal wall in the danger zone (furcation area) of the first and second mesiobuccal canals in the maxillary first and second molars using cone beam computed tomography.

Methods: In this cross-sectional study, 50 CBCT images of maxillary first and second molars were evaluated from one of the specialized radiology centers in Kerman, Iran. The images were prepared by a Planmeca Promax 3D Max machine (Planmeca, Helsinki, Finland), with a field of view (FOV) of 8×8 cm and a resolution of 0.1 mm and analyzed with Romexis Viewer software version 3.1.1 (Planmeca, Helsinki, Finland). In the 0.1-mm-thick axial cross-sections with a distance of 1 mm, the distances from the center of the MB1 and MB2 root canals to the furcation area were measured in three areas: A) furcation area, B) 2 mm below the furcation area, and C) 4 mm below the furcation area (at a magnification of ×10). The data were then analyzed with paired t-test.

Results: The thickness of the dentinal wall in the MB2 root canal was significantly less than that in the MB1 root canal in all the specimens (P<0.05). In both maxillary first and second molars, the thicknesses of the MB1 and MB2 root canals were significantly different in the furcation area and 4 mm below the furcation area (P=0.001). There was no significant difference between the maxillary first and second molars 2 mm below the furcation area; however, the difference was marginal (P=0.07).

Conclusion: Considering the low thickness of the dentinal wall in the MB2 root canal compared with the MB1 root canal in the maxillary first and second molars, the anti-curvature techniques away from the furcation should be used to prepare this root canal to reduce the risk of strip perforation. On the other hand, it might indicate that highly tapered instruments and other aggressive instruments, such as Gates-Glidden drills, should be used with caution in these root canals.
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http://dx.doi.org/10.14744/eej.2020.18189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398989PMC
April 2020

Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial.

Pain Res Manag 2020 30;2020:5853412. Epub 2020 Jun 30.

Endodontology Research Center, Endodontic Department, Dental School, Kerman University of Medical Sciences, Kerman 7618751689, Iran.

This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA ( = 188), PCEM ( = 194), or RCT ( = 168) arms. Preoperative "Pain Intensity" (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients' demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (=0.939), and the trend/changes in pain relief were parallel (=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes ( < 0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.
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http://dx.doi.org/10.1155/2020/5853412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345601PMC
November 2020

The association between beverage consumption pattern and dental problems in Iranian adolescents: a cross sectional study.

BMC Oral Health 2020 03 17;20(1):74. Epub 2020 Mar 17.

Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Background: With regard to the increasing consumption rates of unhealthy beverages among adolescents, the main purpose of the present study was to determine the association between beverage intake pattern and dental caries and tooth erosion in this age group.

Methods: A total sample of 600 adolescents was recruited in this study using a multistage cluster random sampling method in the city of Kerman, in the southeast of Iran, in 2017. Then, the Decayed, Missed and Filled Teeth (DMFT) index and the Tooth Wear Index (TWI) were registered for each participant. A Beverage Frequency Questionnaire was also employed to estimate typical beverage intake frequency. Correspondingly, negative binominal regression and logistic regression were performed to determine the independent variables associated with the DMFT index and the TWI.

Results: The findings revealed that the highest consumed beverage in daily living was tea in both genders, followed by sweetened soft beverages, as well as milk and kefir/yogurt drink. The results of the DMFT index were also significantly different in participants that had never consumed milk compared with those who had used milk on a daily basis. Moreover, the DMFT index in participants who had never consumed sweetened soft beverages was 39%, less than those who had had a daily intake of such beverages. Also, the chance of tooth erosion for participants who had never used sweetened soft beverages was 94%, lower than that in daily consumers.

Conclusions: The results of this study revealed that adolescents had an unhealthy beverage intake pattern. Furthermore, milk consumption was beneficial to dental caries, whereas use of soft drinks associated with more dental caries and tooth erosion.
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http://dx.doi.org/10.1186/s12903-020-01065-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7079373PMC
March 2020

Potential Use of Microbial Surfactant in Microemulsion Drug Delivery System: A Systematic Review.

Drug Des Devel Ther 2020 5;14:541-550. Epub 2020 Feb 5.

Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

Background: Microemulsions drug delivery systems (MDDS) have been known to increase the bioavailability of hydrophobic drugs. The main challenge of the MDDS is the development of an effective and safe system for drug carriage and delivery. Biosurfactants are preferred surface-active molecules because of their lower toxicity and safe characteristics when compared to synthetic surfactants. Glycolipid and lipopeptide are the most common biosurfactants that were tested for MDDS. The main goal of the present systematic review was to estimate the available evidence on the role of biosurfactant in the development of MDDS.

Search Strategy: Literature searches involved the main scientific databases and were focused on the period from 2005 until 2017. The Search filter composed of two items: "Biosurfactant" and/or "Microemulsion."

Inclusion Criteria: Twenty-four studies evaluating the use of biosurfactant in MDDS were eligible for inclusion. Among these 14 were related to the use of glycolipid biosurfactants in the MDDS formulations, while four reported using lipopeptide biosurfactants and six other related review articles.

Results: According to the output study parameters, biosurfactants acted as active stabilizers, hydrophilic or hydrophobic linkers and safety carriers in MDDS, and among them glycolipid biosurfactants had the most application in MDDS formulations.

Conclusion: Synthetic surfactants could be replaced by biosurfactants as an effective bio-source for MDDS due to their excellent self-assembling and emulsifying activity properties.
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http://dx.doi.org/10.2147/DDDT.S232325DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008186PMC
October 2020

Prevention of secondary caries by a new antibacterial compound.

Dent Res J (Isfahan) 2020 Jan-Feb;17(1):40-47. Epub 2020 Jan 21.

Oral and Dental Disease Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Background: Since secondary caries is one of the main problems of dental composites. The creation of an antibacterial property in these composites is essential. The objective of this study was to synthesize 3-(2, 5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one and check its biocompatibility and antibacterial properties in flowable dental composites.

Materials And Methods: In this animal study, the antibacterial activity of flowable resin composites containing 0-5 wt% 3-(2,5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one was investigated by using agar diffusion and direct contact tests on the cured resins. Statistical analysis was performed using one-way ANOVA test ( < 0.001). Thirty male albino Wistar rats were used, weighing 200-250 g. Animals were randomly divided into three groups of ten; each animal received three implants, 3-(2, 5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one, penicillin V, and an empty polyethylene tube. A pathologist, without knowing the type of material tested and the timing of the test, examined the samples. Statistical analysis was performed using Kruskal-Wallis test ( < 0.001).

Results: According to our findings, although the agar diffusion test reveals no significant difference between the groups, the direct contact test demonstrates that, by increasing the 3-(2,5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one content, the bacterial growth was significantly diminished and the 3-(2,5-dimethylfuran-3-yl)-1H-pyrazole-5(4H)-one has a good biocompatibility ( < 0.05).

Conclusion: Incorporation of 3-(2,5-dimethylfuran-3-yl)-IH-pyrazole-5(4H)-one into flowable resin composites can be useful to prevent activity.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001570PMC
January 2020

Virulence Genes, Antibiotic Resistance and Capsule Locus Polymorphisms in isolated from Canals of Root-Filled Teeth with Periapical Lesions.

Infect Chemother 2018 Dec;50(4):340-345

Faculty of Medicine, Microbiology Section, Bam University of Medical Sciences, Bam, Iran.

Frequent isolation of from root canal treated teeth with apical periodontitis, has proposed the role of this organism in endodontic treatment failures. Different factors have been suggested in the pathogenicity of this organism. In this study, 22 isolates from canals of root-filled teeth were identified, and phenotypic and genotypic characteristics were investigated. No resistance to vancomycin and gentamicin was noted, and most isolates (91%) were susceptible to ampicillin. Biofilm formation was detected in 73% of the isolates and may be considered as the most important virulence factor involved in the pathogenesis of these isolates.
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http://dx.doi.org/10.3947/ic.2018.50.4.340DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312899PMC
December 2018

Effective Factors on Oral Health Behaviors of 12-year-old Children in Cities and Villages of Iran: a Path Analysis.

J Dent (Shiraz) 2018 Sep;19(3):225-231

Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Statement Of The Problem: Oral and general health status depends on several factors such as the individual's personal attributes, behaviors, and perceptions.

Purpose: This study aimed to evaluate the factors affecting the oral health-related behaviors in 12-year-old children.

Materials And Method: This cross-sectional study was based on the data obtained from 1554 students being 12 years old and from five provinces in Iran. The data were collected with a culturally adapted questionnaire about the students' demographic characteristics, knowledge, attitudes, and practice (KAP). Path analysis was conducted to evaluate the effect of these factors on oral health-related behaviors in urban and rural areas.

Results: Based on the findings, 61.1% of the samples resided in urban and 38.9% in rural areas. The mean scores were relatively good for knowledge (74.1±21.1%) and attitudes (72.6±21.1%), but unsatisfactory for oral health practice (51.8±12%). Having measured the correlation between the independent variables and oral health-related behaviors, the province of residence and the parents' education and job had the most significant correlations. Behavioral biases were seen in all dimensions of practice such as brushing habits, dental visits, and diet. In urban areas, 30% and in rural areas 49% of oral health behaviors were directly related to knowledge and attitudes. All of the calculated effects exhibited significant differences from zero (< 0.0001).

Conclusion: Path analysis identified some direct and indirect factors influencing the children's oral health-related behaviors. Factors included in this model could only justify a part of oral health behaviors. Thus, other educational models should be considered based on the psychology or social learning theories.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092467PMC
September 2018

Relation between Socioeconomic Indicators and Children Dental Caries in Iran: A Systematic Review and Meta-analysis.

Int J Prev Med 2018 14;9:71. Epub 2018 Aug 14.

Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

The relationship between households' socioeconomic situation (SES) and children dental caries has been assessed in many Iranian studies to evaluate the effect of public dental care programs supporting the poor. Hence, this study through systematic review and meta-analysis has presented a conclusion in this regard. Domestic and foreign databases were searched using keywords designed by concept map. Time limit to search the databases included articles published from 1994 to 2017. Twenty-five articles were entered to the final step of the study, in which 49 relationships between SES and dental caries were assessed. Heterogeneity between studies was assessed using . Publication bias has been assessed using funnel plot and Egger's test. The data were assessed by STATA 13.1. Odds ratio and mean difference of children dental caries in high SES households in comparison with low SES households were 0.41 (confidence interval [CI]: 0.30, 0.52) and -0.49 (CI: -0.85, -0.13), respectively. The CI in both cases did not include "null or no effect line," so there was a significant inverse relation between SES and dental caries. Despite the emphasis on upstream documents on equity in access to dental health services, there was high difference between SES groups in this regard. It is necessary to revise dental health programs at the country level to decrease these differences.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_435_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6106133PMC
August 2018

Thermal Scanning of Dental Pulp Chamber by Thermocouple System and Infrared Camera during Photo Curing of Resin Composites.

Iran Endod J 2018 ;13(2):195-199

Oral and Dental Disease Research Center, Kerman University of Medical Science, Kerman, Iran.

Introduction: Due to thermal hazard during composite restorations, this study was designed to scan the pulp temperature by thermocouple and infrared camera during photo polymerizing different composites.

Methods And Materials: A mesio-occlso-distal (MOD) cavity was prepared in an extracted tooth and the K-type thermocouple was fixed in its pulp chamber. Subsequently, 1 mm increment of each composites were inserted (four composite types were incorporated) and photo polymerized employing either LED or QTH systems for 60 sec while the temperature was recorded with 10 sec intervals. Ultimately, the same tooth was hemisected bucco-lingually and the amalgam was removed. The same composite curing procedure was repeated while the thermogram was recorded using an infrared camera. Thereafter, the data was analyzed by repeated measured ANOVA followed by Tukey's HSD Post Hoc test for multiple comparisons (=0.05).

Results: The pulp temperature was significantly increased (repeated measures) during photo polymerization (=0.000) while there was no significant difference among the results recorded by thermocouple comparing to infrared camera (>0.05). Moreover, different composite materials and LCUs lead to similar outcomes (>0.05).

Conclusion: Although various composites have significant different chemical compositions, they lead to similar pulp thermal changes. Moreover, both the infrared camera and the thermocouple would record parallel results of dental pulp temperature.
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http://dx.doi.org/10.22037/iej.v13i2.18756DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911293PMC
January 2018

Topographic Features of Five K-file Brands in Iranian Market: A Scanning Electron Microscopic Study.

Iran Endod J 2018 ;13(1):66-70

Dental Research Center, Department of Oral and Maxillofacial Medicine, Dental School, Golestan University of Medical Sciences, Gorgan, Iran.

Introduction: Endodontic files which are used to clean and shape the root canal space differ from each other regarding technical specifications. Recently, K-type files are repeatedly studied on their cutting efficiency. This study aims to evaluate the tip design and cutting efficiency of 5 brands of K-files, available in Iran dental market (naming Dentsply, Thomas, Mani, Perfect and Larmrose).

Methods And Materials: In this descriptive study, topographic features of file tips were investigated by the scanning electron microscope (SEM). Those features included tip symmetry, tip design, tip angle, and the distance from the tip to the lowest flute. SEM images (×250 magnification) of files were prepared. Statistical tests (Fisher's exact test, -square, ANOVA, and test) were used and <0.05 was considered as significant.

Results: Dentsply files had the most number of morphologically pyramidal sharp tips and the greatest tip angles. However, Larmrose files were the most frequent files having cutting sharp tips. Symmetrical tips existed among 100% of Dentsply and Mani brands. No significant differences were found with respect to distance from the file tip to the lowermost flute between different file brands of this study (=0.2, One way ANOVA).

Conclusion: Dentsply and Mani files possessed the most symmetrical tips and greatest tip angles. With respect to tip length, all 5 brands were satisfactory. However, neither of 5 brands evaluated topographically were outstanding in every aspect.
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http://dx.doi.org/10.22037/iej.v12i3.16031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800444PMC
January 2018

Success Rate and Time for Bypassing the Fractured Segments of Four NiTi Rotary Instruments.

Iran Endod J 2017 ;12(3):349-353

Postgraduate Student, Department of Periodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction: The aim of this study was to compare the success rate and time required for bypassing the fractured segments of four different nickel-titanium (NiTi) rotary systems.

Methods And Materials: This study was conducted on the mesiobuccal canals of 60 mandibular molars with fully-formed apices. Fifteen Flex Master, K3, RaCe and Hero Shaper instruments with 0.04 taper and tip size of #30 and 25 mm in length, were obtained. These instruments were notched at a point 3 mm from the tip of the instrument and were driven into the canals using a handpiece until the instruments fractured and became lodged therein. In the next step, an endodontist tried to bypass the fractured segment using K-files. The number of bypassed samples and the time required for bypassing of each sample were recorded. The -square test was used to compare the bypassing rate among the experimental groups. One-way analysis of variance followed by Tukey's post hoc test was conducted to compare the time taken for bypassing of the fractured fragments.

Results: One instrument in Flex Master group and two broken segments in each of the K3 and Hero groups were not bypassed. All of the samples in RaCe group were bypassed. No significant difference was found among four tested groups regarding rate of bypassing (=0.738). The time taken to bypass fragments in the Hero group was significantly more than in those of K3 (=0.047) and RaCe (=0.024).

Conclusion: Under the limitations of this study, design features of rotary files can influence the time needed to bypass separated fragments.
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http://dx.doi.org/10.22037/iej.v12i3.16866DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527213PMC
January 2017

Telescopic Dental Needles versus Conventional Dental Needles: Comparison of Pain and Anxiety in Adult Dental Patients of Kerman University of Medical Sciences-A Randomized Clinical Trial.

J Endod 2017 Aug 1;43(8):1273-1278. Epub 2017 Jun 1.

Kerman Oral and Dental Diseases Research Center and Kerman Social Determinants on Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran. Electronic address:

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.
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http://dx.doi.org/10.1016/j.joen.2017.03.027DOI Listing
August 2017

The impact of mother's literacy on child dental caries: Individual data or aggregate data analysis?

J Educ Health Promot 2017 19;6. Epub 2017 Apr 19.

Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Introduction: To evaluate the impact of mother's literacy on child dental caries based on a national oral health survey in Iran and to investigate the possibility of ecological fallacy in aggregate data analysis.

Materials And Methods: Existing data were from second national oral health survey that was carried out in 2004, which including 8725 6 years old participants. The association of mother's literacy with caries occurrence (DMF (Decayed, Missing, Filling) total score >0) of her child was assessed using individual data by logistic regression model. Then the association of the percentages of mother's literacy and the percentages of decayed teeth in each 30 provinces of Iran was assessed using aggregated data retrieved from the data of second national oral health survey of Iran and alternatively from census of "Statistical Center of Iran" using linear regression model. The significance level was set at 0.05 for all analysis.

Results: Individual data analysis showed a statistically significant association between mother's literacy and decayed teeth of children ( = 0.02, odds ratio = 0.83). There were not statistical significant association between mother's literacy and child dental caries in aggregate data analysis of oral health survey ( = 0.79, = 0.03) and census of "Statistical Center of Statistics" ( = 0.60, = 0.14).

Conclusion: Literate mothers have a preventive effect on occurring dental caries of children. According to the high percentage of illiterate parents in Iran, it's logical to consider suitable methods of oral health education which do not need reading or writing. Aggregate data analysis and individual data analysis had completely different results in this study.
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http://dx.doi.org/10.4103/jehp.jehp_2_15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433630PMC
April 2017

The Efficiency Assessment of Dental Units Using Data Envelopment Analysis Approach: The Case of Iran.

Iran J Public Health 2017 Apr;46(4):552-559

Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Background: During the last decades, the number of dentistry units increased significantly across the country. The aim of this study was to assess the efficiency of dental units of Iran provinces regarding dental health inputs and outputs using Data Envelopment Analysis approach.

Methods: In this applied descriptive-analytical study, the study population included all of Iran 31 provinces. The output variables included DMFT and DMFT indices of 6-12 yr old students. The data about DMFT and DMFT indices were taken from 2013 Nationwide School Pupils Screening Program. Input variables included active dental chairs located in the public sector, general dentists of public sector, general and specialist dentists of private sector by different provinces. The data were analyzed using Deap software version 2.1.

Results: The lowest amount of scale efficiency was for Tehran Province (0.204) followed by Isfahan Province (0.205). Provinces of Isfahan, Razavi Khorasan, Kerman, Zanjan, Hamedan, Kordestan, Golestan, Yazd and Tehran, Iran had decreasing return to scale and provinces of Gilan, West Azerbaijan, Mazandaran, Fars, Kermanshah, Markazi, Lorestan, Qazvin, Sistan-and-Baluchestan, Bushehr, Alborz, Hormozgan and Khuzestan had increasing return to scale.

Conclusion: Despite provinces of Isfahan, Razavi Khorasan, Kerman, Zanjan, Hamedan, Kordestan, Golestan, Yazd and Tehran which had a better situation in terms of the number of dentistry chairs, public dentists, general and specialist dentists of private sector than other provinces, they had decreasing return to scale. Investment in dental primary health care, preventive and educational programs can be more cost-effective.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439046PMC
April 2017

PubMed-Indexed Dental Publications from Iran: A Scientometric Study.

J Dent (Tehran) 2016 Jun;13(3):157-167

Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: Scientometric methods and the resulting citations have been applied to investigate the scientific performance of a nation. The present study was designed to collect the statistical information of dental articles by Iranian authors published in PubMed.

Materials And Methods: We searched the PubMed database for dental articles of Iranian authors until June 31, 2015. All abstracts were manually reviewed in order to exclude false retrievals. The number of articles per dental subspecialties, distribution of research designs, Scopus/Google Scholar citation of each article, number of authors and affiliation of the first/corresponding author were extracted and transferred to Microsoft Excel. The data were further analyzed to illustrate the related scientometric indicators.

Results: A total of 3,835 articles were retrieved according to the selection criteria. The number of PubMed-indexed publications between 2008 and 2015 showed a seven-fold increase. The majority of articles were written by four authors (24.56%). Systematic reviews and clinical trials constituted 9.20% of all publications. The number and percentage of articles with ≥4 citations from Google Scholar (n=2024; 52.78%) were higher than those from Scopus (n=1015; 26.47%). According to affiliated departments of the first authors, the top three dental subspecialties with the highest number of publications belonged to endodontics (19.82%), orthodontics (11.13%) and oral and maxillofacial surgery (10.33%). Moreover, the majority of articles originated from Shahid Beheshti- (14.47%), Tehran- (13.72%) and Mashhad- (12.28%) University of Medical Sciences.

Conclusions: Analysis of PubMed-indexed dental publications originating from Iran revealed a growing trend in the recent years.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376542PMC
June 2016

Occupational Stress and Coping Behaviours Among Dentists in Kerman, Iran.

Sultan Qaboos Univ Med J 2016 Aug 19;16(3):e341-6. Epub 2016 Aug 19.

Oral & Dental Diseases Research Centre, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.

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.
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http://dx.doi.org/10.18295/squmj.2016.16.03.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996298PMC
August 2016

Physical Properties of Five Brands of K-Files.

Iran Endod J 2016 20;11(2):114-8. Epub 2016 Mar 20.

Kerman University of Medical Sciences, Kerman, Iran.

Introduction: Endodontic K-files are major tools for cleaning and shaping of the root canal systems. As there are various K-files available in Iranian market, the physical properties of the five available brands were investigated to assist the clinician when selecting suitable endodontic K-files according to the intended application.

Materials And Methods: Physical properties (including debris creation, machinery defect and corrosion) of the selected K-files were investigated by a scanning electron microscope (SEM) under ×250 magnification. For evaluating the flutes number, a stereomicroscope was used with ×40 magnification.

Results: Maximum and minimum debris and corrosion were observed in the Larmrose and Perfect K-files, respectively. Dentsply showed the least machinery defects. Other brands had intermediary properties. In addition, Larmrose K-files showed the maximum flutes number compared to the other brands.

Conclusion: According to the results, none of the K-files had the ideal properties. More studies regarding the physical properties of the K-files and their clinical efficacy are suggested.
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http://dx.doi.org/10.7508/iej.2016.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841346PMC
May 2016

Oral health knowledge, attitude, and practice in 12-year-old schoolchildren in Iran.

J Int Soc Prev Community Dent 2015 Sep-Oct;5(5):419-24

Department of Epidemiology, Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Objective: The knowledge, attitude, practice (KAP) studies play an important role in promotion of oral health. The aim of this study was to assess oral health KAP in 12-year-old schoolchildren in Iran.

Materials And Methods: In a cross-sectional study on 1554 students aged 12 years from the rural and urban areas of five provinces, KAP of subjects was assessed using a culturally adapted questionnaire. Data were analyzed using Chi-squared test, t-test, correlation coefficient, analysis of variance (ANOVA), and linear regression. Statistical significance was set at P < 0.05.

Results: In general, the scores of students in knowledge, attitude, and practice were 74.1 ± 21.1%, 72.6 ± 21.1%, and 51.8 ± 12%, respectively. Urban students had significantly higher scores in KAP (P = 0.0001). Female students got higher scores in all the three dimensions, but the difference was significant only in brushing practice (P = 0.006). Students in Tehran (the capital city) had significantly higher scores in all fields (P = 0.0001). Parents' education and mothers' job had a significant relationship with KAP of children.

Conclusion: The results of this study showed that 12-year-old schoolchildren in Iran had good knowledge and positive attitude. But oral health practice was not satisfactory.
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http://dx.doi.org/10.4103/2231-0762.165926DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606608PMC
November 2015

Factors Affecting Response to Infertility Treatment: Case of Iran.

Glob J Health Sci 2015 May 17;8(1):118-23. Epub 2015 May 17.

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Introduction: Infertility affects both women and men in all the countries. Infertility often has profound long-term or short-term impacts on the people involved and puts them at risk of familial and social pressures. According to WHO estimates, between 8% and 12% of all the couples worldwide experience some form of infertility during their reproductive life, i.e. 50‒80 million people are affected. The aim of this study was to evaluate the response to infertility treatment by taking into account factors such as age, hirsutism, menstruation and galactose among women in Kerman.

Methodology: Of a total of 300 patient files evaluated 220 cases were flawless, of which the study factors were recorded. These data were estimated by Logit model. The dependent variable was the response to treatment (0 and 1) and the independent variables included age of men and women, hirsutism, menstruation, galactose, duration of the period no preventive measures were used and body mass index. After entering the data, model output was analyzed by using the STATA software.

Results: The results showed that of all the model variables, female age (prob=0.0065), menstruation (prob=0.04), hirsutism (prob=0.02), marriage age (in months) (prob=0.02) and BMI were significant and other variables were not significant. McFadden analysis for goodness of fit was 0.92.

Conclusion: The study results showed that women should pay more attention to variables such as BMI, menstruation quality (regular and irregular) and aging because clinical disregard of any of the above can have a significant impact on the individual's fertility.
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http://dx.doi.org/10.5539/gjhs.v8n1p118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803951PMC
May 2015

Prevalence of Upper Extremity Musculoskeletal Disorders in Dentists: Symptoms and Risk Factors.

J Environ Public Health 2015 3;2015:517346. Epub 2015 May 3.

Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Aim: The purpose of the present research was to examine the factors that lead to musculoskeletal disorders in dentists by assessing their posture using RULA method.

Materials And Methods: In this cross-sectional study, 130 dentists (84 male and 46 female) participated. The posture of the subjects during their normal workload was recorded by using the RULA method, and the range of musculoskeletal pains by using the Nordic Musculoskeletal Questionnaire (NMQ), and individual and professional data was assessed by a demographics questionnaire. All tests were performed at the P < 0.05 level.

Results: Assessment of the physical status of the subjects showed that 82.8% of subjects were at high risk of musculoskeletal disorders. The majority of musculoskeletal pains were in the neck (55.9%) and the shoulder (43.8%). Moreover, 68.9% of the subjects had experienced pain at least once over the last year. Significant relationships were observed between musculoskeletal pain and daily work hours (P = 0.07) and number of patients (P = 0.02), but the pain was not significantly associated with BMI and experience.

Conclusion: The present findings showed that unsuitable posture of dentists during work has a considerable effect on musculoskeletal disorders. Therefore, further investigation is required to avoid the detrimental effects of wrong posture.
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http://dx.doi.org/10.1155/2015/517346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433686PMC
May 2016

Predictors of missing data when asking parents about their children's diet based on "Oral Health Situation of Iranian Children" Survey.

J Indian Soc Pedod Prev Dent 2015 Apr-Jun;33(2):100-3

Department of Epidemiology and Biostatistics, Kerman University of Medical Sciences, Kerman; Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Background: The predictors of missing data when parents fill out questionnaire about their children's diet are not defined. The aim of this study was to evaluate predictors which affect unresponsiveness to diet questions based on " Oral Health Situation of Iranian Children" Survey carried out in 1998.

Materials And Methods: A dummy variable was created as dependent variable according to responding eight questions relating to diet. Then predictors of missing data were defined using multivariable logistic regression and classification tree method. To evaluate goodness of fit of logistic regression model, sensitivity and specificity were assessed. Classification tree analysis was done by Quest growing method. Significance level was set at 0.05 in logistic regression analysis.

Observations And Results: "Missing data" variable was marked as missing in 616 (7.2%) of questionnaires. In logistic regression model revealed that, gender, mother's education level and father's education level didn't affect "missing data" variable (P > 0.05). But, dmf index (OR = 0.94), Area of living (OR = 0.49), number of children in the family (OR = 1.19), sibling order (OR = 0.85), brushing (OR = 0.84) and visiting dentist (OR = 0.59) had statistically significant association with dependent variable (P < 0.05). Classification tree analysis showed that questionnaires related to children in urban area whose dmf index is under 5 and haven't visited dentist are predicted to have missing data more than other groups.

Conclusions: Area of living, dmf index, number of children in the family, sibling order, brushing and visiting dentist are significant variables for predicting the risk of missing data when asking parents about their children's diet.
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http://dx.doi.org/10.4103/0970-4388.155117DOI Listing
January 2017

Critical appraisal of reporting randomized clinical trials published in Iranian dental journals during 2003-2010.

J Dent (Tehran) 2014 May 31;11(3):310-8. Epub 2014 May 31.

Dentist, Private Practice, Department of Oral Medicine, Kerman Dental School, Kerman University of Medical Sciences.

Objective: Considering the importance of randomized clinical trials (RCTs) in the evidence-based approach, the objective of this study was critical appraisal of reporting RCTs in Iranian dental journals.

Materials And Methods: After adequate searching, 113 RCT articles published during 2003-2010 were reviewed for quality of reporting with the CONSORT scale. The quality of each paper was assessed on 20.

Results: Although statistical analysis was described in 93.8%, acceptable methods for randomization and blinding were found in only 8% and 11.5% of the papers, respectively. Reasons for withdrawal were also given in just 20.4% of the articles.

Conclusion: This study revealed that the quality of reporting RCTs in Iranian dental journals does not meet the recommended standards generally and needs to be improved.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290759PMC
May 2014

General Dental Practitioners' Concept towards Using Radiography and Apex-Locators in Endodontics.

Iran Endod J 2014 7;9(4):277-82. Epub 2014 Oct 7.

Instructor, Kerman University of Medical Sciences, Kerman, Iran.

Introduction: Despite being the gold standard as well as a routine technique in endodontics, radiographic working length (WL) determination owns many drawbacks. Electronic apex-locators (EALs) are recommended to complement radiographies. The aim of this study was to evaluate the perceptions of Iranian general dental practitioners (GDPs) towards using radiography and EAL.

Methods And Materials: Three hundred and ninety one GDPs attending the 53(th) Iranian Dental Association Congress completed a questionnaire focusing on the use of radiography and EALs during the various stages of root canal treatment. The data was analyzed with the chi-square test with the level of significance set at 0.05. The results were then calculated as frequencies and percentages.

Results: More than half of the GDPs reported using radiographs as the sole method for WL determination. A total of 30.4% of the practitioners were using the combined approach during root canal therapy of a single-rooted tooth, while 38.9% used this method in multi-rooted teeth. Approximately half of the respondents would not order follow-up radiographies after root canal treatment.

Conclusion: Radiography continues to be the most common method for WL determination in Iran.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224766PMC
November 2014

Knowledge and Use of Evidence-based Dentistry among Iranian Dentists.

Sultan Qaboos Univ Med J 2014 May 7;14(2):e223-30. Epub 2014 Apr 7.

Department of Oral Medicine, Oral & Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran.

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.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997540PMC
May 2014

Endodontic epidemiology.

Iran Endod J 2014 8;9(2):98-108. Epub 2014 Mar 8.

The Research Center for Modeling in Health, Institute for future studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Epidemiology is the study of disease distribution and factors determining or affecting it. Likewise, endodontic epidemiology can be defined as the science of studying the distribution pattern and determinants of pulp and periapical diseases; specially apical periodontitis. Although different study designs have been used in endodontics, researchers must pay more attention to study designs with higher level of evidence such as randomized clinical trials.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956956PMC
June 2014

Do you Recommend an Interdisciplinary Field to your Graduate Student?

Int J Health Policy Manag 2013 Jun 12;1(1):1-2. Epub 2013 Jun 12.

Kerman Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran.

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http://dx.doi.org/10.15171/ijhpm.2013.01DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937930PMC
June 2013

Sample size calculation of clinical trials published in two leading endodontic journals.

Iran Endod J 2014 24;9(1):56-60. Epub 2013 Dec 24.

The Research Center for Modeling in Health, Institute for future studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Introduction: The purpose of this article was to evaluate the quality of sample size calculation reports in published clinical trials in Journal of Endodontics and International Endodontic Journal in years 2000-1 and 2009-10.

Materials And Methods: Articles fulfilling the inclusion criteria were collected. The criteria were: publication year, research design, types of control group, reporting sample size calculation, the number of participants in each group, study outcome, amount of type I (α) and II (β) errors, method used for estimating prevalence or standard deviation, percentage of meeting the expected sample size and considering clinically importance level in sample size calculation. Data were extracted from all included articles. Descriptive analyses were conducted. Inferential statistical analyses were done using independent T-test and Chi-square test with the significance level set at 0.05.

Results: There was a statistically significant increase in years between 2009 and 10 compared to 2000-1 in terms of reporting sample size calculation (P=0.002), reporting clinically importance level (P=0.003) and in samples size of clinical trials (P=0.01). But there was not any significant difference between two journals in terms of reporting sample size calculation, type of control group, frequency of various study designs and frequency of positive and negative clinical trials in different time periods (P>0.05).

Conclusion: Sample size calculation in endodontic clinical trials improved significantly in 2009-10 when compared to 2000-1; however further improvements would be desirable.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881303PMC
January 2014

Reporting of Ethical Considerations Associated with Clinical Trials Published in Iranian Dental Journals between 2001 and 2011.

Iran J Public Health 2013 1;42(6):594-601. Epub 2013 Jun 1.

Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Background: Ethical consideration is a basic requirement for design of randomized clinical trials. The purpose of this study was to assess whether reports of Iranian dental clinical trials complied with the requirements of the ethical principles of human research.

Methods: In this retrospective observational study electronic search was performed to identify all dental clinical trials published between 2001 and 2011. Each trial report was assessed for inclusion of a statement that 17 items about research ethics.

Results: Totally 242 papers were identified, of which 15.3%, stated that ethical approval had been obtained and 50.4% of the trial reports indicated that informed consent had been obtained. The mean ethical score for the mentioned studies was 7/68 out of 17.

Conclusions: Most Iranian dental clinical trial reports failed to consider important ethical principles. The reporting of the ethical issues associated with these trials could be improved further not only by the instructions to authors, but also by Journal editors refusing to publish trials that do not comply.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744256PMC
August 2013

Effect of Family Structure and Behavioral and Eyesight Problems on Caries Severity in Pupils by Using an Ordinal Logistic Model.

Iran J Public Health 2013 Aug;42(8):889-95

Youth and Schools Health Unit, Deputy of Hygiene, Kerman University of Medical Sciences, Kerman, Iran.

Background: Dental caries is one of the most preventable yet prevalent chronic diseases worldwide. Our objective was to evaluate the effect of family structure and behavioral and eyesight problems as they relate to caries severity in schoolchildren.

Methods: This research was carried out on 845 primary schoolchildren aged 9 yr in Kerman, Iran, in 2012. Ten variables, including health records, family structure information and a dmft/DMFT index, were collected. Children were categorized into three groups based on the WHO caries severity classification. Low caries level was defined as dmft/DMFT<2.6, moderate as dmft/DMFT of 2.7-4.4 and high as dmft/DMFT>4.4. The Cochran-Armitage test and ordinal logistic regression were employed for data analysis.

Results: Almost half of pupils had moderate or high caries severity. The odds of being in a higher caries severity category in pupils with behavioral problems (OR=2.37, 95% CI: 1.29-4.38) and girls (OR=1.6, 95% CI: 1.22-2.06) were higher than in other categories. In addition, pupils with eyesight problems (OR=0.58, 95% CI: 0.37-0.90) and overweight pupils (OR=0.46, 95% CI: 0.31-0.71) had lower caries severity than others. The effects of parents' education, birth rank, living with parents and consanguineous relationship between parents were not significant on caries severity (P>0.05).

Conclusions: Female pupils with behavioral problems were at a higher risk of caries severity than other pupils. These pupils need to be educated and coached on proper dental care. In addition, overweight pupils and those with eyesight problems had less caries severity than others. Family structure in this study did not have an effect on the severity of dental caries.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441921PMC
August 2013

Success of ultrasonic technique in removing fractured rotary nickel-titanium endodontic instruments from root canals and its effect on the required force for root fracture.

J Endod 2013 Jun 16;39(6):824-8. Epub 2013 Apr 16.

Kerman Oral and Dental Diseases Research Center, Kerman University of Medical Science, Kerman, Iran.

Introduction: Fracture of rotary nickel-titanium files is a real concern among endodontists; it affects the long-term prognosis of treatment. Ultrasound is a favorable technique for removing broken files, although it may result in some complications. The aim of this study was to determine the success rate of ultrasonic technique in removing file fragments and to evaluate its influence on the force required to fracture a tooth root.

Methods: An in vitro study was carried out on 70 extracted maxillary premolars. In the experimental group a #30/.04 taper Hero file was guided into the canal to break and lodge therein. The lodged file was removed by ultrasonic vibration and use of a dental operating microscope. The canals were instrumented with Hero files by using crown-down technique and then obturated. All the teeth were prepared for mechanical testing in Testometric machine to measure the required force for root fracture. The Fisher exact test and independent two-sample t test were used to analyze data.

Results: Ultrasonic technique exhibited a success rate of 80% in removing broken files. Success rate in the roots with file fracture before the curve was 11.5 times more than that of file fracture cases beyond the curve. Other factors such as bypass possibility did not affect success rate. The average time required for removing file fragments was 36.3 ± 7.15 minutes, which did not significantly differ in different file locations within the canal. According to mechanical test results, ultrasonic application did not significantly affect the required force for root fracture. The force required to fracture a root did not significantly differ in various file locations. Vertical fracture in the buccolingual direction (split tooth) was the most incident fracture pattern. Procedural errors observed in this study predominantly included transportation, perforation, and craze line.

Conclusions: Ultrasonic technique was successful in removing 80% of fractured rotary files and did not significantly affect the required force for root fracture.
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http://dx.doi.org/10.1016/j.joen.2013.02.008DOI Listing
June 2013