A randomized clinical trial on the changing of median nerve cross-sectional area and pain after extracorporeal shock wave and low-level laser therapy added to conventional physical therapy in patients with mild-to-moderate carpal tunnel syndrome.

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common mononeuropathy in the upper limb. It remains uncertain whether adding extracorporeal shockwave therapy (ESWT) or low-level laser therapy (LLLT) to conventional treatment benefits CTS patients. PURPOSE: This study aimed to compare the effectiveness of ESWT and LLLT in conjunction with conventional treatments (including carpal mobilization, transcutaneous electrical nerve stimulation, and ultrasound) on the cross-sectional area (CSA) of the median nerve and pain in mild-to-moderate CTS patients. STUDY DESIGN: This was a single-blinded randomized clinical trial with registration number IRCT20220504054734N1. METHODS: Thirty-six patients were randomly assigned using block balanced randomization to receive either four sessions of ESWT or 10 sessions of LLLT in addition to 10 sessions of conventional treatments over 2 weeks. Patients received numbered closed envelopes indicating their treatment group. CSA (primary) and pain (secondary) in 18 patients who completed the treatment were assessed at baseline and after 2 weeks by a blinded assessor. Paired and independent sample t-tests were used for analyses due to the normal distribution of data was checked by Kolmogorov-Smirnoff. Cohen's d effect size was used to assess the intervention's magnitude. RESULTS: Both ESWT and LLLT groups showed significant improvements in CSA (p = 0.002) and pain (p < 0.001) from baseline to posttreatment. CSA improvement was moderate for ESWT (mean difference: 1.2, 95% CI 0.51-1.9) and mild for LLLT (mean difference: 0.76, 95% CI 0.4-1.14). Conversely, pain improvement was substantial in both groups (ESWT: mean difference 4.4, 95% CI 3.6-5.3; LLLT: mean difference 4.4, 95% CI 3.7-5.2). No substantial differences between ESWT and LLLT were observed, highlighting their comparable efficacy. CONCLUSION: The addition of either LLLT or ESWT to conventional treatment effectively reduced pain and median nerve CSA in mild-to-moderate CTS. The absence of significant differences between ESWT and LLLT indicates their comparable efficacy in pain relief and CSA reduction.

Investigating the efficacy of a varnish containing gallic acid on remineralization of enamel lesions: an in vitro study.

This study evaluated the efficacy of a formulated remineralizing gallic acid (GA) varnish in treating artificial enamel caries lesions. Fifty-five intact bovine incisors were collected. Enamel blocks (5 × 9 mm) were prepared. A third of each block's surface remained intact. Primary carious lesions were induced on the middle and bottom thirds of the blocks by immersing the samples in a demineralization solution for 6 h. The bottom third of the blocks were further remineralized by randomly applying 0.5%, 2%, or 8% GA varnishes and 2.26% fluoride varnish (V varnish, Vericom, Seoul, Korea), or the varnish base without active ingredients (n = 11 each). The specimens were immersed in a remineralizing solution for 4 h and then subjected to a 2-hour immersion in the demineralizing solution. After six days of pH cycling, the surface microhardness was measured at depths of 30, 75, and 120 µm. The percentage of surface microhardness recovery (SMHR%) was compared among the groups using the Shapiro-Wilk, ANOVA, and Tukey HSD post-hoc tests (α = 0.05). The SMHR% of all experimental groups was higher than the control group at 30 µm (p < 0.05). The 0.5% GA varnish showed the highest SMHR% at all depths; however, the difference with the other experimental groups was significant at a depth of 30 µm (p < 0.05). The SMHR% of the fluoride and the 2% and 8% GA varnishes was comparable at all depths. All treatments potentially remineralize enamel lesions, with 0.5% GA varnish having the greatest effect, particularly on the top surface layer. As such, this newly developed varnish may emerge as a promising alternative to fluoride varnish.

Color change of tooth-colored restorative materials bonded to silver diamine fluoride-treated dentine: a systematic review.

BACKGROUND: The desirable properties of silver diamine fluoride (SDF) make it an effective agent for managing dental caries and tooth hypersensitivity. There are several clinical instances that SDF application might precede the placement of direct tooth-colored restorations. On the other hand, SDF stains demineralized/carious dental tissues black, which might affect the esthetic outcomes of such restorations. Color is a key parameter of esthetics in dentistry. Therefore, this study aims to systematically review dental literature on color/color change of tooth-colored restorations placed following the application of SDF on dentine. METHODS: Comprehensive search of PubMed, Embase, Scopus and ISI Web of Science databases (until August 2023) as well as reference lists of retrieved studies was performed. In vitro studies reported color or color change of tooth-colored restorative materials applied on SDF-treated dentine were included. Methodological quality assessment was performed using RoBDEMAT tool. Pooled weighted mean difference (WMD) and 95% confidence interval (95% CI) was calculated. RESULTS: Eleven studies/reports with a total of 394 tooth-colored restorations placed following a) no SDF (control) or b) SDF with/without potassium iodide (KI)/glutathione dentine pre-treatments were included. Color change was quantified using ∆E formulas in most reports. The pooled findings for the comparison of resin-based composite (RBC) restorations with and without prior 38% SDF + KI application revealed no statistically significant differences in ∆E values at short- and long-term evaluations (~ 14 days: WMD: -0.56, 95% CI: -2.09 to 0.96; I2: 89.6%, and ~ 60 days: WMD: 0.11; 95% CI: -1.51 to 1.72; I2: 76.9%). No studies provided sufficient information for all the items in the risk of bias tool (moderate to low quality). CONCLUSIONS: The limited evidence suggested comparable color changes of RBC restorations with and without 38% SDF + KI pre-treatment up to 60 days. The included studies lacked uniformity in methodology and reported outcomes. Further studies are imperative to draw more definite conclusions. PROTOCOL REGISTRATION: The protocol of this systematic review was registered in PROSPERO database under number CRD42023485083.

Evaluation and comparison of the effects of a new paste containing 8% L-Arginine and CaCO3 plus KNO3 on dentinal tubules occlusion and dental sensitivity: a randomized, triple blinded clinical trial study.

BACKGROUND: Dentin hypersensitivity, often occurring after dental treatments or from erosive lesions, is a prevalent patient complaint. This study introduces a paste combining 8% L-arginine, calcium carbonate, and potassium nitrate to evaluate its impact on dentinal tubules occlusion, dentin permeability, and tooth sensitivity. METHODS: Dentin surfaces from 24 third molars (thickness: 2 mm) were divided into two groups of 12. One received the experimental paste, while the other received a placebo without desensitizer. Permeability and sealing ability were assessed through scanning electron microscopy (SEM) and dentin permeability measurement. The pastes' effects on hypersensitivity were then examined in a triple-blind, randomized parallel-armed clinical trial with 16 eligible patients. Sensitivity to cold, touch, and spontaneous stimuli was recorded using the VAS scale at various intervals post-treatment. Statistical analysis was conducted using Shapiro-Wilk, Mann-Whitney U, Friedman, and Wilcoxon tests (α = 0.05). RESULTS: The permeability test demonstrated a significant reduction in dentin permeability in the experimental group (P = 0.002) compared to the control (P = 0.178). SEM images revealed most dentinal tubules in the intervention samples to be occluded. Clinically, both groups showed a significant decrease in the three types of evaluated sensitivity throughout the study. However, no significant difference in sensitivities between the two groups was observed, with the exception of cold sensitivity at three months post-treatment (P = 0.054). CONCLUSION: The innovative desensitizing paste featuring 8% L-arginine, calcium carbonate, and potassium nitrate effectively occluded dentinal tubules and reduced dentin permeability. It mitigated immediate and prolonged dentin hypersensitivity to various stimuli, supporting its potential role in managing dentin hypersensitivity. TRIAL REGISTRATION: http://irct.ir : IRCT20220829055822N1, September 9th, 2022.

Using deep ensemble forest for high-resolution mapping of PM2.5 from MODIS MAIAC AOD in Tehran, Iran.

High-resolution mapping of PM2.5 concentration over Tehran city is challenging because of the complicated behavior of numerous sources of pollution and the insufficient number of ground air quality monitoring stations. Alternatively, high-resolution satellite Aerosol Optical Depth (AOD) data can be employed for high-resolution mapping of PM2.5. For this purpose, different data-driven methods have been used in the literature. Recently, deep learning methods have demonstrated their ability to estimate PM2.5 from AOD data. However, these methods have several weaknesses in solving the problem of estimating PM2.5 from satellite AOD data. In this paper, the potential of the deep ensemble forest method for estimating the PM2.5 concentration from AOD data was evaluated. The results showed that the deep ensemble forest method with [Formula: see text] gives a higher accuracy of PM2.5 estimation than deep learning methods ([Formula: see text]) as well as classic data-driven methods such as random forest ([Formula: see text]). Additionally, the estimated values of PM2.5 using the deep ensemble forest algorithm were used along with ground data to generate a high-resolution map of PM2.5. Evaluation of produced PM2.5 map revealed the good performance of the deep ensemble forest for modeling the variation of PM2.5 in the city of Tehran.

Psychometric evaluation of Persian version of Diabetes Acceptance Scale (DAS).

BACKGROUND: Acceptance of diabetes is a psychological adaptation to the potential limitations of the disease. Poor acceptance of diabetes impairs effective self-management of diabetes, leading to worsening metabolic control. This study aimed at determining the psychometric properties of the Persian version of the Diabetes Acceptance Scale. METHODS: This cross-sectional methodological study was performed on diabetic patients in Iran in 2021. The questionnaire consisted of two parts: demographic characteristics and Diabetes Acceptance Scale. The questionnaire was translated into Persian through the forward-backward translation method. The face validity and content validity were performed qualitatively and quantitatively. Exploratory (n = 200) and confirmatory (n = 200) factor analysis were performed to evaluate the validity of the structure. Internal consistency and temporal stability were estimated to determine reliability. RESULTS: Exploratory factor analysis on the polychoric correlation matrix obtained three factors: Rational dealing, Resentment and Avoidance, which explained 68.8% of the total DAS variance. Confirmatory factor analysis showed that the 3-fractor model had a good fit to a second independent data set. Finally, Ordinal Cronbach's alpha coefficient was 0.96, 0.94 and 0.93, respectively for the Rational dealing, Resentment, and Avoidance factor. Also, using intraclass correlation coefficient, the stability of the instrument was 0.97. CONCLUSION: Based on the findings of this study, the Persian version of DAS has sufficient validity and reliability to measure the admission of Iranian diabetic patients.

Effectiveness of ultrasound and median nerve gliding with and without shock-wave therapy in patients with moderate carpal tunnel syndrome.

[Purpose] The aim of this research was to see how ultrasound and nerve gliding with and without shock wave therapy effects on clinical and sonographic data of patients with carpal tunnel syndrome (CTS). [Participants and Methods] Forty four patients with moderate carpal tunnel syndrome participated in this research. One group got shock-wave therapy in addition to median nerve glide exercises and ultrasound, whereas the other group received median nerve glide exercises and ultrasound alone. Hand grip strength (HGS), pinch grip strength (PGS), Visual Analogue Scale (VAS)-pain, Boston Questionnaire (BQ), and Cross-sectional area (CSA) of median nerve were examined before and after 10 sessions of treatment. [Results] HGS, PGS, VAS, BQ and CSA of median nerve improved considerably after therapy. [Conclusion] Patients with moderate CTS who received ultrasound and median nerve glide exercises with and without shock-wave therapy improved considerably without preference of adding shock-wave therapy to other treatment.

Effects of Curcumin and Its Analogues on Infectious Diseases.

Infectious diseases (IDs) are life-threatening illnesses, which result from the spread of pathogenic microorganisms such as bacteria, viruses, fungi, and parasites. IDs are a major challenge for the healthcare systems around the world, leading to a wide variety of clinical manifestations and complications. Despite the capability of frontline-approved medications to partially prevent or mitigate the invasion and subsequent damage of IDs to host tissues and cells, problems such as drug resistance, insufficient efficacy, unpleasant side effects, and high expenses stand in the way of their beneficial applications. One strategy is to evaluate currently explored and available bioactive compounds as possible anti-microbial agents. The natural polyphenol curcumin has been postulated to possess various properties including anti-microbial activities. Studies have shown that it possess pleiotropic effects against bacterial- and parasitic-associating IDs including drug-resistant strains. Curcumin can also potentiate the efficacy of available anti-bacterial and anti-parasitic drugs in a synergistic fashion. In this review, we summarize the findings of these studies along with reported controversies of native curcumin and its analogues, alone and in combination, toward its application in future studies as a natural anti-bacterial and anti-parasitic agent.

Sensory interventions on motor function, activities of daily living, and spasticity of the upper limb in people with stroke: A randomized clinical trial.

STUDY DESIGN: This is a single-blinded clinical trial study. Clinical Trial Number registry: IRCT201610223551N4. INTRODUCTION: Stroke is the second cause of death around the world. Motor and sensory problems are common complications of the stroke. These defects in the upper limb cause reduced use of the affected limb and consequently a decrease in the quality of life. PURPOSE OF THE STUDY: The purpose of this study was to examine the effect of exteroceptive and proprioceptive stimulations on motor function, spasticity of the upper limb, and activities of daily living in people who have had stroke. METHODS: Sixty people with chronic stroke selected by convenience sampling. Before the intervention, Modified Ashworth Scale, Fugl-Meyer assessment of Motor Recovery after Stroke, and Barthel Index were measured and then the intervention phase was started. Exteroceptive and proprioceptive sensory stimulations were performed for 6 weeks. Independent t-test was used to compare groups. RESULTS: The intervention group made improvement in motor function (P = .0001, Cohen's d = 2.14), activities of daily living of upper limb (P = .0001, Cohen's d = 1.32), and spasticity (P = .002, Cohen's d = -0.94). DISCUSSION: Motor function and activities of daily living and spasticity of the upper limb can be improved through exteroceptive and proprioceptive stimulations. In this study, this type of intervention had the most impact on motor function compared with the rest. CONCLUSION: Exteroceptive and proprioceptive stimulations in upper limb can be used in chronic phase of stroke. Improvement in motor function and activities of daily living and reducing spasticity are the results of these stimulations.

The Effects of Inhalation Aromatherapy Using Lavender Essential Oil on Postoperative Pain of Inguinal Hernia: A Randomized Controlled Trial.

PURPOSE: One of the main problems after inguinal hernia surgery is postoperative pain. The purpose of this study was to examine the effects of aromatherapy with lavender oil inhalation on postoperative pain after inguinal hernia surgery. DESIGN: A randomized controlled design was used. METHODS: Ninety participants were selected and assigned to two groups: the intervention group (n = 45) and the control group (n = 45). The patients in the intervention group inhaled four drops of 2% lavender essential oil with oxygen for 20 minutes. The patients in the control group inhaled only oxygen. Postoperative pain was measured 0 minutes after being transferred to the surgery ward, and then 2 hours, 6 hours, and 24 hours after surgery using the visual analog scale. FINDINGS: In comparison to the control group, levels of pain severity in the intervention group were significantly lower in four stages of measurements (P < .001). Also, in all stages, measurements showed significant statistical differences within the groups (P < .001). CONCLUSIONS: Aromatherapy with lavender essential oil helped decrease postoperative pain after inguinal hernia surgery.

Effect of Preoperative Visitation by Operating Room Staff on Preoperative Anxiety in Patients Receiving Elective Hernia Surgery.

PURPOSE: The purpose of this study was to evaluate the effect of preoperative visitation on preoperative anxiety in patients receiving elective hernia surgery. DESIGN: Quasi-experimental study. METHODS: Seventy patients undergoing hernia surgery were selected and assigned to the experimental group (N = 35) and the control group (N = 35). In the intervention group, the surgical technologist visited the patient in the surgical ward the night before surgery and after transferring the patient to the waiting room in the operating room department. The control group received only routine preoperative care by nurses in the surgical ward and operating room department. For both groups, the Spielberger State-Trait Anxiety Inventory was completed in two stages, on the night before surgery and on arrival time in the operating room. FINDINGS: Average age was 41.2 ± 13.4 years. Statistical tests showed a significant reduction in anxiety after intervention (42.3 ± 9.2) compared with before intervention (45.6 ± 9) and between the two groups after intervention (50.9 ± 10.7 in the control group vs 42.3 ± 9.2 in the intervention group). CONCLUSIONS: Using an anxiety evaluation approach in preoperative training programs to manage anxiety in surgical patients is recommended.

Effects of dry needling on tendon-pulley architecture, pain and hand function in patients with trigger finger: a randomized controlled trial study.

[Purpose] The purpose of this study was to determine the effect of dry needling on tendon-pulley architecture, pain and hand function in patients with trigger finger. [Participants and Methods] A randomized controlled trial was conducted. Fifty eight patients having trigger finger were randomly assigned as either an experimental group that received a single session of dry needling over pulleyA1 and flexor tendon or a control group that received no intervention. Thickness of tendon-pulley, and pain-hand function (by disability arm-shoulder questionnaire score and pinch grip strength) were measured by a blinded assessor before and one week after intervention. [Results] The two way mixed ANOVA in the experimental group showed that the thickness of pulley-tendon decreased, pinch grip power increased and DASH questionnaire score was decreased in comparison to the control group. [Conclusion] This study results suggest that a single session of Dry Needling (DN) was effective in decreasing pain, DASH score, pulley-tendon thickness and improving pinch grip power in patients with trigger finger.

A prophylactic effect of local vibration on quadriceps muscle fatigue in non-athletic males: a randomized controlled trial study.

[Purpose] This study was conducted to investigate the immediate prophylactic effects of local vibration on quadriceps muscle fatigue in young non-athletic males. [Participants and Methods] Thirty healthy young males were randomly assigned to vibration and sham control groups. Participants in the local vibration group received a single session vibration (2 minutes, 30 Hz). They also in the control group received a 2-minute vibration, while the vibration system was off. MVC, RMS and median frequency of EMG findings and time to reach fatigue were measured. [Results] Time to reach fatigue and MVC in the local vibration group was significantly high than those in the sham control group. [Conclusion] It seems that the prior local muscle vibration may be useful to attenuate some signs and symptoms of muscle fatigue.

A framework for SAR-optical stereogrammetry over urban areas.

Currently, numerous remote sensing satellites provide a huge volume of diverse earth observation data. As these data show different features regarding resolution, accuracy, coverage, and spectral imaging ability, fusion techniques are required to integrate the different properties of each sensor and produce useful information. For example, synthetic aperture radar (SAR) data can be fused with optical imagery to produce 3D information using stereogrammetric methods. The main focus of this study is to investigate the possibility of applying a stereogrammetry pipeline to very-high-resolution (VHR) SAR-optical image pairs. For this purpose, the applicability of semi-global matching is investigated in this unconventional multi-sensor setting. To support the image matching by reducing the search space and accelerating the identification of correct, reliable matches, the possibility of establishing an epipolarity constraint for VHR SAR-optical image pairs is investigated as well. In addition, it is shown that the absolute geolocation accuracy of VHR optical imagery with respect to VHR SAR imagery such as provided by TerraSAR-X can be improved by a multi-sensor block adjustment formulation based on rational polynomial coefficients. Finally, the feasibility of generating point clouds with a median accuracy of about 2 m is demonstrated and confirms the potential of 3D reconstruction from SAR-optical image pairs over urban areas.

Relationship between illness-related worries and social dignity in patients with heart failure.

BACKGROUND: Heart failure is a major growing problem and affects not only patients but also their families and community networks and reduces the functional capacity of patients and impairs their social life. RESEARCH QUESTIONS: This study was conducted to investigate relationship between illness-related worries and social dignity in patients with heart failure. DESIGN: The study had a descriptive-analytic design, and data collection was carried out by means of two specific questionnaires. Participants and context: A total of 130 inpatients from cardiac wards in hospitals affiliated with Tehran and Shahid Beheshti University of Medical Sciences participated. Ethical consideration: This study was approved by the Research Committee of Shahid Beheshti University of Medical Sciences. RESULTS: The highest mean score of illness-related worries was attributed to the dimension of patient's worry of physical-mental complications, and the least mean score was related to the dimension of the worry about the future of disease. The highest mean score of social dignity was associated with the dimension of social communication and support, and the least is attributed to the dimension of burden to others (economic). Pearson's statistical test showed a significant correlation (r = 0.455, p < 0.05) between the score of illness-related worries and social dignity. DISCUSSION: As the result of this study showed that reducing illness-related worries in patients with heart failure can improve their social dignity, using strategies to decrease worries and promote social dignity in these patients is recommended. CONCLUSION: This study affirms the importance of careful evaluation of individual patients to determine their needs related to dignity. We hope these results will help to promote actions by patient-care staff that honor and support patient dignity, resulting in benefits to patients and developing the quality of care based on human rights.

Test of a Dignity Model in patients with heart failure.

BACKGROUND: Identifying, maintenance, and promotion of dignity in different patients of various cultures is an ethical responsibility of healthcare workers. RESEARCH QUESTIONS: This study was conducted to investigate factors related to dignity in patients with heart failure and test the validity of Dignity Model. DESIGN: The study had a descriptive-correlational design, and data collection was carried out by means of four specific questionnaires. Participants and context: A total of 130 in-patients from cardiac wards in hospitals affiliated with Tehran and Shahid Beheshti University of Medical Sciences participated. Ethical consideration: This study was approved by the Research Committee of Shahid Beheshti University of Medical Sciences. FINDINGS: Significant correlation showed the following: between illness related worries with dignity conserving repertoire score, between illness related worries with social dignity, between illness related worries with dignity conserving repertoire score, and between social dignity with dignity score. Goodness Fit Index and Comparative Fit Index were calculated greater than 0.9. DISCUSSION: This study affirms the importance of careful evaluation of individual patients to determine their needs related to dignity. CONCLUSION: According to the results, the necessity of using appropriate tools to assess various aspects of patients' dignity by clinical healthcare staff and design activities with particular focus on the main factors affecting dignity such as illness related worries and social dignity is recommended. Attention to this issue in everyday clinical practice can facilitate health professionals/nurses to potentially improve their patients' dignity, develop quality of care and treatment, and improve patients' satisfaction.

Effectiveness of Preoperative Visitation on Postanesthesia Complications.

PURPOSE: The purpose of this study was to evaluate the effect of preoperative visitation on postanesthesia complications after hernia surgery. DESIGN: In this quasi-experimental study, 70 patients receiving elective hernia surgery were purposefully selected. METHODS: In the evening preceding surgery, the surgical technologist visited the patient in the surgical ward. Data were collected by checklist of vital signs and postanesthesia complications. FINDINGS: A greater increase is observed in the systolic blood pressure of the experimental group at the moment of entering the postanesthesia care unit. A significant difference was found between groups in the intensity of postanesthesia agitation in the postanesthesia care unit patients, with a higher incidence among the experimental group. CONCLUSIONS: According to the findings, preoperative education programs for operating room staff and other behavioral and mental interventions to manage surgery and its consequences in elective surgical patients is recommended.

Time and Frequency Domain Analysis of Gait Initiation in Younger and Older Adults.

The purpose of study was to demonstrate age-related changes during gait initiation (GI). Therefore, displacement, velocity, total power, mean and median frequency of COP trajectories were measured during phases of GI in anteroposterior (AP) and mediolateral (ML) directions. The older group demonstrated the slower and lesser displacement in comparison with the younger group during anticipatory phase in AP direction and during locomotor phase in AP and ML directions. In addition, the median and mean frequency were greater in the older relative to the younger group during anticipatory phase in AP direction, while these were lesser in older than younger group during locomotor phase in AP and ML directions. Moreover, total power was greater among older than younger adults during the anticipatory phase in ML direction and during all phases in AP direction. This study suggests that COP-related parameters extracted from time and frequency domains have the ability to demonstrate age-related changes.

Test-retest reliability of linear and nonlinear measures of postural stability during visual deprivation in healthy subjects.

[Purpose] The purpose of this study is to evaluate the reliability of linear and nonlinear measures of the center of pressure (COP) during visual deprivation. [Subjects and Methods] Fifteen young adults participated in this study. COP signals were recorded in two conditions: eyes open and eyes closed. Three trials were performed in each condition with a rest period of approximately 1 min. The intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) were calculated. [Results] The investigation of ICC and SEM between trials showed that the Lyapunov exponent (ICC: 0.76-0.96, SEM: 0.03) and total mean velocity (ICC: 0.71-0.95, SEM: 0.05) were more reliable and repeatable than range and area (95% confidence ellipse), while area had the least reliability (ICC: 0.49-0.77, SEM: 0.56). [Conclusion] The Lyapunov exponent can be considered an appropriate postural control index, and the evaluation of postural stability should be done by considering linear and nonlinear tools.

Effectiveness of silica-lasing method on the bond strength of composite resin repair to Ni-Cr alloy.

PURPOSE: The aim of this study was to evaluate the effectiveness of silica-lasing method for improving the composite resin repair of metal ceramic restorations. MATERIALS AND METHODS: Sixty Ni-Cr cylindrical specimens were fabricated. The bonding surface of all specimens was airborne-particle abraded using 50 µm aluminum oxide particles. Specimens were divided into six groups that received the following surface treatments: group 1-airborne-particle abrasion alone (AA); group 2-Nd:YAG laser irradiation (LA); group 3-silica coating (Si-CO); group 4-silica-lasing (metal surface was coated with slurry of opaque porcelain and irradiated by Nd:YAG laser) (Si-LA); group 5-silica-lasing plus etching with HF acid (Si-LA-HF); group 6-CoJet sand lased (CJ-LA). Composite resin was applied on metal surfaces. Specimens were thermocycled and tested in shear mode in a universal testing machine. The shear bond strength values were analyzed using ANOVA and Tukey's tests (α = 0.05). The mode of failure was determined, and two specimens in each group were examined by scanning electron microscopy and wavelength dispersive X-ray spectroscopy. RESULTS: Si-CO showed significantly higher shear bond strength in comparison to other groups (p < 0.001). The shear bond strength values of the LA group were significantly higher than those of the AA group (p < 0.05). No significant difference was found among lased groups (LA, Si-LA, Si-LA-HF, CJ-LA; p > 0.05). The failure mode was 100% adhesive for AA, Si-LA, Si-LA-HF, and CJ-LA. LA and Si-CO groups showed 37.5% and 87.5% cohesive failure, respectively. CONCLUSION: Silica coating of Ni-Cr alloy resulted in higher shear bond strength than those of other surface treatments.