Knowledge, attitude, and practice among staff associated with Human Papillomavirus Vaccine of young children in Iran.

INTRODUCTION: This study aimed to evaluate knowledge, attitudes, practice associated with Human Papillomavirus (HPV) Vaccine for Young Children among lecturers and health staffs of Shahid Beheshti University of Medical Sciences (SBMU). METHOD: This was a cross-sectional study with 220 adults from five different specialties, randomly selected. Data was collected using 45-item questionnaire on knowledge (12- item), attitude (18-item) and practice (15-item) (KAP) about HPV. The demographic questionnaire included information on age, gender, level of education, occupation, and marital status. Content validity was calculated by content validity ratio (CVR) and content validity index (CVI). Reliability was evaluated using test-retest and by Cronbach's Alpha coefficient, internal consistency was calculated values >0.81 which considered as satisfactory. RESULTS: The mean age of the studied population was 37.70± 8.07 (23-67) years. Of the 220 participants, 80 (36.4%) were males and 140 (63.6%) were females. In evaluating KAP in the men and women, the mean and standard deviation of knowledge were estimated at good level and one-way ANOVA analysis showed significant differences between women and men (p=0.019). There was no significant difference in men and women related to attitude (p=0.92) and practice (p=0.38). CONCLUSION: The KAP about HPV among participants was significantly higher at good levels compared to average levels. Women's knowledge was significantly higher than men. Attitude and practice could have been higher because there was consensus to the usage of vaccine among the specialists to prevent HPV.

Accuracy of Demirjian's and Cameriere's Methods for Age Estimation in 6- to 10-Year-Old Iranian Children Using Panoramic Radiographs.

Objective: This study assessed the accuracy of Demirjian's and Cameriere's methods for age estimation in Iranian children using panoramic radiographs. Materials and Methods: This cross-sectional study evaluated 212 panoramic radiographs of 6- to 10-year-old children retrieved from the archives of an oral and maxillofacial radiology department from 2011 to 2017. The chronological age of children at the time of radiography was determined by subtracting the date of radiography from their birth date. The developmental stage of 7 permanent left mandibular teeth was determined according to Demirjian's method. The stage of dental maturation was determined according to Cameriere's method by using the normalized values for 7 permanent left mandibular teeth and the number of teeth with complete root development. The error value of the two methods was calculated by comparing them with the actual chronological age of male and female children, and the absolute error values of the two methods were compared with paired t-tests. Results: The mean error value of Demirjian's and Cameriere's methods was found to be 0.84 and -0.06 in girls and 0.93 and 0.04 in boys, respectively. Significant differences were noted in the absolute error of the two methods compared with the chronological age of male and female children (both Ps < 0.001). Conclusion: In conclusion, this study indicated that Cameriere's method was more accurate than Demirjian's method for age estimation in Iranian children.

Fingerprints as an index for investigating cooperation by children in dentistry: a pilot study.

Behavioral management and patient cooperation are very important in pediatric dentistry. Some studies have indicated that individual behavior can vary in terms of fingerprint patterns (loop, whorl, and arch). Therefore, fingerprint patterns might help to predict the extent of cooperation by children during dental procedures. The present study aimed to investigate the possible relationship between fingerprint patterns and cooperation by children. In this pilot investigation, 51 children aged 3-6 years were examined. The children meeting the inclusion criteria in the first visit were scheduled for a dental procedure in the second visit. Another examiner assessed children's behavior during the dental procedure according to the designed questionnaire and based on the Frankl scale. A third examiner, along with the second examiner, randomly evaluated the children's behavior to determine the inter-examiner agreement. The subjects were categorized as cooperative or uncooperative during dental procedures, according to the Frankel questionnaire. The fingerprints of all subjects were recorded, and the data were compared with SPSS 21 using the chi-squared test at a significance level of P < 0.05. The uncooperative and cooperative groups consisted of 20 and 31 children, respectively. The main fingerprint pattern in the uncooperative children was the whorl; while in the cooperative group, it was the loop. This difference in the fingerprint effect was significant between the groups (P = 0.01). The arch type exhibited the minimum frequency and was not significantly different between the groups. The current findings revealed a relationship between fingerprint type and children's behavior during dental treatment.

Role of attachment style in prediction of behavior of 3 to 6-year-old children.

PURPOSE: Efficient communication with children is the basis of pediatric dentistry and is a prerequisite for provision of pediatric dental care. Prediction of the behavior of children and their reaction to therapeutic procedures is a challenge for many pediatric dentists. This study aimed to assess the attachment styles of children to predict their behavior during a dental visit. METHODS: The participants included 117 healthy children aged 3 to 6 years presented to the Department of Pediatric Dentistry, Tehran University of Medical Sciences, in 2017-2018. A postgraduate dental student examined the children. The parents were requested to fill out the Kinship Center attachment questionnaire (KCAQ) regarding their children, while waiting in the waiting room. The children who met the inclusion criteria in the first visit were scheduled for a dental procedure in the second visit. Another postgraduate student of pediatric dentistry assessed the behavior of children during the dental procedure according to the designed questionnaire and based on the Frankl scale. A third examiner along with the second examiner evaluated the behavior of children on a random basis to determine the inter-examiner agreement. Data were analyzed using the Chi-squared test, t test, Pearson's correlation coefficient, and linear regression. RESULTS: The results showed that 67.5% of the children were cooperative, including 54.7% of boys. The mean age of children was 5.1 ± 0.95 years. Also, 80.3% of children had secure and 19.7% had insecure attachment styles (11.97% insecure avoidant and 7.69% insecure ambivalent). A significant association existed between the insecure ambivalent attachment style and child-dentist communication. A significant inverse correlation was also noted between the total score of the questionnaire and parent-child separation in dental office. CONCLUSIONS: The current findings revealed no significant difference in the attachment styles of cooperative and uncooperative children. Significant associations only existed between the insecure ambivalent attachment style and child-dentist communication, and also between mother-child separation and secure attachment style. Thus, the children's behavior in dental office cannot be predicted based on their attachment style.

Effect of several try-in attempts of crimped preformed metal crowns on their circumference.

AIM: To assess whether several try-in attempts change the circumference of preformed metal crowns (PMCs). METHODS: This in vitro, experimental study was performed on 68 PMCs of maxillary and mandibular molars that required crimping. First, a photograph was obtained of the gingival margin of each crown using a digital camera (fixed at a specific distance). Crown margins were then crimped using 114 pliers. The second photograph was obtained under the same conditions as the first one. After crimping, the crowns were removed using an excavator to assess the amount of crimping. This was repeated for the second time and a photograph was obtained after each time of PMC removal. The crown was crimped again and tried on the tooth and a photograph was obtained after completion of each phase. Photographs were saved in a computer and the circumference of the crowns was calculated using AutoCAD software. RESULTS: The reduction in circumference of the crowns following the first crimping was greater for the primary second molars than for the primary first molars and was on average 0.87%. After trying the crowns on teeth, the circumference of the crowns increased on average by 0.33%. This increase was 0.53% after trying the crowns for the second time. The reduction in circumference after the second crimping was 0.51%. There was an increase in circumference after re-trying of 0.35%. Changes in circumference of the crowns after the first (p = 0.037) and second (p = 0.00) try-in attempts were statistically significant. CONCLUSIONS: Re-crimping is necessary after trying the crown on tooth and prior to cementation.

A comparison of salivary calcium, phosphate, and alkaline phosphatase in children with severe, moderate caries, and caries free in Tehran's kindergartens.

The most common dental disease in childhood is dental caries. This study was carried out to recognize the components of saliva which are protective factors in children to evaluate and predict caries susceptible and caries resistant individuals. Unstimulated whole saliva was obtained from 75 children aged 3-5 years. They divided into three groups: decayed missing and filled teeth (dmft) > 6 (severe caries), 1 P > 0.05 ). Although the results showed that salivary phosphate and alkaline phosphatase in caries free group and calcium in the group with severe caries were somewhat more than those in other groups. Despite of the results of the present study, the relationship between salivary components and caries rate in children remains controversial. So more studies are necessary to achieve some practical criteria for predicting dental caries, recognition of susceptible persons, and finally prevention of caries in children.

Wire reinforced endotracheal tube compared with Parker Flex-Tip tube for oral fiberoptic intubation: a randomized clinical trial.

BACKGROUND: The aim of the study was to compare the Parker Flex-Tip (PFT) (group P) tube to a wire reinforced tracheal tube in two orientations, i.e., with posteriorly and anteriorly positioned tip bevels (WRP and WRA groups, respectively), for oral fiberoptic intubation. METHODS: This was a randomized clinical trial, carried out at the University-affiliated hospital. Ninety adult ASA physical status I-II patients who were scheduled to undergo either ophthalmic or urologic surgery were included in the study and randomly assigned to the P, WRA, or WRP group. Our primary outcome was the difficulty in advancing the tube over the fiberscope, which was quantified in grades (0, 1, or 2). Secondary outcomes were the time to visualize the carina after inserting the scope into the mouth and the time from this point to tracheal intubation. RESULTS: Endotracheal tube (ETT) advancement was easier and faster in the WRP and P groups than in the WRA. (Successful endotracheal intubation on the first attempt 67%, 60% and 20%, respectively; P=0.03) (ETT advancement time 6.9±3.5 s, and 8±3.1 s, 11.7±4.6, respectively; P<0.001). CONCLUSION: Advancement of the ETT over a fiberoptic bronchoscope was easier with the PFT tube and with a posteriorly positioned wire-reinforced tube than with an anteriorly positioned wire-reinforced tube.

Effect of high water fluoride concentration on the intellectual development of children in makoo/iran.

OBJECTIVE: Prolonged excessive intake of fluoride during child's growth and development stages has been associated with mental and physical problems. The aim of this study was to investigate the effect of excessive fluoride intake on the intelligence quotient (IQ) of children living in five rural areas in Makoo/Iran. MATERIALS AND METHODS: In this cross-sectional study, 293 children aged 6-11 years were selected from five villages in Makoo with normal fluoride (0.8±0.3 ppm), medium fluoride (3.1±0.9 ppm) and high fluoride (5.2±1.1 ppm) in their water supplies. The IQ of each child was measured by the Raven's test. Educational and residential information and the medical history of each child was recorded by a questionnaire completed by the parents. Data were analyzed by ANOVA test with a significance level of 0.05. RESULTS: The mean IQ scores decreased from 97.77±18.91 for the normal fluoride group to 89.03±12.99 for the medium fluoride group and to 88.58±16.01 for the high fluoride group (P=0.001). CONCLUSION: Children residing in areas with higher than normal water fluoride levels demonstrated more impaired development of intelligence. Thus, children's intelligence may be affected by high water fluoride levels.

Oral manifestations in selective IgA deficiency.

Selective immunoglobulin A (IgA) deficiency is the most common of the primary immunodeficiencies with a frequency of 1/300-1/3000, depending on the screened population. As secretory IgA (SIgA) has a protective role in mucosal surfaces from invasion of microorganisms, it is thought that IgA-deficient subjects are susceptible to periodontal diseases and oral manifestations. Previous studies show contradictory results, concerning the involvement of the individuals' periodontium with IgA deficiency. The aim of this study was to investigate and compare the oral manifestations in IgA-deficient subjects with controls. Eleven selective IgA-deficient subjects aged 3-18 years with serum IgA levels <10 mg dl(-1) and 11 age-sex-matched healthy children as the controls entered the study. Oral mucosal investigation, dental caries, plaque accumulation and periodontal status were assessed. Serum immunoglobulin levels were measured by single radial immunodiffusion (SRID) method. Saliva immunoglobulins and secretory component levels were measured by enzyme linked immunosorbent assay (ELISA) methods. IgA-deficient patients had serum and saliva IgA levels less than 10 mg dl(-1) and 10 microg ml(-1), respectively, but other serum immunoglobulin levels were normal and saliva immunoglobulin M (IgM) levels were increased, compared with controls. There were no significant differences in oral manifestations between IgA-deficient subjects and controls, which may be a result of compensatory increase of saliva IgM or other non-immunological defence factors in saliva. Thus, it is not necessary to evaluate IgA and SIgA in all the patients with oral and dental lesions and it is thought that it is better to investigate other factors.