Diverse genetic causes of amenorrhea in an ethnically homogeneous cohort and an evolving approach to diagnosis.

RESEARCH QUESTION: Premature ovarian insufficiency (POI) is characterised by amenorrhea associated with elevated follicle stimulating hormone (FSH) under the age of 40 years and affects 1-3.7% women. Genetic factors explain 20-30% of POI cases, but most causes remain unknown despite genomic advancements. DESIGN: We used whole exome sequencing (WES) in four Iranian families, validated variants via Sanger sequencing, and conducted the Acyl-cLIP assay to measure HHAT enzyme activity. RESULTS: Despite ethnic homogeneity, WES revealed diverse genetic causes, including a novel homozygous nonsense variant in SYCP2L, impacting synaptonemal complex (SC) assembly, in the first family. Interestingly, the second family had two independent causes for amenorrhea - the mother had POI due to a novel homozygous loss-of-function variant in FANCM (required for chromosomal stability) and her daughter had primary amenorrhea due to a novel homozygous GNRHR (required for gonadotropic signalling) frameshift variant. WES analysis also provided cytogenetic insights. WES revealed one individual was in fact 46, XY and had a novel homozygous missense variant of uncertain significance in HHAT, potentially responsible for complete sex reversal although functional assays did not support impaired HHAT activity. In the remaining individual, WES indicated likely mosaic Turners with the majority of X chromosome variants having an allelic balance of ∼85% or ∼15%. Microarray validated the individual had 90% 45,XO. CONCLUSIONS: This study demonstrates the diverse causes of amenorrhea in a small, isolated ethnic cohort highlighting how a genetic cause in one individual may not clarify familial cases. We propose that, in time, genomic sequencing may become a single universal test required for the diagnosis of infertility conditions such as POI.

Novel bone morphogenetic protein 15 (BMP15) gene variants implicated in premature ovarian insufficiency.

BACKGROUND: Bone morphogenetic protein 15 (BMP15) is expressed in oocytes and plays a crucial role in the reproduction of mono-ovulating species. In humans, BMP15 gene mutations lead to imperfect protein function and premature ovarian insufficiency. Here we investigated the BMP15 gene variants in a population of Iranian women with premature ovarian insufficiency. We conducted predictive bioinformatics analysis to further study the outcomes of BMP15 gene alterations. METHODS: Twenty-four well-diagnosed premature ovarian insufficiency cases with normal karyotype participated in this study. The entire coding sequence and exon-intron junctions of the BMP15 gene were analyzed by direct sequencing. In-silico analysis was applied using various pipelines integrated into the Ensembl Variant Effect Predictor online tool. The clinical interpretation was performed based on the approved guidelines. RESULTS: By gene screening of BMP15, we discovered p.N103K, p.A180T, and p.M184T heterozygous variants in 3 unrelated patients. The p.N103K and p.M184T were not annotated on gnomAD, 1000 Genome and/or dbSNP. These mutations were not identified in 800 Iranians whole-exome sequencing that is recorded on Iranom database. We identified the p.N103K variant in a patient with secondary amenorrhea at the age of 17, elevated FSH and atrophic ovaries. The p.M184T was detected in a sporadic case with atrophic ovaries and very high FSH who developed secondary amenorrhea at the age of 31. CONCLUSIONS: Here we newly identified p.N103K and p.M184T mutation in the BMP15 gene associated with idiopathic premature ovarian insufficiency. Both mutations have occurred in the prodomain region of protein. Despite prodomain cleavage through dimerization, it is actively involved in the mature protein function. Further studies elucidating the roles of prodomain would lead to a better understanding of the disease pathogenesis.

Skeletal maturation and the location of the mandibular foramen within the ramus mandibulae.

PURPOSE: It is well documented that the mandible does not grow at a constant rate. There are significant correlations between the increase of mandibular size and cervical vertebral maturation. The peak growth velocity of the mandible occurs after the third stage of cervical vertebral maturation. The location of the mandibular foramen (MF) and its changes subsequent to growth are of great interest to clinicians as they relate to the anesthesia of the inferior alveolar nerve and to mandibular surgical procedures. Therefore, the aim of the present study was to assess the influence of the mandibular growth spurt on the location of the MF in various skeletal growth patterns. METHODS: Panoramic and lateral cephalometric radiographs of 98 (32 orthognathic, 50 retrognathic, 16 prognathic) patients before and after the growth peak were collected. For each subject, the maturational stage of the cervical vertebrae was defined on successive lateral cephalograms and the vertical and horizontal position of the MF was evaluated on two panoramic radiographs, one before and one after the growth peak. RESULTS: The MF-Post/MF-Ant ratio (MF distance to the posterior border of the ramus/MF distance to the anterior border of the ramus) significantly increased after the growth peak in orthognathic and retrognathic subjects (P = 0.015 and 0.02, respectively). This ratio did not significantly increase in prognathic subjects (P = 0.882). No statistically significant changes in the vertical position of the MF were found in the three groups after the growth spurt. CONCLUSION: The horizontal position of the MF moves in an anterior direction in orthognathic and retrognathic subjects during the mandibular growth spurt. The vertical position of the mandibular foramen remains unchanged during this period.

Changes of nasolabial angle from rest to smile in relation to cephalometric parameters.

INTRODUCTION: The nasolabial angle (NLA) plays an important role in evaluating a patient's profile and smile appearance. The purpose of this study was to evaluate the changes of the NLA during smile and to correlate those changes with other photographic and cephalometric parameters. METHODS: Fifty young adults ranging from 20 to 30 years of age who had been referred to a private dental clinic for orthodontic treatment for normal maxillary position were enrolled. For the purpose of this study, the angular measurements of the NLA and its compartments as well as changes in the vertical position of the nasal tip were collected from photographs taken at rest and during smile, while other parameters were measured from the lateral cephalograms taken with the head in a natural position. Changes in the NLA were then correlated with the cephalometric parameters in order to observe any potential relationships. RESULTS: The NLA and its upper compartment decreased during smile (with a mean of 5.42 and 0.77 degrees, respectively). The NLA and its lower compartment increased, with a mean of 3.97 degrees. The nasal tip significantly dropped down from rest to smile (mean = 1.6 mm, P = 0.002). Significant correlations were found between changes of the NLA and the maxilla projection as well as between changes of the lower part of the NLA and the upper lip curvature. CONCLUSIONS: Decreasing the NLA during smile is mainly related to the inherent properties of the soft tissues of the nasolabial area and not to the dental parameters under the control of the orthodontist. Patients should therefore be made aware of this from the beginning of the treatment.

Bleaching during orthodontic treatment and its effect on bracket bond strength.

BACKGROUND: This study investigated the effect of two different methods of bleaching during orthodontic treatment on bracket bond strength. MATERIALS AND METHODS: A total of 45 extracted premolar teeth were selected in this experimental study and divided into three groups (office bleaching with 35% hydrogen peroxide, home bleaching with 22% carbamide peroxide, and control). The color of the teeth was assessed initially before the application of bleaching agents and Thermocycling. Orthodontic brackets were subsequently bonded on the treated surfaces. Bleaching procedures were then performed. A final color measurement was performed at two points on the buccal surface both underneath and adjacent to the bracket base. The initial and final color measurements and the bond strengths were compared between the groups using the analysis of variance. P < 0.05 was considered as statistically significant. RESULTS: Bracket bond strength was significantly reduced in both bleaching groups compared with the control group (P < 0.01). The color difference before and after the bleaching procedures was significant in the office bleaching group (P < 0.01), while the control group did not demonstrate a statistical difference between initial and final color assessments (P > 0.05). CONCLUSION: Bleaching procedures performed during orthodontic treatment reduce bond strength. Enamel beneath the bracket base experiences a whitening effect though to a lesser degree compared with an uncovered surface.

Altered T-cell subpopulations in recurrent pregnancy loss patients with cellular immune abnormalities.

Recurrent pregnancy loss (RPL) is a multifactorial disorder of women in reproductive age, which in some cases is caused by immunologic abnormalities. In this study, we aimed to evaluate cellular and molecular components of the immune system like different T-cell subsets and their regulating microRNAs (miRNAs) in RPL women and control group. Fifty RPL and 50 healthy subjects were recruited. Subsets of T cells, including regulatory T (Treg) cells, helper T (Th) 17 cells, exhausted T cells, exhausted Treg cells were evaluated by flow cytometry. Transcription factors of T cells and related miRNA profile were quantified using real-time polymerase chain reaction (RT-PCR). Assessment showed that Treg and exhausted T cells, were decreased in RPL patients (p = 0.009 and 0.02, respectively), while an increase was observed in Th17 and exhausted Treg frequency ( p = 0.013 and 0.0037, respectively). Messenger RNA expression level of T-bet and IRF4 was upregulated in RPL patients ( p = 0.011 and 0.0001, respectively), while Th2- and Treg-related transcription factors, GATA3 and GITR, were downregulated in these patients compared with the healthy subjects ( p = 0.0008 and <0.000, respectively). Treg-associated miRNAs, the miR-106b-25-93 cluster, showed a higher rate in RPL patients ( P = 0.007, 0.001, and 0.029, respectively), however, we observed no significant difference in the expression level of Th17-associated miRNA, mir-326. According to the results, we concluded that unbalanced immune responses and deregulated function of T-cell subsets may lead to reproduction-related failure like a miscarriage. Therefore, evaluation of immune cells and related miRNA profile may serve as prognostic biomarker for the treatment of RPL patients.

Investigation of follicular helper T cells, as a novel player, in preeclampsia.

Preeclampsia (PE) is characterized by hypertension and proteinuria. It occurs in an around 3% to 5% of all pregnancies worldwide. The fetus is kind of semiallograft to the maternal host; immune system components encounter fetal antigens and develop adverse immune responses. Recently, it has been observed that the immune system plays an important role in PE. In the current study, we have tried to investigate the role of follicular helper T (Tfh) cells in the pathogenesis of PE. Blood samples of 49 PE women and 50 healthy controls were collected. Peripheral blood mononuclear cells were isolated, cells were cultured, and then RNA was extracted. Autoantibody and secretory cytokine levels were analyzed by ELISA. Tfh frequency and transcription levels of the related molecules and cytokine were assessed by flow cytometry and real-time PCR, respectively. The frequency of circulating Tfh cell in PE women was significantly higher compared with the healthy pregnant woman (Tfh cells with CD4+ ICOS + , P = 0.0064 and Tfh cells with CD4 + CXCR5 + , P = 0.029). Moreover, mRNA expression levels of CXCR5, BCL6, IL-21, and IL-6 ( P = 0.0006, P = 0.008, P = 0.0063, and P = 0.027, respectively) were upregulated in PE patients. Furthermore, IL-6 ( P = 0.0014) and IL-21 ( P = 0.0059) levels in both group were assayed and the results showed increased in patient group. We also measured autoantibody levels including antiphospholipid antibodies ( P = 0.0001), anticardiolipin antibodies ( P = 0.0004), anti-TPO ( P = 0.0008), anti-TG ( P = 0.001) in circulation of PE group, which were higher than the control group. This study provided insights into the involvement of Tfh cells in etiology and pathogenesis of PE, probably by developing autoantibodies.

Prediction of dental arch width increase in the early mixed dentition using craniofacial parameters.

BACKGROUND: The dimensions of the dental arch have considerable impact on treatment planning. Since the dental arch development has a relationship with the craniofacial growth, we designed a cohort study to find a regression model for predicting the mandibular arch width increase using craniofacial parameters. METHODS: A total of 148 children, all in early mixed dentition, were selected randomly from primary schools by cluster sampling. Craniofacial anthropometric parameters were measured by a caliper bow and intercanine and intermolar widths were assessed on each subject's dental casts by a digital caliper at baseline and after 12 months. Data were analyzed with SPSS v. 15. Student's t-test and linear regression test were applied separately for girls and boys. RESULTS: Out of 153 children, 148 returned for one-year follow-up meeting the inclusion criteria. The results of regression analysis showed a significant inverse correlation between intercanine width and facial index. The bigonial dimension showed a high correlation with both the intermolar width and the intercanine width increase. CONCLUSIONS: We found that the arch width increase in the early mixed dentition could be predicted precisely based on certain craniofacial parameters.

Assessment of the effect of maxillary protraction appliance on pharyngeal airway dimensions in relation to changes in tongue posture.

BACKGROUND: Literature is controversial in regard with alterations in pharyngeal airway dimensions subsequent to maxillary protraction. The correlation between maxillary protraction and sagittal airway dimension was investigated in association with tongue and soft palate position in skeletal Class III children. The results were compared with those of an untreated Class III and a Class I malocclusion control group. MATERIALS AND METHODS: In this cross-sectional study pre- and post-treatment cephalometric radiographs of 19 Class III patients (6 males, 13 females; mean age, 7.93 ± 0.96 years) treated with facemask were analyzed. The correlation between treatment changes in craniofacial morphology and those in the upper airway, tongue, and soft palate was evaluated. These results were compared with those of a group of 16 Class I malocclusion patients (1 male, 15 females; mean age, 7.31 ± 0.7 years) and a group of 15 untreated Class III patients (4 males and 11 females; mean age, 7.46 ± 0.1 years). A paired t-test, the Shapiro-Wilk test and Mann-Whitney U-test was used. The level of significance was established as P < 0.05. RESULTS: Nasopharyngeal airway measurements PNS-ad1 and PNS-ad2 significantly increased by 2 mm and 2.1 mm, respectively. Statistical analysis revealed that maxillary protraction had a positive relationship with PNS-ad1 and PNS-ad2. CONCLUSION: Nasopharyngeal airway dimensions can be improved in the short term with maxillary protraction in skeletal Class III children.

Evaluation of the Corrosion of Five Different Bracket-Archwire Combination: An In-vitro Analysis Using Inductively Coupled Plasma Mass Spectrometry.

STATEMENT OF THE PROBLEM: Stainless steel brackets release metallic ions following the process of corrosion in the oral environment. These released ions have potential adverse effects on health, friction between wire and bracket, staining, strength of brackets. Choosing a bracket with favorable corrosive properties; therefore, should be a goal of every practitioner. PURPOSE: The goal of this study is to compare the amount of corrosion among five different brands of brackets using inductively coupled plasma (ICP) mass spectrometry. MATERIALS AND METHOD: Five different brands of brackets (Dentaurum, 3M, Ortho Organizer, Cobas and O.R.G) were chosen and ten brackets were selected from each brand. A piece of stainless steel wire was ligated to each bracket. The bracket-archwire complex was then immersed in artificial saliva. Subsequently, the samples were analyzed using an ICP device and the levels of iron, chromium, nickel, and manganese ions were measured. RESULTS: The findings of this study demonstrated that iron was released the most from the tested brackets, followed by nickel. We also found that the Cobas bracket had the most ion release among the tested brackets (p< 0.05), while Ortho Organizer and ORG performed favorably. There was no significant difference between Dentaurum and 3M (p> 0.05). CONCLUSION: Based on the results, Ortho Organizer and ORG brackets are suggested in terms of resistance to corrosion.

The impact of an educational pamphlet on the awareness of parents about 4‒6-year-old children's oral habits and dentofacial discrepancies.

Background. This study aimed to evaluate whether the parents' knowledge about the adverse effects of oral habits and dentoskeletal discrepancies would improve by an educational pamphlet. Methods. A parallel-group randomized clinical trial was conducted on parents in kindergartens of Shiraz, Iran, 2013. The parents completed a designed questionnaire to determine the pre-intervention score. The study group received an educational pamphlet on the oral habits and dentoskeletal discrepancies, in contrast to the control group. Three weeks later, the parents in both groups took the questionnaire again (post-intervention score). The primary outcome was a change in the parents' knowledge about oral habits and dentoskeletal discrepancies, which was measured by 13 questions of the questionnaire. Each correct answer was given a positive point and each incorrect answer a negative point. The total pre- and post-intervention scores were calculated by summing up the points and compared using Mann-Whitney U test. Results. A total of 550 subjects were assessed for eligibility and 413 were randomized. Of the study group, 203 subjects (98.56%), and of the control group, 204 parents (98.54%) completed the questionnaire for the second time. The score of the study group in the "normal occlusion" section of the questionnaire had significantly improved (P < 0.001) and in the "oral habits" section the score of both groups had improved but in the study group the improvement was significantly higher (P < 0.001). Conclusion . The educational pamphlet can be effective in increasing the level of parents' knowledge about normal occlusion and complications of oral habits.

Evaluation of Anatomic Variations in Maxillary Sinus with the Aid of Cone Beam Computed Tomography (CBCT) in a Population in South of Iran.

STATEMENT OF THE PROBLEM: Anatomic variations of the maxillary sinus can be detected in cone-beam computed tomography (CBCT) and may assist to locate the posterior superior alveolar artery (PSAA) and define the maxillary sinus morphology more accurately for a more strict surgical treatment plan. PURPOSE: The study aimed to determine normal variations of the maxillary sinus with the aid of CBCT in a sample population in south of Iran. MATERIALS AND METHOD: This cross-sectional prevalence study was based on evaluation of 198 projection data of CBCT scans of some Iranian patients aged 18-45 who referred to a private oral and maxillofacial radiology center in Shiraz from 2011 to 2013. CBCT scans were taken and analyzed with NewTom VGi device and software. The anatomic variations which were evaluated in the axial images included the presence of alveolar pneumatization, anterior pneumatization, exostosis, and hypoplasia. Moreover the location and height of sinus septa, and the location of PSAA were assessed. SPSS software (version 17.0) was used to analyze the data. RESULTS: In a total of 396 examined sinuses, maxillary sinus alveolar pneumatization was the most common anatomic variation detected. Anterior pneumatization was detected in 96 sinuses (24.2%). Antral septa were found in 180 sinuses (45.4%) and were mostly located in the anterior region. Meanwhile, PSAA was mostly detected intra-osseous in 242 sinuses (65.7%). CONCLUSION: Anatomic variations of the maxillary sinus were common findings in CBCT of the maxilla. Preoperative imaging with CBCT seems to be very helpful for assessing the location of PSAA and the maxillary sinus morphology, which may be used to adjust the surgical treatment plan to yield more successful treatments.

An Analytical Study on an Orthodontic Index: Index of Complexity, Outcome and Need (ICON).

STATEMENT OF THE PROBLEM: The validity of the Index of Complexity, Outcome and Need (ICON) which is an orthodontic index developed and introduced in 2000 should be studied in different ethnic groups. PURPOSE: The aim of this study was to perform an analysis on the ICON and to verify whether this index is valid for assessing both the need and complexity of orthodontic treatment in Iran. MATERIALS AND METHOD: Five orthodontists were asked to score pre-treatment diagnostic records of 100 patients with a uniform distribution of different types of malocclusions determined by Dental Health Component of the Index of Treatment Need. A calibrated examiner also assessed the need for orthodontic treatment and complexity of the cases based on the ICON index as well as the Index of Orthodontic Treatment Need (IOTN). 10 days later, 25% of the cases were re-scored by the panel of experts and the calibrated orthodontist. RESULTS: The weighted kappa revealed the inter-examiner reliability of the experts to be 0.63 and 0.51 for the need and complexity components, respectively. ROC curve was used to assess the validity of the index. A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point. This cut-off point showed the highest level of sensitivity and specificity in our society for orthodontic treatment need (0.77 and 0.78, respectively), but it failed to define definite ranges for the complexity of treatment. CONCLUSION: ICON is a valid index in assessing the need for treatment in Iran when the cut-off point is adjusted to 35. As for complexity of treatment, the index is not validated for our society. It seems that ICON is a well-suited substitute for the IOTN index.

Evaluating the clinical quality of departments as viewed by juniors and seniors of Shiraz dental school.

INTRODUCTION: Assessment of students' perspective is an essential element in effective educational quality evaluation. By identifying strengths and weaknesses, it leads to improvement in future performance. METHODS: This cross-sectional study was performed through a questionnaire comprising 23 questions. Reliability was assessed using α-Chronbach (α =0.87), and validity was confirmed by a group of five experts. Tukey test, Pearson correlation coefficient, and two sample t-tests were used for data analysis. METHODS: This cross-sectional study was performed through a questionnaire comprising 23 questions. Reliability was assessed using α-Chronbach (α =0.87), and validity was confirmed by a group of five experts. Tukey test, Pearson correlation coefficient, and two sample t-tests were used for data analysis. RESULTS: A total of 168 answered questionnaires were entered in our study. Maximum satisfaction in most items was shown in removable prosthodontics and orthodontics departments whereas oral surgery and comprehensive treatment departments acquired the least scores. In all departments, personnels' respectful attitude had the highest score whereas minimum grade was given to stressful workload and overall satisfaction in each department. In comparison with a similar study, conducted 3 years ago, level of satisfaction was raised for orthodontics and removable prosthodontics departments though it was declined for the pediatrics department. CONCLUSION: The special cadre of clinical instructors comprising both experienced and young members is considered as an important factor leading to high student satisfaction in the orthodontics department. Promotion of a removable prosthodontics department is related to the high relevance between the implemented educational program and the curriculum. The moderate performance of oral surgery and restorative departments is indicative of the need for more attention from ministry authorities to major dental departments such as oral surgery, endodontic, restorative and periodontics, in order to increase the students' scientific capability in these fields.

The effect of vertical bracket positioning on torque and the resultant stress in the periodontal ligament--a finite element study.

BACKGROUND: The ideal built-in tip and torque values of the straight wire appliance reduce the need for wire bending and hence reduce chair time. The vertical position of the bracket on the tooth surface can alter the torque exerted on the tooth. This is a result of the altered surface curvature observed at each vertical position. To further clarify the role of vertical bracket positioning on the applied torque and the resultant stresses in the periodontal ligament (PDL), we designed a mandibular first premolar using finite element modeling. METHODS: Cone beam computed tomography of 52 patients (83 lower first premolars) was selected to be included in the study. Curvature was measured for points along the labial surface with increasing distances (0.5 mm increments) from the cusp tip by calculating the angle between tangents drawn from these points and the axis joining the cusp tip and the root apex. The mean values for each distance were calculated, and a finite element model was designed incorporating these mean values. The resultant stress and hydrostatic pressure in the PDL were calculated using finite element analysis. RESULTS: The labial surface of the mandibular first premolar demonstrated a 26.39° change from 2.5 to 6 mm from the cusp tip. The maximum Von-Mises stress and hydrostatic pressure in the PDL were observed at the root apex for all of the bracket positions, and these values demonstrated, respectively, a change of up to 0.059 and 0.186 MPa between two successive points. CONCLUSIONS: It can be concluded that the variation in the vertical position of the bracket can have an important effect on the torque and subsequently on the stresses and pressures in the PDL.

Measuring agreement between cervical vertebrae and hand-wrist maturation in determining skeletal age: reassessing the theory in patients with short stature.

INTRODUCTION: The objective of this study was to determine the degree of agreement between hand-wrist radiography and cervical vertebral maturation analysis in patients diagnosed with short stature. METHODS: A cross-sectional study was designed; 178 patients (90 girls, 88 boys) diagnosed with short stature and seeking treatment were selected. The patients were divided into 2 groups (76 with familial short stature, 102 with nonfamilial short stature). Hand-wrist and lateral cephalometric radiographs were obtained from the patients. The hand-wrist radiographs were analyzed using the Fishman method, and the lateral cephalometric views were categorized according to the method of Hassel and Farman. The degree of agreement between the 2 methods of predicting skeletal maturation was measured by calculating the contingency coefficient and the weighted kappa statistic. RESULTS: A high degree of agreement was observed between the 2 methods of analyzing skeletal maturation. It was also observed that agreement was higher in girls in the familial short-stature group, whereas boys had higher agreement in the nonfamilial short-stature group. CONCLUSIONS: Cervical vertebral maturation can be a valuable substitute for hand-wrist radiography in patients with short stature.

Study skills and habits in Shiraz dental students; strengths and weaknesses.

INTRODUCTION: The dental students, the same as other students, during their academic courses are required to learn a wide range of scientific subjects. Obviously, choosing the inappropriate method of study leads to confuse and disenchantment of students and it causes wasting of their energy. The purpose of this study was to assess the existing strengths and weaknesses of the skills and study habits in Dental Students of Shiraz University of Medical Sciences in 2009-10. MATERIALS AND METHODS: In this cross-sectional study, all of the dental students (n = 274), who studied at the time of study at all levels in the academic year of 2009-10, were selected by the census. Data were collected by using the Huston University questionnaire consisted of two parts of demographic questions and 64 specific areas of study skills in eight domains of time management, concentration/memory, study aids/note taking, test strategies, information processing, motivation, self-assessment/reading, and writing skills. Following the retranslation of the questionnaire, the validity was confirmed by using the content validity method. The reliability was obtained by using the Cronbach's Alpha of 0.92. The data were analyzed with SPSS software version 17 and using analytical statistic tests. RESULTS: Students who have previously participated in the study skills workshops had stronger skills in comparison with the students who had not participated in these workshops. Time management skills (P = 0.04), motivation (P = 0.0001) and information processing (P = 0.03) in students with professional status were in a more favorable position and showed significant differences in terms of educational levels. The study skills mean score of the students living in student housings in comparison with the other students were significantly higher (P = 0.04). Marital status showed no significant differences in reading skills. CONCLUSION AND RECOMMENDATIONS: The review of study skills in the undergraduate and post-graduate dental students indicated that the residents had higher reading skills. By recognizing the existing strengths and weaknesses and holding programs through counseling centers can develop the study skills in the students.

Ion release from orthodontic brackets in 3 mouthwashes: an in-vitro study.

INTRODUCTION: Stainless steel orthodontic brackets can release metal ions into the saliva. Fluoridated mouthwashes are often recommended to orthodontic patients to reduce the risk of white-spot lesions around their brackets. However, little information is available regarding the effect of different mouthwashes in ion release of orthodontic brackets. The purpose of this study was to measure the amount of metal ion release from orthodontic brackets when kept in different mouthwashes. METHODS: One hundred sixty stainless steel brackets (0.022-in, 3M Unitek, Monrovia, Calif) were divided randomly into 4 equal groups and immersed in Oral B (Procter & Gamble, Weybridge, United Kingdom), chlorhexidine (Shahdaru Labratories, Tehran, Iran), and Persica (Poursina Pharmaceutical Laboratories, Tehran, Iran) mouthwashes and distilled deionized water and incubated at 37°C for 45 days. Nickel, chromium, iron, copper, and manganese released from the orthodontic brackets were measured with an inductively coupled plasma spectrometer. For statistical analysis, 1-way analysis of variance (ANOVA) and the Duncan multiple-range tests were used. RESULTS: The results showed that ion release in deionized water was significantly (P <0.05) higher than in the 3 mouthwashes. Higher ion release was found with chlorhexidine compared with the other 2 mouthwashes. There was no significant difference (P >0.05) in nickel, chromium, iron, and copper ion release in the Oral B and Persica mouthwashes. The level of manganese release was significantly different in all 4 groups. CONCLUSIONS: If ion release is a concern, Oral B and Persica mouthwashes might be better options than chlorhexidine for orthodontic patients with stainless steel brackets.

Association between normative and self-perceived orthodontic treatment need among 12- to 15-year-old students in Shiraz, Iran.

Self-perception of dental attractiveness is an important factor affecting orthodontic treatment need. The purpose of this study was to investigate the association between normative and self-perceived orthodontic treatment need and to evaluate the influence of gender and socioeconomic background such as family size, parental education and father's employment. The subjects were 900 male and female junior high school students (450 males, 450 females) aged 12-15 years, from four districts in the city of Shiraz, Iran. The participants were asked to complete a questionnaire and then underwent a dental examination. Normative treatment need was assessed clinically using the Dental Aesthetic Index (DAI) according to the World Health Organization guidelines. Statistical analysis was undertaken using t- and chi-squared tests. There was no statistically significant correlation between DAI scores and demographics. The results showed a significant correlation between DAI scores and a subject's awareness of malocclusion and their satisfaction with dental appearance. There were no differences between genders concerning the questionnaire data. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment.

Orthodontic treatment needs assessment of 14- to 18-year-old students in Shiraz, Iran.

AIM: Orthodontic need assessment is instrumental for dental treatment planning. The objective of this examination was to evaluate the orthodontic treatment need of students in Shiraz, Iran, using the Dental Aesthetic Index (DAI) and to assess the relationship between DAI and sociodemographic variables. METHODS: Using random cluster sampling, 1,818 pupils (965 male and 853 female) 14 to 18 years of age without any history of orthodontic treatment were selected. Information was gathered using a questionnaire, including demographics such as sex, family size, and parents' education. Orthodontic assessments were performed by two orthodontists over 2 months. The data were analyzed with chi-square and t tests. RESULTS: Many of the subjects (48.3%) had no need for orthodontic treatment. About one-fifth of the population (21%) had intense-to-disabling malocclusions, and 8.4% had disabling malocclusion with compulsory treatment needs. The study showed a close relationship between sex and malocclusion. CONCLUSION: The study showed that Iranian youth in Shiraz had better dental appearances and less orthodontic treatment need than some populations (Japanese, Caucasian and Native Americans, and Caucasian Australians) but worse than Chinese, Spanish, and Nigerian populations. It might be possible to relate the difference to genetics, cultural differences, and growth.