An Analysis of Approaches to Reduction of HIV Stigma across the World through educational interventions: A Scoping Review / Análisis de los enfoques para reducir el estigma del VIH en todo el mundo mediante intervenciones educativas: Una revisión de alcanza / Análise das abordagens para reduzir o estigma do HIV em nível global por meio de intervenções educacionais: uma análise de escopo

Objective. To determinate the educational interventions for reducing the stigma caused by HIV worldwide. Methods. This scoping review study analyzed all papers published from early 2000 to the end of 2022 by searching all the scientific databases, Scopus, Web of Science, PubMed, Cochrane, Embase and CINHAL. The quality assessment of the papers was done using the ROBIS tool checklist. Results. 31papers were admitted to the scoping review process. Stigma reduction intervention was founded on three parts: Society, health and therapeutic services providers, and the patients who had HIV and their families. The interventions included education on the reduction of fear, and shame, observation of protective standards, conducting tests and treatment at the above levels, as well as the support provided by the society, policymakers, religious leaders and families of patients in economic, psychological and cultural terms, together with the establishment of social centres and organization of campaigns. Conclusion. The stigma associated with HIV is a significant obstacle before treatment, life expectancy and living quality of patients. Therefore, the stigma associated with this disease can be reduced, and the living quality of patients can be raised using approaches such as education of healthcare service providers and afflicted people, as well as economic, social, cultural, and psychological support.

Objetivo. Determinar las intervenciones educativas para reducir el estigma causado por el VIH en todo el mundo. Métodos. Revisión de alcance en el que se analizaron los artículos publicados desde 2000 a 2022 recuperados en las bases de datos científicas Scopus, Web of Science, PubMed, Cochrane, Embase y CINHAL. La evaluación de la calidad de los artículos se realizó mediante la lista de comprobación de la herramienta ROBIS. Resultados. Se admitieron 31 artículos. Las intervenciones para la reducción del estigma se basaron principalmente en tres componentes: La sociedad, los proveedores de los servicios de salud, y los pacientes con VIH y sus familias. Las intervenciones incluyeron la educación sobre la reducción del miedo y la vergüenza, la observación de las normas de protección, la realización de pruebas y el tratamiento en los niveles de atención, así como el apoyo prestado por la sociedad, los responsables políticos, los líderes religiosos y las familias de los pacientes en términos económicos, psicológicos y culturales, junto con la creación de centros sociales y la organización de campañas. Conclusión. El estigma asociado al VIH es un obstáculo importante ante el tratamiento, la esperanza y la calidad de vida de los pacientes. Por lo tanto, es posible reducir el estigma asociado a esta enfermedad y elevar la calidad de vida de los pacientes mediante enfoques como la educación de los proveedores de servicios sanitarios y de las personas afectadas; así como el apoyo económico, social, cultural y sicológico.

Objetivo. Analisar as intervenções educacionais implementadas para reduzir o estigma relacionado ao HIV. Métodos. A revisão de escopo analisou artigos publicados de 2000 a 2022 recuperados dos bancos de dados científicos Scopus, Web of Science, PubMed, Cochrane, Embase e CINHAL. A avaliação da qualidade dos artigos foi realizada usando a lista de verificação da ferramenta ROBIS. Resultados.31 artigos foram admitidos. As intervenções para redução do estigma baseavam-se principalmente em três componentes: Sociedade, prestadores de serviços de saúde e pacientes com HIV e suas famílias. As intervenções incluíram educação sobre a redução do medo e da vergonha, adesão a normas de proteção, testagem e tratamento nos níveis de atendimento, bem como apoio fornecido pela sociedade, formuladores de políticas, líderes religiosos e familiares dos pacientes em termos econômicos, psicológicos e culturais, juntamente com a criação de centros sociais e a organização de campanhas. Conclusão. O estigma associado ao HIV é um grande obstáculo ao tratamento, à esperança e à qualidade de vida dos pacientes. Portanto, é importante reduzir o estigma associado a esta doença e aumentar a qualidade de vida dos pacientes através de abordagens como a educação dos prestadores de cuidados de saúde e das pessoas afetadas; bem como apoio económico, social, cultural e psicológico.

Surface Heparinization of a Magnesium-Based Alloy: A Comparison Study of Aminopropyltriethoxysilane (APTES) and Polyamidoamine (PAMAM) Dendrimers.

Magnesium (Mg)-based alloys are biodegradable metallic biomaterials that show promise in minimizing the risks of permanent metallic implants. However, their clinical applications are restricted due to their rapid in vivo degradation and low surface hemocompatibilities. Surface modifications are critically important for controlling the corrosion rates of Mg-based alloys and improving their hemocompatibilities. In the present study, two heparinization methods were developed to simultaneously increase the corrosion resistance and hemocompatibility of the AZ31 Mg alloy. In the first method, the surface of the AZ31 alloy was modified by alkali-heat treatment and then aminolyzed by 3-amino propyltriethoxy silane (APTES), a self-assembly molecule, and heparin was grafted onto the aminolyzed surface. In the second method, before heparinization, polyamidoamine dendrimers (PAMAM4-4) were grafted onto the aminolyzed surface with APTES to increase the number of surface functional groups, and heparinization was subsequently performed. The presence of a peak with a wavelength of about 1560 cm-1 in the FTIR spectrum for the sample modified with APTES and dendrimers indicated aminolysis of the surface. The results indicated that the corrosion resistance of the Mg alloy was significantly improved as a result of the formation of a passive layer following the alkali-heat treatment. The results obtained from a potentiodynamic polarization (PDP) test showed that the corrosion current in the uncoated sample decreased from 25 µA to 3.7 µA in the alkali-heat-treated sample. The corrosion current density was reduced by 14 and 50 times in samples treated with the self-assembly molecules, APTES and dendrimers, respectively. After heparinization, the clotting time for pristine Mg was greatly improved. Clotting time increased from 480 s for the pristine Mg sample to 630 s for the APTES- and heparin-modified samples and to 715 s for the PAMAM- and heparin-modified samples. Cell culture data showed a slight improvement in the cell-supporting behavior of the modified samples.

Clinical and radiographic effectiveness of mineral trioxide aggregate (MTA) partial pulpotomy with low power or high power diode laser irradiation in deciduous molars: a randomized clinical trial.

This study investigated the clinical and radiographic effectiveness of MTA partial pulpotomy with low power or high power diode laser irradiation in primary molars. In this randomized single-blind clinical trial, 63 mandibular second molars were assigned into three groups (n = 21). After pulp amputation and achieving hemostasis, MTA was placed over pulp stumps in group 1 (MTA). The patients in groups 2 (LLLT-MTA) and 3 (DL-MTA) underwent low level (660 nm, 200 mW) and high power (810 nm, 1 W) diode laser radiation prior to MTA placement, respectively. The occurrence of clinical failure (spontaneous pain, tenderness upon percussion, swelling, fistula, mobility) and radiographic failure (periodontal ligament widening, external or internal root resorption, periapical or furcal radiolucency) was recorded up to 18 months after therapy. MTA and LLLT-MTA groups showed clinical success rate of 100% throughout the experiment. The clinical success rate of DL-MTA group was 95.2%, 95.2%, and 87.5% after 6, 9, and 18 months. The radiographic success rates were 90.5%, 90.5%, and 87.5% in the MTA group; 100%, 95.2%, and 88.2% in the LLLT-MTA group, and 85.7%, 76.2%, and 68.7% in the DL-MTA group, at 6-, 9-, and 18-month follow-ups, respectively. No significant differences were found in the frequency of clinical or radiographic failure among the groups at any interval (p > 0.05). MTA partial pulpotomy was a suitable technique for vital pulp therapy in deciduous teeth. The addition of low power or high power diode laser radiation to the procedure did not cause a significant difference in success rate values.

Effect of Chlorhexidine on Immediate and Delayed Bond Strength between Resin and Dentin of Primary Teeth: A Systematic Review and Meta-Analysis.

Objectives: The purpose of this study was to systematically review the literature and use meta-analysis to investigate whether chlorhexidine (CHX) application after acid etching as an adjunct treatment has any influence on the immediate and delayed bond strength to primary dentin. Materials and Methods: In this review, PubMed, ISI (all data bases), Scopus and Cochrane were searched according to the selected keywords up to April 30, 2018. The full texts of all published articles that met our primary inclusion criteria were obtained. The studies were analyzed in two parts: in vitro studies that evaluated the effect of CHX application during the bonding procedures (application after acid etching) on immediate and delay dentin bond strength of resin-dentin interface. Results: The initial search yielded 214 publications, of which 8 were selected after thorough methodological assessment. None of the clinical studies fulfilled the eligibility criteria. Our results indicated that in comparison to the control group, CHX significantly reduced immediate resin-dentin bond strength (P=0.043). These values were increased after aging (P<0.001). Conclusion: Based on this invitro Meta-analysis CHX application, improve resin-dentin bond strength durability in primary teeth.

Anti-proliferative and apoptotic effect of gemini curcumin in p53-wild type and p53-mutant colorectal cancer cell lines.

BACKGROUND: Despite recent advances in therapy, colorectal cancer remains a leading cause of death in affected people. Curcumin is the main bioactive compound of turmeric that has been demonstrated as an effective agent against cancer. However, its poor stability and bioavailability limit therapeutic application. We previously showed that delivery of curcumin by using gemini surfactant nanoparticles called gemini curcumin (Gemini-Cur) could improve its solubility, uptake and toxic effect on breast and ovarian cancer cells. Here, we aimed to investigate the anticancer activity of Gemini-Cur in both p53-mutant and p53-wild type colorectal cancer cells. The toxicity of Gemini-Cur on HT-29 and HCT116 was studied through MTT, uptake kinetics, fluorescence microscopy, annexin V/FITC, and cell cycle assays. Also, real-time PCR and western blotting were performed to evaluate the expression of p53, p21, BAX, BCL-2, and NOXA genes. Our data showed that Gemini-Cur not only enters cells quite rapidly compared to free curcumin crystals, but also suppresses HT-29 and HCT-116 cells proliferation in a time- and dose-dependent manner (p < 0.001). The IC50 values as well as apoptosis assays showed that p53-wild type cells are sensitive to Gemini-Cur. Flow cytometry also revealed that the number of apoptotic cells is dramatically increased in HCT-116 cells earlier than HT-29 cells (p < 0.0001). Gemini-Cur upregulated apoptotic genes including p53 (in both mutant and wild-type forms), p21, NOXA and BAX while decreased anti-apoptotic BCL-2 in mRNA and protein level (p < 0.0001). As a hallmark of apoptosis, the expression ratio of BAX/BCL-2 was significantly increased in all treated cells. Taken together, our findings demonstrated that Gemini-Cur suppresses the proliferation of cancer cells via induction of apoptosis and could be considered as novel nano-formulated phytochemical for cancer targeting.

GeFeS: A generalized wrapper feature selection approach for optimizing classification performance.

In this paper, we propose a generalized wrapper-based feature selection, called GeFeS, which is based on a parallel new intelligent genetic algorithm (GA). The proposed GeFeS works properly under different numerical dataset dimensions and sizes, carefully tries to avoid overfitting and significantly enhances classification accuracy. To make the GA more accurate, robust and intelligent, we have proposed a new operator for features weighting, improved the mutation and crossover operators, and integrated nested cross-validation into the GA process to properly validate the learning model. The k-nearest neighbor (kNN) classifier is utilized to evaluate the goodness of selected features. We have evaluated the efficiency of GeFeS on various datasets selected from the UCI machine learning repository. The performance is compared with state-of-the-art classification and feature selection methods. The results demonstrate that GeFeS can significantly generalize the proposed multi-population intelligent genetic algorithm under different sizes of two-class and multi-class datasets. We have achieved the average classification accuracy of 95.83%, 97.62%, 99.02%, 98.51%, and 94.28% while reducing the number of features from 56 to 28, 34 to 18, 279 to 135, 30 to 16, and 19 to 9 under lung cancer, dermatology, arrhythmia, WDBC, and hepatitis, respectively.

Association of a novel homozygous mutation in the HMGCS2 gene with an HMGCSD in an Iranian patient.

BACKGROUND: 3-Hydroxy-3-methylglutaryl-CoA (HMG-CoA) synthase 2 gene (HMGCS2) encodes a mitochondrial enzyme catalyzing the first reaction of ketogenesis metabolic pathway which provides lipid-derived energy for various organs during times of carbohydrate deprivation, such as fasting. Mutations in this gene are responsible for HMG-CoA synthase deficiency (HMGCSD). The aim of present study was to investigate the association of mutation in the HMGCS2 gene with HMGCSD in a patient with atypical symptoms. METHODS: The clinical and genetic features of an 8-months-old girl with HMGCSD were evaluated. Molecular genetic testing was conducted using whole-exome sequencing (WES) in order to identify potential disease-causing mutation. The WES finding was confirmed by the polymerase chain reaction (PCR) amplification of the target sequence carried out for the patient and her parents. The PCR products were subjected to direct sequencing using forward and reverse specific primers corresponding to the HMGCS2 gene. RESULTS: A novel homozygous missense mutation (c.266G>A p.Gly89Asp) was detected in the HMGCS2 gene. Sanger sequencing along with co-segregation analysis of all family members confirmed this novel pathogenic germline mutation. The mutant gene was found to be pathogenic by bioinformatics analysis. CONCLUSION: To our best knowledge, this is the first report of HMGCSD in Iran which would expand our knowledge about the mutational spectrum of the HMGCS2 gene and the phenotype variations of the disease.

Success and Behavior During Atraumatic Restorative Treatment, the Hall Technique, and the Stainless Steel Crown Technique for Primary Molar Teeth.

Purposes: The purposes of this prospective trial were to: (1) compare the clinical and radiographic outcomes of three restorative methods -modified atraumatic restorative treatment (mART), the Hall technique (HT), and stainless steel crown (SSC)-in primary molars with multi-surface carious lesions; and (2) assess child behavior throughout these treatments. Methods: In this randomized controlled trial (RCT), 123 primary molars in four- to nine-year-old children were randomly divided into treatment groups (HT, mART, and SSC). Variables, including signs of failure, treatment time, child's discomfort, child's behavior, and canine overbite relationship in HT, were recorded immediately after the treatment and at six- and 12-month recalls. Results: Failures occurred most significantly for mART at all recalls (P=0.001). The treatment time was significantly higher in SSC. There was no significant difference in the child-assessment of discomfort (P=0.814). The child's behavior, as evaluated by the dentist, however, was significantly better for the SSC group. Alterations to the canine overbite relationship of HT decreased significantly during recalls (P<0.001). Conclusions: The high success and shorter treatment time of the Hall technique support its consideration as an alternative to the conventional technique for the treatment of carious primary teeth with multisurface lesions. The results for modified atraumatic restorative treatment were not as satisfying.

Identification of Two Novel Mutations in the ATM Gene from Patients with Ataxia-Telangiectasia by Whole Exome Sequencing.

BACKGROUND: Ataxia telangiectasia (AT) is one of the most common autosomal recessive hereditary ataxia presenting in childhood. The responsible gene for AT designated ATM (AT, mutated) encodes a protein which is involved in cell cycle checkpoints and other responses to genotoxicity. We describe two novel disease-causing mutations in two unrelated Iranian families with Ataxia-telangiectasia. METHODS: The probands including a 6-year-old female and an 18-year-old boy were diagnosed with Ataxia-telangiectasia among two different Iranian families. In this study, Whole-Exome Sequencing (WES) was employed for the detection of genetic changes in probands. The analysis of the co-segregation of the variants with the disease in families was conducted using PCR direct sequencing. RESULTS: Two novel frameshift mutations, (c.4236_4236del p. Pro1412fs) and (c.8907T>G p. Tyr2969Ter) in the ataxia telangiectasia mutated ATM gene were detected using Whole-Exome Sequencing (WES) in the probands. These mutations were observed in two separate A-T families. CONCLUSION: Next-generation sequencing successfully identified the causative mutation in families with ataxia-telangiectasia. These novel mutations in the ATM gene reported in the present study could assist genetic counseling, Preimplantation Genetic Diagnosis (PGD) and prenatal diagnosis (PND) of AT.

Association between oral findings and laboratory tests in children and adolescents undergoing dialysis: A cross- sectional study.

BACKGROUND: Diagnosis of oral complications in the dialysis patients is important to prevent potential infections. The aim of this cross-sectional study was to compare oral findings in dialysis patients with healthy individuals and determination of the correlation of these findings and laboratory tests. MATERIAL AND METHODS: In this cross-sectional study, DMFT, dmft, DI , CI , OHIS , PI, GI and enamel defects were evaluated in 25 hemodialysis patients, 30 peritoneal dialysis patients and 26 healthy individuals. Then the correlation of laboratory tests (including Hemoglobin, Urea, Creatinine, Ca, Na, Ph, K and ALP) and oral findings was determined in each groups using SPSS (Version 16). Data analyzed with One-way ANOVA test, Chi-Square , Kruskal-Wallis , Tukey's test and Fisher's-Exact test. RESULTS: Findings revealed significant differences in dmft, DI, CI, OHIs, PI and GI between study groups. A positive correlation between Ca and DI was found in hemodialysis group. In peritoneal dialysis group positive significant correlations between DMFT index and Urea, Cr , ALP and K , between OHIs and K , between PI and Cr and negative correlations between Na and CI and OHIs were found. CONCLUSIONS: Presence of oral problems in dialysis patients, especially hemodialysis, indicate the necessity of appropriate therapeutic considerations in these patients. The correlation of blood biochemical compounds and oral status in dialysis patients may warn clinicians to control the level of the biochemical blood compounds for oral health improvement. Key words:Hemodialysis, laboratory tests, oral findings, peritoneal dialysis.

Are self-etch adhesives reliable for primary tooth dentin? A systematic review and meta-analysis.

The purpose of this study was to systematically evaluate the dentin bond strength of etch-and-rinse and self-etch adhesives to primary teeth. In this study, PubMed, ISI (all databases), Scopus, and Cochrane Database were searched according to the selected keywords up to May 11, 2016. The full texts of published articles that appeared to meet the primary criteria for inclusion in this study were obtained. Due to the variation in the methods used, the studies were divided into 2 groups: Group 1 - studies that evaluated the micro-tensile bond strengths (MTBSs) of two-step etch-and-rinse adhesives and two-step self-etch adhesives and Group 2 - studies that evaluated the MTBSs of two-step etch-and-rinse adhesives and one-step self-etch adhesives. The initial search yielded 1447 publications. After a methodological assessment, 8 publications were selected. The results of this study showed that the MTBS of the etch-and-rinse adhesives and the two-step self-etch adhesives were similar (P = 0.34), and both were significantly higher than that of the one-step self-etch adhesive (P = 0.001). This meta-analysis showed that the application of two-step self-etch adhesives performs well when used for primary dentin and can be used to save time in pediatric dentistry.

Can Chlorhexidine enhance the Bond Strength of Self-etch and Etch-and-rinse Systems to Primary Teeth Dentin?

Introduction: Modifying the durability of resin bonding systems resulted in introducing materials with cross-link property, such as chlorhexidine (CHX) that can promote the strength of resin-dentin bonding. The aim of this study was evaluation of the effect of CHX on shear bond strength (SBS) of self-etch (SE) and etch-and-rinse (E&R) bonding systems to the primary teeth dentin. Materials and methods: In this in vitro study, 40 freshly extracted primary molars collected and were cut mesiodistally, and then the buccal and lingual surface enamel was grounded. The specimens were randomly divided into two groups: I: Single Bond adhesive and II: Clearfil SE Bond adhesive. Then, each group was divided into two subgroups: On the buccal surface of each sample CHX was applied for 30 seconds and on the lingual surface of (I2, II2 groups), CHX was not applied. The SBS (MPa) of samples was assessed using the Zwick universal testing machine. Data were analyzed by paired t-test and independent t-test using Statistical Package for the Social Sciences (SPSS), version 16. Results: The mean SBS was significantly higher in the Single Bond group with CHX (66.45 ± 8.3) than without CHX (25.43 ± 12.94) in the nonaging group (p = 0.002). There was no significant difference in the mean SBS in the Clearfil SE Bond group with CHX and without CHX in the aging and nonaging groups. Conclusion: CHX had positive influence on immediate SBS of Single Bond adhesive to primary teeth dentin. In addition, no positive effect has been seen in the Clearfil SE Bond system. Clinical significance: Now more researches are needed about the recommendation of CHX in resin restorations of primary teeth. Keywords: Chlorhexidine, Etch-and-rinse adhesive, Failure pattern, Self-etch adhesive, Shear bond strength.

The effects of three remineralizing agents on regression of white spot lesions in children: A two-week, single-blind, randomized clinical trial.

BACKGROUND: This study investigated the effect of three remineralizing agents on improving white spot lesions (WSLs). MATERIAL AND METHODS: This clinical trial included children who had at least one WSL on anterior teeth of upper or lower jaws. The participants were randomly assigned to 4 groups by treatment: 1) a cream containing casein phosphopeptide-amorphous calcium phosphate and fluoride (MI Paste Plus); 2) a cream containing hydroxyapatite and fluoride (Remin Pro); 3) a 2% sodium fluoride gel; and 4) usual home care (control). The treatment was performed for 3 times over 10 days using special trays for retaining remineralizing agents. The area and mineral content of WSLs were measured at baseline (T1) and 1 day after finishing treatment (T2). Blinding was applied for outcome assessment. RESULTS: Eighty patients were assigned to MI Paste Plus, Remin Pro, NaF or control groups. The application of all remineralizing agents caused a significant decrease in area and a significant increase in mineral content of WSLs (p<0.05), whereas the control patients did not experience any significant alteration (p>0.05). At T2, the area of WSLs was significantly lower in three experimental groups compared to the control group (p=0.023), but between-group difference in mineral content of WSLs failed to achieve statistical significance (p=0.08). CONCLUSIONS: The in-office application of either MI Paste Plus or Remin Pro was as effective as 2% NaF for reducing area and increasing mineral content of WSLs. MI Paste Plus and Remin Pro could be recommended as suitable alternatives to NaF for managing WSLs. Key words:White spot lesion, caries, casein phosphopeptide-amorphous calcium phosphate, hydroxyapatite, sodium fluoride, CPP-ACP, MPlus, Remin Pro, NaF.

Effect of Tannic Acid on Bond Strength of Etch and Rinse and Self-etch Adhesive Systems in Dentin of Primary Teeth.

INTRODUCTION: One of the possible mechanisms for the gradual destruction of bond strength in dentin-resin interface, could be due to the demineralized unstable collagen matrix. Use of protease inhibitors, such as tannic acid (TA) could prevent destruction of collagen fibers. The aim of this study was to compare the TA effect on bond strength of etch and rinse and self-etch adhesive systems in the dentin of primary teeth. MATERIALS AND METHODS: This in vitro study was done on 40 extracted primary molar teeth. The teeth were sectioned in the mesiodistal direction, and enamel of buccal and lingual surfaces was removed. Samples were randomly divided into four groups: Single bond (SB) + TA, SB, Clearfil SE Bond (CSB) + TA, and CSB. Then, Z250 and Clearfil AP-X composites were cured on the surfaces of SB and CSB groups respectively. After that, all samples were divided into aging and non-aging groups. For 3 months, samples were placed under 1,000 thermal cycles in aging group. Subsequently, the shear bond strengths of all groups were measured by the International testing machine, and failure mode was evaluated by an optical stereomicroscope. Data were analyzed with paired t-test and independent t-test. RESULTS: Tannic acid induced a significant reduction in the immediate bond strength of adhesive SB. Meanwhile, TA had no significant effect on shear bond strength of the CSB system. CONCLUSION: Based on our findings, use of TA is not recommended with SB and CSB adhesives on primary teeth. CLINICAL SIGNIFICANCE: Tannic acid may not be considered in resin restorations of primary teeth.

A smart rotary technique versus conventional pulpectomy for primary teeth: A randomized controlled clinical study.

BACKGROUND: Techniques with adequate accuracy of working length determination along with shorter duration of treatment in pulpectomy procedure seems to be essential in pediatric dentistry. The aim of the present study was to evaluate the accuracy of root canal length measurement with Root ZX II apex locator and rotary system in pulpectomy of primary teeth. MATERIAL AND METHODS: In this randomized control clinical trial complete pulpectomy was performed on 80 mandibular primary molars in 80, 4-6-year-old children. The study population was randomly divided into case and control groups. In control group conventional pulpectomy was performed and in the case group working length was determined by electronic apex locator Root ZXII and instrumented with Mtwo rotary files. Statistical evaluation was performed using Mann-Whitney and Chi-Square tests (P<0.05). RESULTS: There were no significant differences between electronic apex locator Root ZXII and conventional method in accuracy of root canal length determination. However significantly less time was needed for instrumenting with rotary files (P=0.000). CONCLUSIONS: Considering the comparable results in accuracy of root canal length determination and the considerably shorter instrumentation time in Root ZXII apex locator and rotary system, it may be suggested for pulpectomy in primary molar teeth. Key words:Rotary technique, conventional technique, pulpectomy, primary teeth.

Serum 25-Hydroxyvitamin D Levels in Pediatric Burn Patients.

BACKGROUND: Previous studies have implicated the important and active role of vitamin D in the immune system. OBJECTIVES: The aim of this study was to evaluate serum levels of 25-hydroxyvitamin D in children with burn injuries. MATERIALS AND METHODS: In this cross-sectional study, 118 patients with various degrees of burn injuries were enrolled. A checklist consisting of demographic data, total body surface area (TBSA) affected by burn, degree of burn, serum level of 25(OH)D, total protein, albumin, electrolytes, and parathyroid hormone was recorded for each patient. RESULTS: Sixty-eight (57.6%) males and 50 (42.4%) females with a mean age of 4.04 years (SD = 3.04) were evaluated. The mean level of 25(OH)D was 14.58 ng/mL (SD = 6.94). Levels of 25(OH)D in four (3.39%) cases were higher than 30 ng/mL, while 95 (81.35%) cases had levels lower than 20 ng/mL, and 19 (16.10%) cases had levels of 21 - 30 ng/mL. The level of 25(OH)D was below recommended levels in 96.61% of cases, while 81.34% had vitamin D deficiency and 16.1% had insufficiency. We found a significant correlation between vitamin 25(OH)D and total protein, albumin, and total and ionized calcium (P < 0.001). There was also a significant negative correlation between 25(OH)D and TBSA affected by burn (P = 0.001). CONCLUSIONS: The levels of 25(OH)D in children suffering from severe burns were low. Supplementation might be useful in patients with very low levels of serum vitamin D.

Effects of sealant, viscosity, and bonding agents on microleakage of fissure sealants: An in vitro study.

OBJECTIVE: The aim of this study was to evaluate the effects of enamel or dentin bonding agent (DBA) and sealant viscosity on sealant microleakage. MATERIALS AND METHODS: Sixty extracted human premolars were randomly divided into two equal groups (based on sealant viscosity) and each group was divided into three subgroups of 10 teeth. Group 1 (low viscosity sealant, Seal-Rite, Pulpdent, USA with 7.7% filler): Prophylaxis, enameloplasty, etching of occlusal surfaces with 38% of phosphoric acid gel, rinsing and drying, followed by (1) enamel bonding agent (EBA) (Margin Bond, Coltène/Whaledent AG) or (2) DBA (Excite, Ivoclar Vivadent AG, Liechtenstein) or (3) no bonding (NB) prior to sealant application. In Group 2, similar procedures were performed except for applying a high viscosity sealant (Seal-Rite, Pulpdent, The USA with 34.4% filler). Specimens were thermocycled and then immersed in a 0.5% basic fuchsine solution for 24 h next, buccolingual slices of samples were scored under a stereomicroscope. The Kruskal-Wallis and Mann-Whitney U-tests were used for data analysis. RESULTS: There was no significant difference between DBA, EBA, and NB subgroups in the microleakage scores in both groups. Low viscosity sealant had a lower microleakage than the high viscosity sealant in both DBA (P = 0.002) and NB (P = 0.041) subgroups. CONCLUSION: The results indicated that the use of low viscosity sealant reduced the microleakage of pit and fissure sealants. However, the use of a bonding agent before sealant placement didn't affect the microleakage.

Radiographic assessment and chair time of rotary instruments in the pulpectomy of primary second molar teeth: a randomized controlled clinical trial.

Background and aims. The superiority of rotary systems has been reported in several clinical studies on permanent teeth. This study consisted of radiographic assessment and chair time of rotary instruments in the pulpectomy of primary second molar teeth. Materials and methods. In this randomized controlled clinical study, 46 children, 3-6 years of age, were selected. The patients were divided randomly into two groups. In the first group (group A) pulpectomy was carried out with hand instruments and in the second group (group B) the Rotary FlexMaster System was used. T-test and chi-squared test were used to analyze data. Results. The mean instrumentation time in group A was significantly more than that in group B (P<0.001). Also there was a significant difference between both groups in relation to the distance between the apex of mesial root (P<0.001) and distal root (P=0.007) and the canal filling level. Conclusion. Superior radiographic findings and less chair time of pulpectomy with rotary instruments in second primary molar teeth were achieved.

Major differences in oral health knowledge and behavior in a group of Iranian pre-university students: a cross-sectional study.

To establish efficient methods for self-prevention of oral diseases, assessment of dental health behavior and knowledge in various social classes is necessary. The main purpose of this study was to determine the major differences in oral health knowledge and behavior in a group of Iranian pre-university students. In this cross-sectional study, 591 pre-university students from different regions of Mashhad, Iran were randomly selected to complete a questionnaire consisting of two parts including dental health behavior and knowledge. Scores were recorded and statistical analyses performed to determine the correlation between dental health behavior and knowledge. Data was analyzed with Student's t-test, one-way analysis of variance and Pearson correlation. The mean score of dental health knowledge was significantly lower than the dental health behavior (2.95 ± 0.02 vs. 3.31 ± 0.05, P < 0.001). This difference was observed with gender, birth location and major subject of study. The dental health behavior of Iranian pre-university students was inadequate and their dental health knowledge was at a lower level compared to their behavior. Experimental science students had better oral health behavior compared to other students.

Temporomandibular Disorders and Related Factors in a Group of Iranian Adolescents: A Cross-sectional Survey.

BACKGROUND AND AIMS: Temporomandibular disorders (TMDs) are the most common condition affecting the tem-poromandibular joint and associated structures. The aim of this study was the epidemiologic evaluation of TMDs and re-lated factors in a group of Iranian adolescents. MATERIALS AND METHODS: This descriptive cross-sectional survey included a sample of800 high school students (400 girls and 400 boys) aged 14 to18 years, in Mashhad, Iran, selected using cluster sampling. Examiners completed question-naires and performed the clinical examinations. Data were analyzed with the Chi-square and Fisher exact tests. RESULTS: The prevalence of TMDs in the studied sample was 34.7%. The most common signs of TMDs were clicking, muscle tenderness and TMJ tenderness. The most prevalent predisposing factors of TMDs were clenching, premature con-tact in protrusive movement and bruxism. A clear predominance was seen in girls (40.5%) compared with boys (29%) (P = 0.001). CONCLUSION: Signs and symptoms of TMDs were prevalent in Iranian adolescents with a clear female predominance.