Knowledge, attitudes, and practices regarding the oral health of children: a cross-sectional study among iranian parents

Parents are responsible for their children's health care, and their oral health-related knowledge, attitude, and habits can affect their children's oral health. Aim: The objective of this study was to evaluate parents' knowledge, attitudes, and practices regarding their children's oral health. Methods: In this study, a sample of 398 parents of 4- to 6-year-old children completed a self-designed questionnaire. The parents' oral health-related knowledge, attitudes, and practices were assessed. Children's oral health was evaluated using decayed, missing, and filled tooth index (dmft). Data were analyzed using the SPSS version 23.0 with a p < 0.05 as statistically significant. Categorical data were reported as frequency (%), and continuous data were reported as mean ± SD. Moreover, Spearman's correlation, multiple regression, Mann-Whitney test, Kruskal Wallis test, and Kolmogorov-Smirnov test were used. Results: Most of the parents had a satisfactory level of knowledge and positive attitudes regarding their children's oral health. The knowledge and attitude scores were higher among parents with higher education (p<0.001), and the knowledge score was higher among mothers (p=0.004). Also, the attitude score was correlated with the number of decayed, missed, and filled teeth of children (p=0.01, p=0.04, and p=0.007, respectively). However, there was no significant relationship between dmft and the parents' knowledge, attitudes, and practices using multiple regression. The mean dmft of children was 6.86 ± 3.56, and most of the parents had poor oral health-related practices. Conclusion: The parents' level of knowledge and attitudes were satisfactory, but they had poor oral health practices. Moreover, there was no significant relationship between children's oral health and their parents' level of knowledge, attitudes, and practices. Educating programs and strategies are needed to enhance parents' oral health-related attitudes and knowledge and, more importantly, change their oral health practices

Dynamics, Efficacies, and Adverse Effects of Maxillary Full-Arch Intrusion Using Temporary Anchorage Devices (Miniscrews): A Finite Element Analysis.

Introduction: Absolute anchorages obtained from temporary anchorage devices (TADs, miniscrews) considerably facilitate dental movements and make some very difficult movements such as full-arch intrusions possible. Despite the significance of assessing strategies to fully intrude the arch using mini-implants, there is no study in this regard except a few case reports. Therefore, we simulated/tested 4 scenarios. Methods: Four maxilla models were created with different miniscrews/appliances: (1) two miniscrews were placed distal to laterals and one in the mid sagittal region. (2) Two mini-implants were inserted in mesial of canines and 2 others between bilateral first and second molars, plus another TAD in the midpalatal area, plus a transpalatal arch (TPA). (3) Two mini-implants were inserted between bilateral canines and first premolars and 2 others between bilateral first and second molars + TPA. (4) Two mini-implants were installed between lateral-and-canine and 2 miniscrews between second premolars and first molars + TPA. Intrusive forces (80 g anterior, 150 g posterior) were exerted using stainless-steel coil springs. Stresses/displacements were measured. Risk of external root resorption was evaluated. Results: The highest amounts of incisor/molar intrusion were seen in model 1. Model 2 had fewer intrusions, but its control over undesired movements was greater. Model 4 drastically reduced molar intrusion and considerably increased premolar intrusion. Overall amounts of intrusion were highest in the first 2 models, marking them as proper candidates for cases needing greater intrusion extents. Model 2 may be useful when miniscrew loosening/failure is a concern, while model 1 is recommended when fewer miniscrews are allowed. Overall, the highest and lowest root resorptions might occur in models 1 and 4, respectively. Conclusions: Each model showed certain efficacies/drawbacks and thus is recommended for a particular set of cases. Therefore, depending on the diagnosis and treatment plan, one or more of these scenarios might be desirable.

Characteristics and Dynamics of Full Arch Distalization Using Transpalatal Arches with Midpalatal and Interradicular Miniscrews as Temporary Anchorage Devices: A Preliminary Finite Element Analysis.

INTRODUCTION: Miniscrews have proved quite effective in fixed orthodontic treatment. They can be placed in areas like palatal interradicular zones or midpalatal suture. Despite the value of these methods and their ever-increasing use, their characteristics are not assessed before when implanted in palatal interradicular areas or in the midpalatal suture. We aimed to assess, for the first time, the dynamics of full arch distalization using such miniscrews. METHODS: A 3D model of maxilla with all permanent dentition was created from a CT scan volume. Tissues were segmented and differentiated. Afterward, miniscrews and appliances were designed, and the whole model was registered within a finite element analysis software by assigning proper mechanical properties to tissues and orthodontic appliances. The full arches were distalized using transpalatal arches with miniscrews as anchorage devices (in two different models). The extents of stresses and patterns of movements of various elements (teeth, miniscrews, appliances, tissues) were estimated. Results and Conclusions. Comparing the two models, it is obvious that in both models, the stress distribution is the highest in the TPA arms and the head of the miniscrew where the spring is connected. In comparison with the displacement in the X-axis, the "mesial in" rotation is seen in the first molar of both models. But there is one exception and that is the "mesial out" rotation of the right second molar. In all measurements, the amount of movement in Model 2 (with palatal interradicular miniscrews) is more than that in Model 1 (with midpalatal miniscrew). In the Y-axis, more tipping is seen in Model 2, especially the anterior teeth (detorque) and the first molar, but in Model 1, bodily movement of the first molar is more evident. Along the Z-axis, the mesial intrusion of the first molar and the distal extrusion of this tooth can be seen in both models. Again, the displacement values are higher in the second model (with interradicular miniscrews). In comparison with micromotion and stress distribution of miniscrews, in Model 1, maximum stress and micromotion is observed at the head of the miniscrew where it is attached to the spring. Of course, this amount of micromotion increases over time. The same is true for Model 2, but with a lower micromotion. As for the amount of stress, the stress distribution in both miniscrews of both models is almost uniform and rather severe.

Investigating The Antimicrobial Activity Of Different Root Canal Filling Pastes In Deciduous Teeth.

BACKGROUND: The antiseptic property of root canal filling materials is very important for the removal of residual pathogens from root canals. The aim of the current study was to investigate the antimicrobial activity of mineral trioxide aggregate (MTA), calcium hydroxide (CH), Metapex, zinc oxide eugenol (ZOE), and CEM-cement. MATERIALS AND METHODS: Four standard bacterial strains including Staphylococcus aureus (ATCC 6538), Enterococcus faecalis (ATCC 29212), Pseudomonas aeruginosa (ATCC 27853), and Bacillus subtilis (ATCC 6633) and Candida albicans (ATCC 10231) were used. On five plates containing Brain Heart Infusion (BHI) agar, five cavities were made. Then, the plates were cultured by 0.1 mL of bacterial suspension with a concentration of 0.5 McFarland. Afterwards, the cavities were filled with the tested materials and were incubated at 37 °C for 24, 48, and 72 hrs. Diameters of microbial inhibition zones were then measured. RESULTS: The highest mean diameter of growth inhibition zones was observed around ZOE and then CH and CEM-cement. According to the Kruskal-Wallis test, there was a significant difference among the tested groups (P<0.041). CONCLUSION: Considering antimicrobial activity, CH was an acceptable alternative to ZOE.

The Effect of MIpaste Plus and Reminpro on Incipient Caries Using DIAGNOdent and SEM: An Invitro Study.

BACKGROUND: The remineralization of early caries lesion has an effective role on decreasing caries. For initial remineralization of caries lesion, using Compounds of Casein phosphopeptides (CPP) in different studies has been proposed. REMINPRO including Fluoride, Xylitol and Calcium phosphate has just been offered in the market. This study aims to investigate the efficacy of Reminpro and MI paste plus in terms of remineralization of early enamel lesions. MATERIALS AND METHODS: In 15 samples of healthy enamels of the maxillary first premolar teeth and 15 samples of Primary Mandibular First Molar under the effect of demineralized gel, artificial caries has been created. The samples have been divided in 3 groups of 20. After performing the cycles of demineralization and remineralization during 5 weeks, the samples were investigated by DIAGNOdent and two samples from each group were compared with SEM. To investigate the remineralization of enamel, two-way ANOVA and to compare the groups in pair, the post hoc tests were used. RESULTS: The mean of mineralization of teeth in the group using reminpro was 25.2 ± 6.16 and in the group using MI paste plus was 23 ± 5.60, which was significantly high. CONCLUSIONS: MI paste plus in mineralization of initial enamel caries were more efficient that reminpro pate.

Comparative evaluation of shear bond strength of metallic brackets bonded with two different bonding agents under dry conditions and with saliva contamination.

BACKGROUND: This study compared the shear bond strength of metallic brackets bonded with Single Bond and Assure bonding agents under dry and saliva-contamination conditions. METHODS: Sixty sound premolar teeth were selected, and stainless-steel brackets were bonded on enamel surfaces with Single Bond and Assure bonding agents under dry condition or with saliva contamination. Shear bond strength values of brackets were measured in a universal testing machine. The adhesive remnant index scores were determined after debonding of the brackets under a stereomicroscope. One-way analysis of variance (ANOVA) was used to analyze bond strength. Two-by-two comparisons were made with post hoc Tukey tests (p<0.001). Frequencies of adhesive remnant index scores were analyzed by Kruskal-Wallis test. RESULTS: Bond strength values of brackets to tooth structure were 9.29±8.56 MPa and 21.25±8.93 MPa with the use of Assure resin bonding agent under saliva-contamination and dry conditions, respectively. These values were 10.13±6.69 MPa and 14.09±6.6 MPa, respectively, under the same conditions with the use of Single Bond adhesive. Contamination with saliva resulted in a significant decrease in the bond strength of brackets to tooth structure with the application of Assure adhesive resin (p<0.001). There were no significant differences in the adhesive remnant index scores between the study groups. CONCLUSION: Application of Single Bond and Assure bonding agents resulted in adequate bond strength of brackets to tooth structures. Contamination with saliva significantly decreased the bond strength of Assure bonding agent compared with dry conditions.

Evaluation of orthodontic treatment needs using the dental aesthetic index in Iranian students.

BACKGROUND: In the contemporary orthodontics, the number of people who demand orthodontic treatment to improve their psychosocial issues related to facial esthetic is constantly increasing. Even in treatment plans, appearance and esthetic gain more attention. OBJECTIVES: The purpose of this study was to determine the need for orthodontic treatment on the basis of the dental aesthetic index (DAI) in the Iranian students of Ahvaz city. MATERIAL AND METHODS: This cross sectional study was performed on 900 students aged between 11 - 14 years (450 boys, 450 girls). Schools were selected based on random cluster sampling from different parts of the city. Students\ who had or were having orthodontic treatment including those on interceptive orthodontics, were excluded from the study. Two questionnaires were used; the first one included different DAI criteria, and the second one included two questions about orthodontic treatment need and satisfaction of personal dental appearance. The results were analyzed by Chi-Square and T test. RESULTS: In 70.9% of the students, DAI score was 13 - 25, 19.2% of the samples had a DAI score of 26 - 30, the DAI score of 7.8% was 31 - 35, and in 2.1% the DAI score was greater than 35. The association between the DAI score and sex was not statistically significant (P = 0.778). In relation to orthodontic treatment need, 44.8% of students answered positively, while in 55.2% the answer was negative. In relation to satisfaction with appearance, 21% of the students were satisfied with their appearance, 59% were relatively satisfied, and 19.9% were not satisfied with their appearance. The association between DAI score and the need for orthodontic treatment and satisfaction of dental appearance was significant (P = 0.000). CONCLUSION: In comparison to other studies, the students in Iran (Ahvaz) have a better dental appearance and less need for orthodontic treatment. Significantly positive correlations were found between the DAI and satisfaction of dental appearance, orthodontic treatment need and student's perception.

Survey on the Condition of First Permanent Molars in 15-year-old Students in Ahwaz, Iran in 2005.

BACKGROUND AND AIMS: Many children still face active and uncontrolled dental caries and data is needed for evaluating the situation in many parts of the country. The aim of the present survey was to evaluate the oral health of the young population of Ahwaz, Iran in 2005. MATERIALS AND METHODS: In this descriptive cross-sectional study, 600 15-year-old students were se-lected randomly. Data was gathered with clinical examination and a questionnaire, collecting data of DMFT of first permanent molars, OHI-S, oral hygiene and nutrition habits, and parents' education. Statistical analysis was performed by descriptive statistics and t-test. RESULTS: Mean DMFT of first permanent molars was 1.84 ± 1.54, with a higher value seen among girls. Mean decayed teeth component was 1.56, followed by filled (0.17) and missing (0.1) components. Higher DMFT values were significantly associated with poor OHI-S score (P = 0.001). CONCLUSION: The observed oral hygiene status among the 15-year-olds necessitates implementing pre-ventive as well as restorative measures to improve the oral health status of the young population.