Educational content of professional ethics in postgraduate dental education.

PURPOSE: Inclusion of proper educational content with respect to professional ethics in dental curricula is an important step to achieve objectives of ethics education especially in postgraduate programs when the time and opportunities for explicit instruction of ethics are limited. This study aimed to find and discuss the topics of ethics and professionalism for dental postgraduate programs. METHODS: A modified Delphi survey of experts' opinions with three rounds was conducted to establish a consensus on the need to teach professional ethics topics. The topics were identified through a literature review and according to the opinion of the experts. Items scored as highly important by over 80% of the participants in each round of the survey were considered educational needs. RESULTS: A total of 154 ethical issues were identified and classified into 29 topical categories to design the initial questionnaire. A consensus was developed on 24 ethics and professionalism topics for inclusion in the professional ethics curriculum for all dental postgraduate programs. CONCLUSIONS: Based on the results of this study, the same educational content in professional ethics is needed for all dental residency programs in all specialties. Most of the topics on which experts reached a consensus to be included in the ethics educational content were related to ethical and professional standards of conduct.

Barriers of students' adherence to dress code policy in clinical settings: dental students' viewpoint.

Medical universities have called for a professional dress code to preserve the dignity of the medical profession, creating a sense of respect, tranquility, and trust in healthcare recipients and improve patient safety. This study aims to explain the reasons behind poor adherence to the professional dress code by students of the dentistry school. A qualitative study was conducted to explain the viewpoints of dentistry students of Tehran University of Medical Sciences (TUMS). Twenty-three in-depth interviews with dentistry students of different genders, study years, living in different accommodations, and having different tuition payment status were conducted. Conventional content analysis was used to analyze the data. One hundred and twenty initial codes were extracted. They were categorized into common causes of non-adherence to the TUMS Dress Code and specific causes of not following a specific section of the dress code (hygiene, jewelry, and makeup sections). The codes of common causes were categorized into 4 main categories including defects in education, management shortcomings, changes in societal culture, and personal factors. All components of the educational system must be aligned with each other to overcome the barriers against the students' adherence to professional dress and put forward appropriate interventions at the policymaking, regulatory and educational levels.

Effect of Cyclic Loading on Shear Bond Strength of Orthodontic Brackets: An In Vitro Study.

OBJECTIVES: In clinical conditions, orthodontic brackets are exposed to periodic stresses mainly induced by mastication and intraoral forces. The objective of the present study was to evaluate the effects of cyclic loading to simulate masticatory forces on shear bond strength (SBS) of metal brackets bonded to teeth using self-etch and total-etch bonding systems. MATERIALS AND METHODS: Eighty-four caries- and crack-free bovine mandibular incisors were selected and randomly assigned to two groups based on the type of bonding system. After bonding, all samples were thermocycled (500 cycles) followed by cyclic loading of the half of the specimens in each group by applying 40 N load with 2 Hz frequency for 10,000 cycles. The SBS was measured using a universal testing machine. The adhesive remnant index (ARI) score was calculated subsequently. Data were analyzed using Kolmogorov-Smirnov test, two-way ANOVA and Mann-Whitney test. RESULTS: The SBS was 10.09±3.78 MPa and 14.44±6.06 MPa for self-etch and total-etch bonding systems in cyclic loading group, respectively. The SBS was 9.43±5.3 MPa and 11.31±5.42 MPa in self-etch and total-etch groups without cyclic loading, respectively. Cyclic loading did not cause any significant difference in SBS (P>0.05). The ARI scores of the groups were significantly different (P<0.05). CONCLUSIONS: The present results demonstrated that low masticatory forces at 10,000 cycles did not have a significant impact on bracket-adhesive SBS; however, they significantly changed the ARI score. Even though the total-etch bonding system yielded higher SBS than the self-etch system, the performance of both was clinically acceptable.

Effect of supplementary zinc on orthodontic tooth movement in a rat model.

INTRODUCTION: Osteoclasts and osteoblasts are responsible for regulating bone homeostasis during which the trace element zinc has been shown to exert a cumulative effect on bone mass by stimulating osteoblastic bone formation and inhibiting osteoclastic bone resorption. OBJECTIVE: The aim of the present study was to investigate the effects of zinc (Zn) on orthodontic tooth movement (OTM) in a rat model. MATERIAL AND METHODS: A total of 44 male Wistar rats were divided into four groups of 11 animals each and received 0, 1.5, 20 and 50 ppm Zn in distilled water for 60 days. In the last 21 days of the study, nickel-titanium closed coil springs were ligated between maxillary right incisors and first molars of all rats, and tooth movement was measured at the end of this period. Histological analysis of hematoxylin/eosin slides was performed to assess root resorption lacunae, osteoclast number and periodontal ligament (PDL) width. RESULTS: Mean OTM was calculated as 51.8, 49.1, 35.5 and 45 µm in the 0, 1.5, 20 and 50 ppm zinc-receiving groups, respectively. There were no significant differences in neither OTM nor histological parameters among the study groups (p > 0.05). CONCLUSION: According to the results obtained in the current investigation, increase in supplementary zinc up to 50 ppm does not affect the rate of OTM neither bone and root resorption in rats.

Assessment of the Role of NO-cGMP Pathway in Orthodontic Tooth Movement Using PDE5 Inhibitors: An Animal Study.

OBJECTIVES: Nitric oxide (NO) is a signaling molecule that mediates mechanical bone loading. Cyclic guanosine 3', 5' monophosphate (cGMP) is a NO-induced effector molecule. The aim of this study was to assess the effect of NO-cGMP pathway on orthodontic tooth movement (OTM) in rats by use of two phosphodiesterase 5 (PDE5) inhibitors namely sildenafil and tadalafil as chemical tools. MATERIALS AND METHODS: Forty-five male Wistar rats were divided into three equal groups (n=15) based on the substance they received. The first group received daily injections of tadalafil; the second group received daily injections of sildenafil and the third group received daily injections of normal saline. The orthodontic appliances consisted of nickel-titanium closed-coil spring ligated between the maxillary right incisor and the first molar of the animals for 21 days. The amount of tooth movement was measured in all three groups at the end of this period. Histological analysis was performed to assess root resorption lacunae, osteoclast number and periodontal ligament (PDL) thickness. RESULTS: All appliance-treated molars in the experimental and control groups showed evidence of tooth movement. The mean OTM was calculated to be 0.39±0.16, 0.32±0.16 and 0.26±0.16mm in tadalafil, sildenafil and control groups, respectively and there were no significant differences in OTM among the study groups (P>0.05). In the tadalafil group, significantly greater root resorption on the tension side was seen when compared with controls (P≤0.05). CONCLUSIONS: Tadalafil and sildenafil PDE-5 inhibitors affecting the NO-cGMP pathway did not affect OTM in rats.

Prevalence of blood-borne viruses among Iranian dentists: Results of a national survey.

OBJECTIVES: Health care workers, including dentists, are at the front line for acquiring blood-borne virus infections. This study aimed to investigate the prevalence of hepatitis B, hepatitis C and human immunodeficiency viruses among Iranian dentists. MATERIAL AND METHODS: The survey included 1628 dental health care workers who attended the 51st annual Congress of the Iranian Dental Association. Data on the risk of blood-borne virus transmission during health care and infection control practices were gathered from self-administered questionnaires. Sera were screened serologically by enzyme-linked immunosorbent assay (ELISA). The positive samples were examined by polymerase chain reaction (PRC) followed by direct sequencing. RESULTS: Six (0.36%) and 81 (5.0%) were positive for hepatitis B surface antigen (HBsAg) and (anti-hepatitis B virus core antigen (anti-HBc), respectively. Only 1 (0.061%) was positive for anti-hepatitis C virus (anti-HCV). No case was positive for anti-human immunodeficiency virus (anti-HIV). One case was diagnosed as being occult hepatitis B virus (HBV) infection. One thousand five hundred thirty-five (94.3%) of participants had received at least 1 dose of HBV vaccine. One thousand three hundred fifty-nine (88.5%) contained hepatitis B surface antibody (anti-HBs) > 10 IU/ml, of whom 55 (4.0%) were anti-HBc positive, suggesting that they had been infected with HBV in the past. Anti-HBc positive cases had past histories of hepatitis, either their own or their spouses'. Individuals with inadequate anti-HBs levels (< 10 IU/ml) were significantly more prevalent among anti-HBc positive cases (p < 0.001). CONCLUSIONS: The prevalence of blood-borne viruses among dental HCWs found in this study was lower than past reports from Iranian dentists and general population. The implementation of HBV vaccination together with improvement in infection control procedures has reduced the potential for risk infection among Iranian dentists.

HBV vaccination status and response to hepatitis B vaccine among Iranian dentists, correlation with risk factors and preventive measures.

BACKGROUND: Studies showed that HBV vaccination and consequent level of antibody are not completely adequate among dentists despite performance of highly exposure prone procedures. OBJECTIVES: The objectives of the study were to evaluate the levels of responsiveness to HBV vaccine and to determine the occupational factors associated among dental staff. MATERIALS AND METHODS: In total, 1612 dental health care workers were recruited. The level of anti-HBs was tested using a commercially enzyme-linked immunosorbent assay (ELISA). Data on demographic, risk factors associated with dental practice and level of protective procedures and occupational exposure aspects were collected through self-reported questionnaires. RESULTS: Of 1538 vaccinated individuals, 55 (3.7%), 126 (8.4%) and 1309 (87.9%) had received one, two and full three doses of vaccine, respectively. One-hundred-seventy-six (11.5%) were nonimmune (anti-HBs < 10 IU/mL) and 1362 (88.5%) were immune (anti-HBs > 10 IU/ mL). 392/542 (72.3%) of dentists who received their third dose of vaccination less than five years before the commencement of study were completely immune compared to those who had completed all three recommended doses in a longer period (308/491, 64.3%) (P = 0.001). Fifty-eight (3.59%) of participants did not receive any HBV vaccine at all; however, they had positive results for anti-HBs, indicating a past HBV infection. Statistically, the levels of anti-HBs were significantly associated with gender, age, duration of dental practice engagement and regularly use of mask, glasses and shield. CONCLUSIONS: Since dental care workers have a high risk of exposure to hepatitis virus, they should be advised to receive hepatitis B vaccine and it should be confirmed if they have acquired immunity to HBV by testing the level of anti-HBs.

Effect of Fluoxetine Consumption on Orthodontic Tooth Movement in Rats.

OBJECTIVES: Fluoxetine is a selective serotonin re-uptake inhibitor (SSRI) widely used for depression, bipolar disorder, anxiety and obsessive-compulsive disorder. The aim of this study was to assess the effect of fluoxetine on orthodontic tooth movement (OTM) in rats. MATERIALS AND METHODS: Forty-five male Wistar rats were randomly divided into three groups namely the control group (no medication), saline and fluoxetine dissolved in saline. In all groups, nickel titanium closed-coil spring was used between the left maxillary central incisor and first molar to exert 60g force at 2mm activation. Radiographs were taken at one and 21 days. After 21 days, the rats were sacrificed. The distance between the first and second molar teeth, optical density of bone, periodontal ligament (PDL) width, lacuna length and depth and number of osteoclasts were measured and compared among the groups. RESULTS: Tooth movement significantly increased in the fluoxetine group (P=0.005). No significant differences were found in osteoclast count (P=0.069). The PDL width in the mesioapical region of root was significantly different among the groups (P=0.015). Statistical analysis did not show significant differences in depth or length of lacunae in any examined part of the root (P>0.05). Bone densitometry results showed that in fluoxetine group, density of bone in all four areas (alveolar bone, hard palate, skull and mandibular bone) significantly decreased from day one to day 21 (P< 0.05). CONCLUSION: This study indicated that fluoxetine decreased bone density, which resulted in subsequently greater tooth movement in rats; however, further studies are needed on humans.

Orthodontic research output from iran in international and national journals.

OBJECTIVE: The number of scientific papers is a conventional metric to measure a country's research performance in a particular area. The aim of this survey was to demonstrate statistical information about orthodontic research published in international and national journals. MATERIALS AND METHODS: Pubmed as an international and IranMedex and SID as national databases were searched between1997 and 2012. The keyword searching method was used in English and Persian. Abstracts were reviewed and unrelated articles were omitted. Data were obtained and transferred to Microsoft Excel to survey the scintometric indicators. RESULTS: According to the defined criteria, a total of 733 papers were found showing a considerable increase. Five hundred papers (68.2%) were published in domestic journals, and 233 (31.8%) were published in PubMed indexed journals. Most of the orthodontic articles originated from Shahid Beheshti University of Medical Sciences (22.9%). The Journal of Dental School, Shahid Beheshti University of Medical Sciences published most of the national papers (27.8%) and the Australian Orthodontic Journal published the majority of international papers (9.9%) In terms of study design, 52.5% of the articles were observational and 39.4% were interventional. CONCLUSION: Orthodontic research production in Iran has made significant strides in the recent years and researchers should focus on the quality of the study in this field in order to apply research production in evidence base dentistry.