Clinical, radiological, and histological correlation in diagnosis of pulpitis.

Background: To establish an endodontic diagnosis, a clinician should consider a variety of factors. Various studies have failed to demonstrate a strong correlation between histological findings with clinical and radiographic assessments. This study sought to evaluate the histopathological features of reversible and irreversible pulpitis diseases and their correlation with clinical diagnosis in extracted human molar teeth. Materials and Methods: In this experimental ex vivo study, 75 molars with caries and three intact molars were used. According to the radiographic findings and clinical criteria and the need for root canal therapy, samples were categorized as having normal/reversible pulpitis and irreversible pulpitis. Immediately after extraction, an exposure was made at 2 mm below the cementoenamel junction. Formalin-fixed specimens were decalcified, sectioned and stained with hematoxylin and eosin for histological examinations using light microscopy. Variables including the type and severity of the inflammation, hyperemia, necrosis, fibrosis and the existence of an odontoblastic layer and dentin bridge were evaluated. The Fisher's exact test and the Chi-squared test were used for statistical analysis. P <0.05 was considered as significant. Results: Acute inflammation, hyperemia and pulp exposure were significantly more common among subjects with irreversible pulpitis (P < 0/005). However, fibrosis was significantly higher in the reversible group (P < 0/005). There were no statistically significant differences between the groups regarding the other variables. Conclusion: Some discrepancies between clinical, radiographic and histological findings were observed in our experimental study. Indeed, effective clinical practice requires consideration of all discrepancies found.

Preferred materials and methods employed for endodontic treatment by Iranian general practitioners.

INTRODUCTION: The aim of this study was to gather information on the materials and methods employed in root canal treatment (RCT) by general dental practitioners (GDPs) in Iran. METHODS AND MATERIALS: A questionnaire was distributed among 450 dentists who attended the 53(th) Iranian Dental Association congress. Participants were asked to consider demographic variables and answer the questions regarding the materials and methods commonly used in RCT. Descriptive statistics were given as absolute frequencies and valid percentages. The chi-square test was used to investigate the influence of gender and the years of professional activity for the employed materials and techniques. RESULTS: The response rate was 84.88%. The results showed that 61.5% of the participants did not perform pulp sensitivity tests prior to RCT. Less than half of the general dental practitioners (47.4%) said that they would trace a sinus tract before starting the treatment. Nearly 16% of practitioners preferred the rubber dam isolation method. Over 36% of the practitioners reported using formocresol for pulpotomy. The combined approach of working length (WL) radiographs and electronic apex locators was used by 35.2% of the practitioners. Most of the respondents used K-file hand instruments for canal preparation and the technique of choice was step-back (43.5%), while 40.1% of respondents used NiTi rotary files, mostly ProTaper and RaCe. The most widely used irrigant was normal saline (61.8%). Calcium hydroxide was the most commonly used inter appointment medicament (84.6%). The most popular obturation technique was cold lateral condensation (81.7%) with 51% using zinc oxide-eugenol-based sealers. CONCLUSIONS: The majority of Iranian GDPs who participated in the present survey do not comply with quality guidelines of endodontic treatment.

Long-term effect of an educational intervention regarding dental trauma first aid: a phase II study.

AIM: Interventions that improve knowledge about emergency management of traumatic dental injuries may be a good way to achieve a more favorable prognosis in such situations. We set out to evaluate the short- and long-term effects of combined educational interventions on health teachers, including lecture presentation, question-and-answer sessions, and informational posters to promote awareness regarding emergency measures for traumatized teeth. Assessment was performed using a three-part questionnaire, including demographic data, knowledge, and self-assessment. Using a census sampling method, 52 health teachers of 68 potential candidates participated in the study. The questionnaires of 38 teachers who participated at all three intervals, including before (T0), immediately after (T1), and 36 months after (T2) the intervention, were analyzed. Statistical analysis involved Cochrane and McNemar's tests. Totally, results revealed an increase in knowledge from T0 to T1 and T2 intervals (P < 0.017). This study shows the positive effect of educational campaigns and, therefore, serves to encourage professionals to embark on innovative educational programs in this field.

Perceived Social Support and Stress among Pregnant Women at Health Centers of Iran- Tabriz.

INTRODUCTION: Social support is considered the interaction between the person and environment, which reduces stressors, covers the effects of stress and consequently protects individuals from the harmful effects of stressful situations. This study aimed to determine social support in pregnant women and its relationship with the rate of pregnant women's perceived stress at health centers of Tabriz in 2012-13. METHODS: This cross-sectional study was carried out on 450 pregnant women selected through cluster sampling. Data collection tools consisted of a demographic questionnaire, interpersonal support evaluation list (ISEL) and perceived stress questionnaire (PSS) that were completed in an interview. The range of obtainable score for social support and perceived stress was 0-90 and 0-30, respectively. Descriptive and analytical statistics including Pearson and Independent t-test were used for analyzing the data. RESULTS: The mean score of social support and perceived stress in pregnant women was 96.6 (14.6), and 11.5 (5.5), respectively .The women with favorable social support had significantly less stress than the women with unfavorable social support. CONCLUSION: The study finding showed that the rate of social support in highly stressful women is significantly less than low-stress mothers. Therefore, considering adverse effects of the stress on pregnancy outcomes, some strategies should be designed and implemented in order to strengthen and improve the social support for pregnant women so that it can reduce the rate of pregnant women's stress.

Should medical students be educated about dental trauma emergency management? A study of physicians and dentists in Kerman Province, Iran.

Since physicians sometimes need to attend a case of dental trauma, it is necessary that they possess sufficient knowledge of management of traumatic dental emergencies. This study was conducted to assess the knowledge of dental trauma among dentists and physicians. A three-part questionnaire, including demographic data, knowledge, and self-assessment, was administered to 104 dentists and 151 physicians in Kerman Province, Iran. Data obtained from 255 completed questionnaires were statistically analyzed using t-test, Mann-Whitney U test, chi-square, and Pearson correlation coefficient. Among the physicians, only fourteen (9.3 percent) had received education regarding dental trauma. In contrast, seventy-seven dentists (74 percent) had received information on what to do if a tooth is traumatized. Regarding knowledge level, only 10.6 percent of the physicians had high knowledge, while 66.3 percent of the dentists demonstrated high knowledge. The differences of knowledge level between the two groups were statistically significant (p=0.0001). More than half of the dentists (58.3 percent) and nearly all the physicians (98.7 percent) were dissatisfied with their level of knowledge and suggested that further education on the topic should be offered.

Xerostomia after radiotherapy and its effect on quality of life in head and neck cancer patients.

BACKGROUND: Xerostomia is one of the one complications following radiotherapy that can affect quality of life (QoL). This study aims to assess the severity of xerostomia in patients with head and neck cancers after radiotherapy and its effect on QoL. METHODS: In this longitudinal prospective study, the severity of xerostomia and related QoL were was assessed in 63 head and neck cancer patients who referred to the Radiotherapy Ward. Patients completed a xerostomia questionnaire (XQ) at the beginning, and 2, 4, and 6 weeks after treatment over a period of 6 months. Additionally, unstimulated saliva was collected using the spitting method at all 4 visits. RESULTS: QoL significantly worsened with increased time (P = 0.0001); meanwhile, the severity of xerostomia increased significantly (P = 0.0001). However, there was no significant change in the amount of saliva at these 4 time points (P = 0.23). Regression analysis showed that with each milliliter decrease in saliva secretion, the QoL score decreased 2.25%. With one score increase in xerostomia, from the QoL mean score there was a 1.65% decrease. CONCLUSION: The decrease in saliva and xerostomia that resulted from radiotherapy plays an important role in worsening QoL among patients who undergo radiotherapy for head and neck cancers. Although the amount of saliva has a significant association with QoL, the xerostomia score which shows subjects' general feeling also independently impacts QoL. In future studies, we recommend patient assessments for periods longer than 6 months.

Elementary school staff knowledge and attitude with regard to first-aid management of dental trauma in Iran: a basic premise for developing future intervention.

AIM: The purpose of this study was to evaluate Iranian teachers' knowledge and attitude with regard to emergency management of dental trauma. MATERIAL AND METHODS: A four-part questionnaire, including demographic data, knowledge, attitude, and self-assessment, was given to 422 teachers from 14 schools. Data obtained from 400 completed questionnaires were statistically analyzed using t-test, one-way anova and Pearson correlation coefficient. RESULTS: It was found that there was no statistically significant difference between knowledge and demographic variations (P > 0.05). However, there was a moderate positive association between knowledge and attitude toward emergency management of dental trauma (r = 0.38, P = 0.0001). The outcome indicated completely inadequate knowledge regarding the management of tooth fracture and avulsion. Most participants (94.3%) were unsatisfied with their awareness and suggested that further education on the topic should be offered. CONCLUSIONS: The present study revealed considerably low knowledge of the participants regarding the first-aid management of dental trauma for the study group. As teachers get an opportunity to attend a case of dental trauma, strategies to improve the teachers' knowledge seem crucial.

Pregnancy rate following bromocriptine treatment in infertile women with galactorrhea.

OBJECTIVE: Infertility is one of the most common causes of women refer to gynecology clinics. Galactorrhea is defined as one of the causes of infertility caused by luteal phase defect and anovulatory cycles. The study aim was to investigate the effect of bromocriptine on pregnancy rate in infertile women with galactorrhea with or without high prolactin level. MATERIALS AND METHODS: In a prospective study, consecutive women with infertility and galactorrhea who referred to Afzalipour Hospital and a private clinic during 5 years from May 2001 to May 2006 were included. The study was conducted on 205 infertile women (18-39 years) with galactorrhea. They were treated with 2.5 mg bromocriptine BID for up to 6 months. RESULTS: The mean duration of sterility was 43.1 +/- 37.1 months (range, 12-16). 76.1% of patients showed positive signs for pregnancy. The pregnancy rate was 81.7% in the patients with high prolactin level (>20 ng/dl) and 74.3% in the patients with normal prolactin level (P = 0.26). There was a significant difference between mean duration of treatment with bromocriptine in women with and without pregnancy, 103.71 and 193.03 days, respectively (P < 0.001). CONCLUSION: Considering the efficacy of bromocriptine in the treatment of infertile women with galactorrhea, we suggest treatment with bromocriptine in these patients regardless of serum prolactin level.

A comparison of patients' and nurses' assessments of pain intensity in patients with coronary artery disease.

Self-report of pain is the single most reliable indicator of pain intensity. The purpose of this study was to compare patients' and nurses' ratings of patients' pain. The sample comprised 76 patients and 65 nurses in coronary care units that rated the patient's pain intensity on a 0-10 numeric rating scale. Results showed that the mean scores of nurses were lower than their patients significantly (P < 0.01). Also, nurses assessed patients' pain intensity accurately 60% of the time. Overestimations and underestimations were 12.4% and 27.6% respectively. In addition, there were positive, moderate and significant correlations between patients' and nurses' ratings (r = 0.41, P < 0.001). Underestimation of patient's pain can have negative effects if appropriate treatment is withheld. This emphasizes the importance of a systematic assessment and acceptance of the patient's self-reported of pain.