The Effect of Direct Observation of Procedural Skills on Learning and Satisfaction of Students in Community Dentistry Course.

Introduction: Direct Observation of Practical Skills (DOPS) tests is a valuable method for clinical assessment. This study aimed to implement the DOPS test to assess the procedural skills of community dentistry courses and its effects on mastery learning and satisfaction of professors and students at Tabriz faculty of dentistry in 2021-2022. Methods: In a quasi-experimental study, 60 dentistry students of a class were assigned into two study (n=30) and control (n=30) groups by Permuted block randomization. In the case group, the skills were related to Fluoride therapy, fissure sealant therapy, and health education evaluated by DOPS. In the control group, these skills were evaluated by traditional evaluation methods. Each test was repeated three times. Finally, the satisfaction of students in the case group was assessed by a questionnaire. The chi-square test was used to compare qualitative variables. Repeated measure ANOVA test was used to compare the mean scores in three stages and two groups. P value less than 0.05 was considered significant. Data were analyzed using SPSS 16 software. Results: A significant difference in the mean score of Fluoride therapy, pit and fissure sealant therapy, and health education was seen between the case and control groups (P<0.001). Also a significant increase in these skills in the third stage of assessment in the case group was observed (P<0.001). The professors and students' satisfaction was considerably high on the DOPS test. Conclusion: The DOPS method had more impact on Fluoride therapy, pit and fissure sealant therapy, and health education's learning process in dentistry students than the conventional evaluation. The professors and students' satisfaction level was high regarding DOPS. The advantages of the DOPS method are student-centeredness, objectivity, and appropriate feedback.

Effect of zinc supplementation as an adjuvant to corticosteroid treatment in patients with oral lichen planus: A systematic review.

Background: Oral lichen planus (OLP) and one of its main presentations, desquamative gingivitis, are common diseases with no definite treatment. Zinc deficiency has a critical role in the pathogenesis of oral mucosal diseases. The current study systematically reviewed the effect of zinc in addition to topical corticosteroids in the treatment of OLP. Methods: English articles in PubMed, Web of Sciences, Embase, and Scopus were searched until August 2022. The differences in symptoms were analyzed, including pain, burning sensation, and lesion sizes in patients with lichen planus receiving zinc supplementation as an adjuvant to corticosteroid treatment. Results: A total of 148 articles related to the searched keywords were found. Eventually, two clinical trials were selected. The total population of studied individuals included 60 patients. Due to the high heterogeneity between the studies, meta-analysis was not possible. Administering zinc, in addition to corticosteroids, did not improve the symptoms compared to corticosteroid monotherapy. Conclusion: Considering the limited number of studies and lack of sufficient evidence, it is not currently possible to reach a definite conclusion regarding the effects of zinc on OLP.

Ergonomic Evaluation of Senior Undergraduate Students and Effect of Instruction Regarding Ergonomic Principles on It.

Background and objective: Musculoskeletal disorders in dentists due to abnormal postures may result in economic and health problems. To prevent these problems, the working posture of dental students should be assessed and corrected in dental procedures. This study was undertaken to assess the effect of instruction regarding ergonomic principles on them by using the Rapid Entire Body Assessment (REBA) method. Material and methods: The posture of 117 students was assessed by REBA before and after of the "Ergonomic principles in dentistry" course. The sample size was selected based on previous studies on this issue. REBA scores were assessed by SPSS software using Friedman-test. Results: The statistical analysis of data gathered from this study showed that the ergonomic structure had a significant effect only in the group of right-handed females (P=0.046). In other groups, no significant change was observed (P>0.05). There was no significant change before and after instruction in REBA classifications (negligible, low risk, medium risk, high risk, very high risk) (P>0.05). There was no relation between the types of positions and REBA score (P>0.05). Conclusion: Ergonomic instruction can significantly decrease musculoskeletal disorders in female dentists who use their right-hand to work. In the other groups, however, the absolute amount of danger became better, but this change was not statistically significant.

The Viewpoints of Last-Year Dentistry Students of Shahid Beheshti University on the Application of Lasers as an Independent Credit in the Education of General Dentistry.

Introduction: Enhancing students' pragmatic skills as an enabling means brings about changes in their curriculum, which should be reconciled with the students' educational needs. Thus, this study seeks to examine the viewpoints of last-year dentistry students on the need for the instruction of laser application as an independent credit in the general dentistry curriculum. The findings of this study can help determine the educational priorities of students while providing and compiling their curriculum. Methods: This descriptive study was done on 91 last-year dentistry students of Shahid Beheshti University in a full census manner. The data collection tool was a fieldwork questionnaire, the validity and reliability of which were evaluated. To report the findings, frequency distribution, frequency percentage, and average tableaux were utilized. Results: Amongst the 91 participants, regarding the average figures of value assignment from 1 to 10 to respond to questions, the highest value was assigned to learning the side effects of lasers (7.99 ± 0.01) and the lowest value was assigned to learning about the history of lasers and light physics (4.53 ± 0.47). Conclusion: The findings indicate that students have a positive attitude toward the incorporation of an independent laser credit in their curriculum and thus the necessity of incorporating this credit in their curriculum can be posed.

Salivary Transferrin Levels in Patients with Oral Lichen Planus

Objective: To compare salivary transferrin levels between patients with oral lichen planus (OLP) and healthy subjects. Material and Methods: In this descriptive, analytical, crosssectional study, 11 patients with OLP and 22 healthy subjects were selected after matching in terms of age and gender. OLP was confirmed by two oral medicine specialists based on clinical and histopathological criteria. Salivary samples were collected by spitting. The patients were asked to collect their saliva in their oral cavity and then evacuate it into sterilized Falcon tubes. The procedure was repeated every 60 seconds for 5-15 minutes. A total of 5 mL of saliva was collected using this method. The samples were collected from 8 to 9 in the morning in a fasting state to avoid circadian changes. The collected salivary samples were immediately placed next to ice and transferred to the laboratory to be centrifuged at 4°C at 800 g to isolate squamous cells and cellular debris. Then the samples were frozen at -80°C until the samples were prepared. An ELISA kit was used to determine salivary transferrin levels. Data were analyzed with descriptive statistics (means and standard deviations) and t-test for independent groups using SPSS 17. Statistical significance was set at p<0.05. Results: The mean salivary transferrin concentrations in patients with OLP and healthy subjects were 0.9055±0.28229 and 1.5932±0.80041 mg/dL, respectively (p<0.05). Conclusion: The salivary transferrin levels in patients with OLP were significantly lower than those in healthy subjects.

Comparing Vitamin D Serum Levels in Patients with Oral Lichen Planus and Healthy Subjects.

STATEMENT OF THE PROBLEM: Lichen planus disease is a chronic inflammatory lesion without a known etiology. Recent studies have indicated the role of vitamin D on immune system and proposed its anti-inflammatory effects. PURPOSE: This study aimed to compare vitamin D serum levels in patients with oral lichen planus and healthy subjects. MATERIALS AND METHOD: In this case‒control study, 18 patients suffering from oral lichen planus referred to the Department of Oral Medicine, Tabriz Faculty of Dentistry were chosen as the case group and 18 healthy people were chosen as the control group. A 5-mL blood sample was taken from all subjects and the subjects' vitamin D serum levels were assessed with a vitamin D total (25-hydroxy vitamin D) kit by employing the electrochemiluminescence technique. The results were analyzed and compared by using SPSS17 statistic software. p< 0.05 was considered statistically significant. RESULTS: The mean vitamin D level in serum of patients with oral lichen planus was 30.7±20.38ng/ml and in healthy subjects was 36.45± 15.33ng/ml, the difference was not statistically significant (p= 0.346). CONCLUSION: The difference between the level of vitamin D in the serum of patients suffering from oral lichen planus and healthy individuals was not significant.

A Comparative Study of Macrophage Density in Odontogenic Cysts and Tumors with Diverse Clinical Behavior.

STATEMENT OF THE PROBLEM: Macrophages are the target of attention in numerous diseases. Many studies reported them as the regulators of the growth, dissemination, and clinical behavior of various lesions. There are relatively scarce data regarding the role of macrophages in oral lesions, particularly odontogenic lesions. PURPOSE: This study investigated the macrophage density in odontogenic lesions of diverse biologic performance. MATERIALS AND METHOD: In this comparative analytical study, 60 cases of odontogenic lesions including ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and radicular cyst were immunohistochemically stained with anti-CD68 antibody. One-way ANOVA and Tukey's HSD test were used for statistical analysis. RESULTS: The results showed that the macrophage density in keratocystic odontogenic tumor (35.72±7.74) and ameloblastoma (46.12±9.84) was not significantly different from that in dentigerous cyst (43.87±8.13). Interestingly, the macrophage density in keratocystic odontogenic tumor was lower than that in dentigerous cyst. No significant difference was observed in macrophage density between the ameloblastoma and much less aggressive lesions like dentigerous cyst (p= 0.59). Macrophage density in radicular cyst (81.53±11.04) was significantly higher than other odontogenic lesions (p< 0.001). CONCLUSION: The lack of significant differences in macrophage density between the known aggressive odontogenic tumors and much less aggressive lesions implied that macrophages might not contribute to the biological behavior of the odontogenic lesions. Therefore, it could support the notion that targeted therapy would not have prominent clinical potential to decrease the extent of mutilating surgeries in odontogenic lesions.

Effect of Home Bleaching on the Color Matching of Composite Resin Restorations

Objective: To investigate the effect of home bleaching on color matching between the dental restoration and the adjacent tooth structure after the staining process. Material and Methods: Ten intact maxillary central incisors were used. After preparation (semimesial restoration of the specimens), the specimens were immersed in a colored solution for 14 days and then were washed and the bleaching process was there after performed. A spectrophotometer apparatus was used to determine the color of the specimens in the part of the tooth filled with restorative material three times, including before the staining process, fourteen days after the staining process and immediately after the bleaching process. Paired t-test was employed to compare the color of the intact tooth and the dental restoration before and after the staining and bleaching processes. The level of significance was set at 5%. Results: Pre-bleaching E color of the teeth was 68.1, which increased to 78.8% after bleaching, and this increase was also statistically significant (p<0.001). Pre and Post-bleaching E color of composite restorations was 65% and 77.6%, respectively. This increase was also statistically significant (p<0.001). Postbleaching E color of the tooth and composite material was 78.8% and 77.6%, respectively. This difference was not statistically significant (p=0.342). Conclusion: The staining and bleaching processes had a significant effect on the discoloration of the dental restoration and the tooth; however, the application of bleaching on the teeth and composite improved the tooth composite color-match.

Comparing Serum and Salivary Levels of Vitamin D in Patients with Recurrent Aphthous Stomatitis and Healthy Individuals.

STATEMENT OF THE PROBLEM: Recurrent aphthous stomatitis (RAS) is the most prevalent ulcerative condition of the oral mucosa. Many studies have emphasized on immunologic factors as the reason of inducing RAS; however, the exact etiologic cause of RAS has not been identified yet. Vitamin D has an endocrine function and regulatory effects on the immune system. It has potential therapeutic effects on autoimmune diseases, psoriasis, and neoplasms. Vitamin D deficiency has been detected in some autoimmune diseases such as rheumatoid arteritis. PURPOSE: The aim of the present study was to compare the serum and salivary levels of vitamin D in patients with RAS and healthy individuals. MATERIALS AND METHOD: In this cross sectional study, patients with RAS, referring to the Department of Oral Medicine, Tabriz Faculty of Dentistry, were evaluated after taking medical history, clinical examinations, and completing an informed consent form. The serum and salivary vitamin D levels were compared between case (n=26) and control (n=26) groups. RESULTS: The mean serum vitamin D levels in the case and control groups were 33.0.7±12.41 and 50.89±9.30 (ng/dL), respectively, with a statistically significant difference (p<0.001). On the other hand, the mean salivary vitamin D levels in the case and control groups were 17.36± 8.01 and 20.79±6.31 (ng/dL), respectively, with no statistically significant difference (p= 0.09). In addition, the correlation between the serum and salivary levels of vitamin D was 56%, being statistically significant (p< 0.001). CONCLUSION: The serum levels of vitamin D in patients with RAS were significantly less than that in healthy individuals; however, there were no significant differences in salivary vitamin D levels between patients with RAS and healthy individuals. In addition, there was a significant and positive correlation between serum and salivary levels of vitamin D in all patients.

The Role of Botulinum Toxin A in Treatment of Temporomandibular Joint Disorders: A Review.

Temporomandibular joint disorders (TMDs) usually present with symptoms and signs such as pain, mandibular movement, dysfunction, or joint sounds. Botulinum toxin type A (BTX-A) is a biologic toxin which inhibits skeletal muscle through hindering the production of acetylcholine in the nerve endings. This toxin is used for the treatment of hyperactivity of lateral pterygoid muscle and TMD symptoms. This comprehensive review aimed to evaluate the effect of BTX-A injections in the lateral pterygoid muscle on treatment of TMDs symptoms. In this study, online databases including Scopus, Medline, Ebsco, Cochrane, EMBASE, and Google scholar were searched for the keywords "pterygoid muscle" and "Onabotulinumtoxin A". Twenty-four articles were eligible to be enrolled in the study. In 4 interventional studies and 20 descriptive studies, BTX-A was used for the treatment of TMDs. The dosage and number of injections were different in each study; however, the injection methods were relatively similar. Regardless of the type, number of injections, and dosage, injection of BTX-A in lateral pterygoid seems effective in reducing the click sound and other TMJ-related muscle disorders such as pain, hyperactivity, and dysfunction.

A comparison of the effect of triamcinolone ointment and mouthwash with or without zinc on the healing process of aphthous stomatitis lesions.

Background. Recurrent aphthous stomatitis (RAS) is one of the most common ulcerative diseases of the oral mucosa. Definitive etiology of RAS has not been conclusively established. There is no certain treatment for aphthous stomatitis but some drugs such as steroids are commonly used for the treatment of RAS. Regarding the effect of zinc on the healing process of epithelial layer and cell division, in this research the effect of triamcinolone (with orabase) in combination with a zinc-containing mouthwash and triamcinolone alone on the healing process of RAS lesions was assessed. Methods. The present study consisted of 20 patients diagnosed with RAS. The patients were instructed to rinse the mouth-wash or placebo three times a day and triamcinolone ointment twice a day for two weeks. The largest dimension of the ulcer was measured by a digital caliper and the severity of pain was assessed by visual analogue scale (VAS). Number, size, duration, ulcer-free period and pain of the lesions were evaluated twice a week for twomonths. Data were analyzed by SPSS 16 using Mann-Whitney U test and t-test. Results . A decrease was seen in the mean pain severity score (P = 0.631) and the size of the lesions but it was not statistically significant (P = 0.739). Also the difference between the number of lesions (P = 0.739), duration and ulcer-free period (P = 0.873) were not statistically significant. Conclusion. Zinc mouthwash seems to be as effective on wound healing process as typical treatment modalities for RAS.

Squamous cell carcinoma arising from an oral lichenoid lesion: a case report.

Lichenoid reactions represent a family of lesions with different etiologic factors and a common clinical and histologic ap-pearance. Lichen planus is included with lichenoid reactions and is a relatively common chronic mucocutaneous disorder. The most important complication of lichenoid reactions is the possibility of malignant transformation. That is why it has been considered a precancerous condition. Although the malignant transformation rate varies widely in the literature, from 0.4 to 6.5 percent, in most studies it does not exceed 1%. The aim of this paper is to report a rare case of squamous cell car-cinoma (SCC) arising within an oral lichenoid lesion in a 17-year-old woman, where SCC is very uncommon. The patient did not have any risk factors and was healthy. The lesion was located on the border of the tongue. In view of thecommon occurrence of OLP (oral lichen planus) and the unresolved issues regarding its premalignant potential, this case report illus-trates the need for histologic confirmation and a close follow-up of clinical lesions with lichenoid features.