The measurement of the quality of educational services provided to medical students of Semnan University of Medical Sciences based on the SERQUAL model.

Introduction: The SERQUAL model is a model that measures quality by comparing the level of expectations and perceptions of service recipients to identify gaps. Since students are the main recipients of services in universities, this study was conducted with the aim of the measurement of educational services from the viewpoint of medical students of Semnan University of Medical Sciences based on the SERQUAL model. Materials and Methods: The present study was based on a cross-sectional study, and its statistical population included 180 medical students. The SERQUAL questionnaire has two parts; the first part has demographic information including gender and age, and the second part has 24 questions with two parts (including the performance part and the importance part) about the quality of educational services in the form of a 5-item Likert rating list. The obtained data were analyzed using SPSS-24 software. Results: In all five evaluated areas, the scores of the male group were significantly higher than the scores of the female group (P < 0.05). In all five evaluated areas, the scores of the age group less than 25 years old were significantly higher than the scores of the 25-30-year-old group (P < 0.05). Conclusion: The results of the present study showed that in general, according to the points of view of students of all different educational levels, there is a gap between the student's perception and their expectations of quality in all five dimensions of educational services. Based on this issue, it seems that educational services need to be revised and reviewed in all studied courses and in all dimensions.

Examination of the Dundee Ready Educational Environment Measure (DREEM) Model-Based Educational Quality in the Clinical Divisions of Semnan University: A Descriptive Study.

INTRODUCTION: It is widely recognized that there is a significant correlation between the quality of the learning environment and the level of satisfaction and achievement of students. To enhance the quality of education, it is vital to discern and rectify any inadequacies or deficiencies within the learning environment. Since the examination of strengths and weaknesses of the clinical learning environment provides valuable information to educational managers in improving the quality of education, the primary objective of this study was to examine the educational atmosphere prevalent in the principal clinical departments of the academic medical centers affiliated with Semnan University of Medical Sciences. The investigation was carried out based on the principles of the Dundee Ready Educational Environment Measure (DREEM) model. MATERIALS AND METHODS: The present study was conducted with a descriptive-analytical approach which consisted of 232 trainees and interns affiliated with the departments of pediatrics, gynecology, internal medicine, and surgery. Sampling was done by census method. Then, a standard questionnaire was designed based on the DREEM model in Google Forum and its link was uploaded by representatives in class groups and channels. The data were collected within a period of three months and then were statistically analyzed using SPSS, version 24 (IBM Corp., Armonk, NY). RESULTS: Based on the results, the mean age of students was 23.92 years. The mean score of the educational environment of interns and stagers based on the questionnaire was 122.45 and 143.35, respectively. Regarding the mean score of the educational environment, a statistically significant difference was observed between pediatric and internal medicine (P-value<0.001), and surgical and internal medicine departments (P-value=0.03). CONCLUSION: In general, the educational environment was evaluated as semi-optimal from students' point of view; thus, it appears imperative for university officials to allocate greater attention toward enhancing the quality of the learning environment by devising more meticulous plans and engaging in consistent self-assessment of the educational landscape.

Comparison of Clinical and Radiographic Success between MTA and Biodentine in Pulpotomy of Primary Mandibular Second Molars with Irreversible Pulpitis: A Randomized Double-Blind Clinical Trial.

Introduction: Among the new therapeutic materials, MTA and Biodentine are recommended for pulpotomy and sealing the pulp. Considering the similar characteristics of these two materials and considering that their effects on the treatment of primary second molars with irreversible pulpitis have not been compared properly, this study aimed to compare clinical and radiographic success between MTA and Biodentine in pulpotomy of primary mandibular second molars with irreversible pulpitis. Materials and Methods: This study was conducted as a randomized double-blind clinical trial. Participants were selected according to inclusion criteria and 52 samples were randomly selected using random numbers table in group A. Then, patients in the next group B were matched with the first group in terms of age range and sex. In group A, the remaining pulp was covered with 2 mm MTA+ and in group B with 3 mm Biodentine. Participants were called for clinical evaluation every three months for 12 months (long-term follow-up). Radiographic evaluations were in the sixth and twelfth months. Results: Fischer's exact test showed that there was no significant difference between MTA and Biodentine in terms of clinical and radiographic success rates (P value = 1). According to the results of the Kaplan-Meier test, the survival rate in both pulp treatment methods was similar in symptomatic teeth. Conclusions: The results of this study showed that Biodentine properties are similar to MTA, and both materials show high clinical and radiographic success rates in long-term follow-up.

In vitro antimicrobial effects of green tea, microwaving, cold boiled water, and chlorhexidine on Streptococcus mutans and Candida albicans on silicone pacifiers.

Background: This study aimed to compare the antimicrobial effects of green tea, microwaving, cold boiled water, and chlorhexidine (CHX) on Streptococcus mutans and Candida albicans on silicone pacifiers. Materials and Methods: In this in vitro experimental study, 60 equal-size samples of silicone pacifiers were cut, ultraviolet sterilized, and randomly divided into two groups (n = 30) for immersion in 0.5 McFarland standard suspension of S. mutans and C. albicans. The samples in each group were then randomly divided into five subgroups (n = 6) for disinfection with 0.12% CHX, cold boiled water, green tea, microwaving for 7 min, and distilled water. The sample suspensions were cultured on blood agar (for S. mutans) and Sabouraud dextrose agar (for C. albicans) and incubated. The number of colonies was counted after 24 and 48 h. Data were analyzed using the Kruskal-Wallis and Mann-Whitney tests (P < 0.05). Results: At 24 and 48 h, the S. mutans colony count was the lowest in CHX and green tea subgroups followed by microwave, cold boiled water, and distilled water subgroups (P < 0.05). Conclusion: CHX and green tea can significantly decrease the S. mutans and C. albicans colony count on silicone pacifiers.

Oral health knowledge, attitude, and performance of the parents of 3-12-year-old autistic children.

Background: This study aimed to assess the oral health knowledge, attitude, and performance of the parents of autistic 3-12-year-old. Materials and Methods: This descriptive cross-sectional study evaluated 50 parents of autistic 3-12-year-old in Isfahan city. The oral health knowledge, attitude, and performance of the parents were evaluated using a self-administered questionnaire with closed questions, after confirming its validity and reliability. Data were analyzed using independent t-test, one-way ANOVA, Pearson's correlation coefficient, regression analysis, and Cronbach's alpha (α =0.05). Results: Of children, 32 (64%) were males and 18 (36%) were females. A total of 28 (56%) fathers and 22 (44%) mothers participated in this study. The mean age of the children and parents was 8.12 ± 2.4 years and 39.6 ± 6.8 years, respectively. The mean age at the time of diagnosis of autism was 4.08 ± 1.33 years. Of all children, 24 (46.2%) had a previous dental history. The mean scores of the knowledge and attitude of the parents were 5.2 ± 1.7 out of 11, and 16.1 ± 3.1 out of 30, respectively. Of demographic variables, order of child birth had a significant correlation with attitude of the parents, and those with one single child had significantly higher attitude score (P = 0.03). Conclusion: The oral health knowledge, attitude, and performance of the parents of autistic children in Isfahan city were lower than expected, which calls for knowledge enhancement strategies in this respect.

Comparative Evaluation of Antibacterial Effect of Propolis and Aloe Vera, Xylitol, and Cpp-Acp Gels on Streptococcus mutans and Lactobacillus in Vitro.

INTRODUCTION: Early childhood caries is a kind of caries occurring in deciduous teeth. Bacteria are among the main factors. Antibacterial agents such as fluoride are used in both prevention and treatment, but their application in children faces limitations such as fluorosis. Therefore, novel methods of caries prevention among the children are mainly focused on the use of fluoride-free active ingredients. In this comparative study, antibacterial effects of gels containing propolis and aloe vera, fluoride, xylitol, and CPP-ACP were investigated. METHODS: This is an in vitro study. By plate well technique, plates containing gels were created in the culture medium of Streptococcus mutans and Lactobacillus, and their antibacterial impacts were evaluated by measuring the inhibition zone after 24, 48, and 72 hours. Then, different concentrations of each gel were evaluated in the same way for the antibacterial properties. For each sample, this process was iterated 3 times, where the average was declared as the final number. The collected data were entered in SPSS 24. RESULTS: In both bacteria, propolis gel and aloe vera had the highest zone of inhibition, followed by fluoride and xylitol in the second and third places, respectively. Different concentrations of gels are significantly different in terms of antimicrobial effect (P value ≤ 0/05). The antimicrobial effect of propolis and aloe vera gel was kept up to the concentration of 1/16. As the bacterial and gel contact time is prolonged, the antibacterial effect of different gels increases, but the difference is not statistically significant (P value = 0.109). CPP-ACP gel had no antimicrobial effect at any concentration. CONCLUSION: Propolis and aloe vera gel had a greater antimicrobial effect than other gels, where such effect was observed in low concentrations. CPP-ACP gel had no antimicrobial properties.

Comparison of information provided by pediatricians regarding tooth eruption and the information available on the internet.

BACKGROUND: Most parents believe that teething is associated with some symptoms and commonly use Internet to gain more information about the health of their children. Pediatricians can also serve as a source of information for health-related requirements of parents. This study aimed to compare the information provided by pediatricians regarding tooth eruption and the information available in Persian-language websites. MATERIALS AND METHODS: This descriptive, analytical, cross-sectional study was performed in two phases. In the first phase, the questionnaire was designed by 85 pediatric pediatricians in Isfahan about children's dental eruption and internet resources. The second phase was the study of 22 Persian websites about children's tooth eruption using Google search engine and the keywords "tooth eruption," "tooth eruption symptoms." Then a checklist was prepared to evaluate the quality and completeness of the content. Data were analyzed by the Chi-square test and Fisher's exact test using SPSS (P < 0.05). RESULTS: None of the retrieved websites had the health on the net code of conduct. The most common symptoms of teething reported by both pediatricians and websites included irritability, drooling, gingival tenderness, chewing tendency, decreased appetite and sleep disturbances. In non-pharmacological methods to control the symptoms related to tooth eruption in both groups, embracing the baby (P < 0.001), using soft tooth ring (P = 0.049) and chewing hard foods (0.016 P = significant. Use of oral pain medication (P = 0.01) and sedatives and medications (P = 0.04) were significant in the medication method. CONCLUSION: None of the websites reviewed had a valid source code and author. Although websites cannot replace the instructions of pediatricians regarding growth and development of children and their teething, supplementary information can be acquired from high-quality websites because there seems to be no significant difference between these two information sources regarding tooth eruption symptoms and their management.

Operationalization of the concepts of interdisciplinarity: An implication elicitation exercises based on the framework synthesis methodology.

BACKGROUND: Over the last few centuries, the overspecialization of various sciences under the pretext of benefiting from pure disciplinary knowledge led to alienation among and competition between different fields of science. Such competition has deviated knowledge from its main objective which is to understand and explain the phenomena. The remedy to this dilemma is to address a new approach, introduced to higher education in the late 1950s as "interdisciplinarity." Accordingly, the main purpose of this article is to propose the strategic instances of operationalizing interdisciplinarity as the key requirements to provide a guideline for designing interdisciplinarity activities. MATERIALS AND METHODS: The present survey was carried out through the framework synthesis method. To codify the instances of operationalizing interdisciplinarity, the main elements and structures of the model were set as the basis of the query for each element and structure; an independent query was carried out in the literature of the study. The correspondence of the discovered instances was once more compared with the conceptual boxes of the primary theoretical model. Ultimately, the taxonomy was concluded through the operational instances based on the primary framework. RESULTS: A total of 152 strategies were identified as implications of operationalization of 13 layers and 38 sublayers of the multilayer interdisciplinary model. CONCLUSION: The development of interdisciplinarity in the national higher education system requires several measures to be taken at different levels of a discipline or scientific field of study. Relying on this, which is the main basis of entering into interdisciplinarity activities, the present study suggests and presents strategic instances of interdisciplinarity operationalization.

Rethinking interdisciplinarity: Proposing a multilayered model.

Background: One of the efforts that solve complex real-world problems is to use an interdisciplinary approach. However, the contradictions among different disciplines and the absence of a theoretical model add to the difficulty of interdisciplinary activities. When interdisciplinary researchers face a complex problem, they need to integrate several different disciplines. It seems the first step in interdisciplinary activities is to have a theoretical model to understand and examine by what content and method the processes of integrating and crossing the disciplinary boundaries are done. The purpose of this study is to propose a new theoretical model for interdisciplinary development. It also show that a multilayered model can be formed based on the boundaries of scientific disciplines. Methods: In this study, the critical review strategy of Carnwell and Daly has been used to synthesize the theoretical model using online databases. The method consists of 5 stages: defining the scope of the review, identifying the sources of relevant information, reviewing the literature, writing the review, and applying the literature to the proposed study. Results: The results of this study showed for interdisciplinarity, the artificial boundaries of disciplines must be broken. Therefore, we first began to explain the disciplinary boundaries in 13 levels, then, we proposed interdisciplinary development by examining the views of the experts in this field and with the synthesis opinion of researchers of this study on each of the disciplinary boundaries of the multilayered model. Conclusion: This model can effectively support interdisciplinary programs and can bring the goals of interdisciplinary programs closer to practical reality.

Comparative Evaluation of Efficacy of "Green Tea" and "Green Tea with Xylitol" Mouthwashes on the Salivary Streptococcus mutans and Lactobacillus Colony Count in Children: A Randomized Clinical Trial.

AIM: Green tea is an antimicrobial agent that has beneficial effects on oral and dental health. The aim of this study was to compare the effect of "green tea" and "green tea with xylitol" mouthwashes on the salivary Streptococcus mutans and Lactobacillus colony count in children. MATERIALS AND METHODS: In this double-blind randomized controlled clinical trial, 64 children aged 6-12 years were randomly divided into two groups. Subjects were instructed to wash their mouth with 5% "green tea" or 20% "green tea with xylitol" mouthwashes twice a day for a period of 2 weeks. Salivary counts of bacteria were determined at the baseline and after 2 weeks of intervention. RESULTS: A significant difference was found between the average number of bacterial colonies between the two groups after intervention (p < 0.001). CONCLUSION: Findings of this study suggest that the effect of the "green tea with xylitol" mouthwash on reducing the number of salivary colonies of S. mutans and Lactobacillus is significantly higher than that of the "green tea" mouthwash. CLINICAL SIGNIFICANCE: The green tea mouthwash can be advised for dental and oral health of children. How to cite this article: Hajiahmadi M, Yegdaneh A, Homayoni A, et al. Comparative Evaluation of Efficacy of "Green Tea" and "Green Tea with Xylitol" Mouthwashes on the Salivary Streptococcus Mutans and Lactobacillus Colony Count in Children: A Randomized Clinical Trial. J Contemp Dent Pract 2019;20(10):1190-1194.

Persica Chewing Gum Effects on Saliva Fluoride Concentration and Flow Rate: A Triple-Blind Randomized Clinical Trial.

CONTEXT: Dental caries is a prevalent disease worldwide. Salvadora persica or Miswak could be a source of fluoride and has caries preventive effects. AIMS: The aim of this study was to compare saliva fluoride concentration and flow rate after using Persica and sodium fluoride chewing gums. SETTINGS AND DESIGN: In a triple-blind crossover randomized trial, 44 healthy volunteers (21-25 year old) were recruited according to the inclusion criteria and were randomly allocated into two groups (22 each). PARTICIPANTS AND METHODS: This study was performed within two sets of trial with a 10-day washout period. Participants (subjects) were followed a running period and matched for trial confounders. Saliva samples were collected under controlled conditions at similar time (11 am) within baseline, 5, 10, 20, and 45 min intervals preceded by 5-min chewing of Persica or sodium fluoride chewing gum. Saliva samples were analyzed for fluoride ion using hexamethyldisiloxane diffusion method. STATISTICAL ANALYSIS USED: Saliva flow rate (ml/min) and mean fluoride concentration (ppm) during different time periods in two types of gum were compared using ANOVA-repeated measures (P < 0.05). RESULTS: The difference in total means of stimulated saliva flow rates between two Persica and sodium fluoride gum intervention groups was statistically significant (P = 0.048); however, difference of fluoride concentrations was not statistically significant (P = 0.244). CONCLUSIONS: Chewing Persica containing gum released fluoride ions in saliva and increased saliva flow rate comparable with sodium fluoride chewing gum use as a gold standard.

Attitudes of Parents and Children toward Primary Molars Restoration with Stainless Steel Crown.

CONTEXT: Today, attention has increasingly been focused on the studies which include patient-centered consequences. AIMS: The study aims to investigate the attitude of parents and children toward the application of stainless steel crown (SSC) on primary molars. SETTINGS AND DESIGN: This cross-sectional descriptive study included eighty 4-6-year-old children having treated with SSC over the past 3-6 months. SUBJECTS AND METHODS: Eventually, a validated child- and parent-centered self-report questionnaire was filled, having 14 questions about demographic information, six questions about childrens' attitude, and eight questions about parents' attitude. STATISTICAL ANALYSIS USED: Data analysis was conducted using t-test and one-way ANOVA at significant level P < 0.05. RESULTS: In general, the score of children's attitude was positive, and the mean of attitude scores was obtained to be 9.9 ± 2.6; attitudes of 82.43% of children were good. Parents had neutral attitude; the mean of their attitude was obtained to be 20.2 ± 4.8. Only 53% of the parents scored good attitudes. CONCLUSIONS: The attitude score of children toward SSC was good and independent of age, gender, career, and education of the parents. Although the parents were not satisfied with how it appeared, the majority of them reported that their child had well accepted the crown.

Comparing the range of µ and ß angles in 6-17-year-old children of Isfahan with normal occlusion.

BACKGROUND: Linear and angular measurements such as A point, nasion, B point (ANB) angle and Wits appraisal index are not accurate enough to evaluate sagittal relationship of the jaws. The aim of this study was to evaluate and compare the range of µ and ß angles in 6-17-year-old children of Isfahan, having normal occlusion. MATERIALS AND METHODS: This was an analytical descriptive study. For this study, 235 cephalometric radiographs of patients who didn't receive orthodontics treatments and based on 13 indexes had normal occlusion, were selected. After tracing of cephalograms, ANB angle, Wits appraisal index, µ angle (resulted from the intersection of AB line and perpendicular line from point A to mandibular plane) and ß angle (resulted from the intersection of AB line and perpendicular line from point A on CB line) were measured. Data was analyzed by t-test, ANOVA and Pierson-Spearman correlation coefficient (P < 0.05). RESULTS: Mean value of µ and ß angles were 17.34 ± 3.47 and 31.7 ± 3.31 and ranged from 8-27 to 21.5-39 respectively. According to t-test, there was a significant difference between two sex groups for µ angle (P = 0.02); however, it was not significant for ß angle. According to Spearman correlation coefficient, there was no significant difference between age and µ angle; however, ß angle was directly and significantly related to age (r = 0.435). There was significant and reverse relationship between µ and ß angles with ANB angle and Wits appraisal index. CONCLUSION: µ and ß angles are reliable and can be used to evaluate the anterior-posterior relationship of the jaws.

Comparison of the efficacy of two anesthetic techniques of mandibular primary first molar: A randomized clinical trial.

BACKGROUND: The most common technique to anesthetize mandibular primary teeth is inferior alveolar (I.A) nerve block injection which induces a relatively sustained anesthesia and in turn may potentially traumatize soft-tissues. Therefore, the need of having an alternative technique of anesthesia with a shorter term but the same efficacy is reasonable. The aim of this study was a comparison of the efficacy of two anesthetic techniques of mandibular primary first molar. MATERIALS AND METHODS: In this randomized crossover clinical trial, 40 children with ages ranged from 5 years to 8 years whose mandibular primary first molars were eligible for pulpotomy, were selected and divided randomly into two groups. The right and left mandibular first molars of group A were anesthetized with infiltration and I. A nerve block techniques in the first and second sessions respectively. The left and right mandibular first molars of group B were anesthetized with I.A nerve block and infiltration techniques in the first and second sessions respectively. The severity of pain were measured and recorded according to sound-eye-motor scale by a certain person. Data was analyzed using Wilcoxon Signed Rank and Mann-Whitney U tests (P > 0.05). RESULTS: The severity of pain was lower in infiltration technique versus I.A nerve block. There were no significant differences between the severities of pain on pulpal exposure of two techniques. CONCLUSION: It seems that infiltration technique is more favorable to anesthetize the mandibular primary first molar compared to I.A nerve block.

Evaluation of efficacy of restorative dental treatment provided under general anesthesia at hospitalized pediatric dental patients of Isfahan.

BACKGROUND: General anesthesia (GA) allows dental treatment to be rendered under optimal conditions, theoretically ensuring ideal outcomes. The aim of this study was to determine the efficacy of restorative dental procedures performed under GA. MATERIALS AND METHODS: In this cross-sectional retrospective study, 305 pediatric patients who had been treated under GA 6 to 24 months before our survey at Isfahan's hospitalized dentistry center were examined. The examination was performed on dental chair with oral mirror and dental probe. The results were recorded in a special form for each patient for statistical analysis and evaluation of restorations to be successful or failed. Statistical analysis was performed by chi-square and fisher exact tests for comparison between success rates of restorations and Kendall's tau-b test for evaluating the effect of time on success rates of them (P < 0.05). RESULTS: Stainless steel crown restorations had significantly better results vs class I and class II amalgam and class I and class II tooth color restorations. All types of posterior tooth color restorations had statistically same results with amalgam restorations. Anterior composite resin build-up represented significantly low success rates. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up (P = 0.344 and P = 0.091, respectively). CONCLUSION: Stainless steel crown restorations had significantly better results vs other posterior restorations. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up in comparison of other restorations.

Comparing Streptococcus mutans and Lactobacillus colony count changes following green tea mouth rinse or sodium fluoride mouth rinse use in children (Randomized double-blind controlled clinical trial).

BACKGROUND: Green tea contains phenolic compounds which could be considered as an anticariogenic agent. In addition, there has not been any significant side effect reported compared to sodium fluoride. So it seems that any comparison between the effects of green tea extract on the level of cariogenic bacteria with sodium fluoride is beneficial. The purpose of this study was to compare the effect of sodium fluoride and green tea mouth rinses on the level of salivary Streptococcus mutans and Lactobacillus of children. MATERIALS AND METHODS: In a double-blind randomized controlled parallel study, 60 children (8- to 12-year old) were selected according to inclusion criteria and were randomly divided into two groups. Subjects were instructed to rinse their mouth with 0.05% sodium fluoride mouth rinse or 0.5% green tea mouth rinse, twice a day for 2 weeks. Before intervention and after 2 weeks, salivary levels of bacteria were measured. Bacterial level changes were compared using t-test (α = 0.05). RESULTS: Independent t-test showed no significant differences in the average number of bacterial colonies before and after intervention in both groups (P>0.05). According to the paired t-test there was a significant difference between the mean number of bacterial colonies, before and after intervention, in each group (P<0.05). CONCLUSION: Green tea mouth rinse resulted in significant reduction of colony number of salivary S. mutans and Lactobacillus which is comparable with sodium fluoride mouth rinse. Due to fewer side effects, it seems that green tea can be used with less concern compared to sodium fluoride in children.