Journal of Dental School

Objective(s): This study aimed to investigate the changes in salivary pH and flow rates during fixed orthodontic treatment with nickel-titanium (Ni-Ti) and stainless steel (SS) wires. Methods: A longitudinal clinical investigation was conducted among 43 participants undergoing fixed orthodontic treatment. Salivary pH levels and flow rates were measured at three time points: before treatment (T1), one month after placement of Ni-Ti 0.016 wires (T2), and one month after placement of SS 0.016 wires (T3). Repeated-measures ANOVA was performed to analyze trends over time, and pairwise comparisons with Bonferroni adjustment were used to identify significant differences between the time points. Statistical analysis was conducted at a significance level of 0.05. Results: A significant progressive decline in salivary pH levels was observed, with mean values decreasing from 6.85 at T1 to 6.71 at T2 and 6.68 at T3 (p < 0.001). Both linear (F = 128.360, p < 0.001) and quadratic trends (F = 19.680, p < 0.001) were evident. Saliva flow rates showed a slight but significant increase after wire placement (T2: 0.375 ml; T3: 0.374 ml) compared to baseline (T1: 0.358 ml), stabilizing thereafter (p = 0.003). Pairwise comparisons revealed greater pH declines after SS wire placement compared to Ni-Ti wires (p = 0.002). Conclusions: Fixed orthodontic treatment significantly affects salivary pH levels and flow rates, with SS wires exerting a greater impact on oral acidity. These results highlight the need for preventive strategies to mitigate potential adverse effects on oral health during orthodontic treatment.

Objective(s): The extent to which mothers' oral health, knowledge, and attitudes influence their children's oral health remains a subject of debate. Many researchers consider parents' inadequate knowledge and attitudes regarding their children's oral health to be responsible for poor oral health outcomes. This study investigated the level of knowledge regarding the prevention of dental caries and its impact on oral health-related behaviors among mothers. Methods: In this cross-sectional study, 196 mother-child pairs were selected, with children aged 5 to 12 years seeking dental treatment. A questionnaire was provided to the mothers, including demographic information, the mothers' oral health behaviors, the children's oral health behaviors, and the mothers' knowledge of methods for preventing dental caries. In addition, an oral health examination was conducted to measure the child's DMFT/dmft index. Quantitative variables were described using central tendency and distribution measures, while qualitative variables were reported using frequency percentages. T-test/Mann-Whitney were used to compare quantitative variables. For the comparison of qualitative variables, the Chi-square test was applied at p<0.05. Results: There was a significant relationship between the oral health behaviors of mothers and those of their children. Although mothers' knowledge of caries prevention was moderate, both mothers' and children's behaviors were unsatisfactory. No significant relationships were found between the mothers' knowledge and their oral health behaviors, their children's oral health behaviors, or the children's DMFT/dmft scores. Conclusion: Educational interventions should focus on improving mothers' oral health behaviors to promote oral health in children. Further studies are needed to evaluate the relationship between knowledge and its impact on oral health behaviors.

Objective(s): This study aimed to evaluate and compare the perspectives of endodontists and pediatric dentists on pulp regeneration treatments, the frequency of their use, and their methods of implementation. Methods: The study employed a cross-sectional design. The sampling process involved distributing questionnaires to all mentioned specialists practicing in Mashhad in 2023. Chi-Square test was utilized to assess the association between categorical variables with the significance level set at 0.05. Results: A total of 67 specialists completed the questionnaires. 50.7% were endodontists, and 49.3% were pediatric dentists. 59.7% of the respondents stated that they had received training in regeneration treatments, 32.3% stated that they incorporate it into their practice. 66.2% of the specialists expressed willingness to participate in regeneration treatment training courses. Of the participants, 58.5% considered it to be successful, and 66.7% believed it to be a superior alternative to dental implants. 44.9% identified high cost as the main barrier to patient acceptance. 62.1% regarded pulp revitalization as the most valuable outcome, and 57.6% agreed that it is the optimal approach for necrotic immature teeth. Conclusion: Only 33% of specialists offered regenerative treatment, with over 50% of them utilizing it in less than 10% of their overall treatments. Endodontists were more inclined to provide this treatment compared to pediatric dentists. Most of the experts expressed interest in participating in a training course regarding regeneration.

Objective(s): Oral health-related quality of life (OHRQoL) is widely used to assess how oral conditions influence both individuals and communities. The purpose of this study was to examine patients’ satisfaction with dental appearance and its association with OHRQoL. Methods: This cross-sectional survey included 400 patients who visited dental clinics in Bushehr, Iran. Information was obtained through a questionnaire covering demographics, perceptions of dental aesthetics, Oral Health Impact Profile-14 (OHIP-14) scale, and clinical dental findings. Data analysis was performed using Chi-square, independent t-test, linear regression, and ANOVA with a significance level set at p<0.05. Results: Among participants, 41.5% were male, with a mean age of 34.78 ± 12.14 years. Most participants had a diploma (37.5%), and reported a moderate economic status (52%). The mean scores for dental aesthetic satisfaction and OHRQoL were 10.10 ± 4.50 and 13.60 ± 4.50, respectively. No significant gender differences were observed. A significant positive correlation was found between satisfaction with teeth and OHRQoL (p < 0.001). Conclusion: The highest satisfaction was related to smile appearance (53.5%), while the lowest was with tooth color (31%). Satisfaction with teeth was significantly associated with better OHRQoL, emphasizing the importance of dental aesthetics in overall well-being.

Objective(s): The COVID-19 pandemic, caused by SARS-CoV-2, significantly impacted healthcare practices worldwide. Maxillofacial imaging centers were particularly affected due to their close interaction with patients and the use of aerosol-generating procedures. This study aimed to evaluate the changes in personal protective equipment (PPE) use, infection control protocols, and imaging practices before and after the pandemic in maxillofacial imaging centers in Tehran. Methods: This cross-sectional study used a before-and-after design to examine infection control and PPE protocol changes in maxillofacial imaging centers. A questionnaire that covered general information, patient triage, staff performance, and health protocols was distributed to 25 imaging centers and completed by the staff. Data was analyzed utilizing McNemar’s test to compare the conditions before and after the pandemic. Results: The study found a significant increase in the use of PPE among staff and patients following the COVID-19 outbreak. There was a 60% increase in mask usage by staff (P<0.05), and 72% of centers required patients to wear masks after the pandemic (P<0.05). Changes in ventilation systems and social distancing measures were also noted, with 27% of centers installing new ventilation systems after the pandemic (P<0.05). However, the sterilization of imaging equipment remained largely unchanged, with 98% of centers maintaining chemical disinfection practices.

Objective(s): The morphology and size of the nasolacrimal duct play essential roles in development of primary acquired nasolacrimal duct obstruction (PANDO), dacryocystitis, and Epiphora, in cleft palate patients. Furthermore, the treatment approaches for nasolacrimal duct obstruction require precise determination of the duct dimensions to select the most suitable treatment. The purpose of the present study was to assess the dimensions of the nasolacrimal duct in unilateral cleft palate patients through cone beam computed tomography (CBCT). Methods: In this observational-analytic study, 37 CBCT images of individuals with unilateral cleft were assessed. Nasolacrimal canal dimensions were measured at three segments; The entrance (proximal), narrowest part, and opening into the inferior meatus (distal) on the affected and unaffected sides. The length and angulation of the canal with the nasal floor were also assessed using OnDemand3D software. T-test and Shapiro-Wilk test were used for statistical data analysis at p<0.05. Results: The anterior-posterior dimension of the nasolacrimal canal in the distal segment was significantly lower on the affected side (p < 0.001). The mediolateral dimensions at the distal and narrowest segments were significantly lower on the affected side than the unaffected side (p = 0.03 and p = 0.04, respectively). No significant differences were observed between the surface area, length, or angulation of the nasolacrimal canal relative to the nasal floor on either sides (p > 0.05). Conclusion: The narrowest and distal segments of the nasolacrimal canal in unilateral cleft palate patients were significantly narrower compared to the unaffected side. This suggests an increased likelihood of conditions such as PANDO, dacryocystitis, epiphora, and other complications associated with a constricted duct in these individuals. However, the surface area, length, and angulation of the nasolacrimal canal in relation to the nasal floor were not influenced by the presence of a cleft palate.

Objective(s): Polyetheretherketone (PEEK) is a thermoplastic, semi-crystalline, aromatic polymer known for its excellent physical, mechanical, and electrical properties. This review has explored PEEK's properties and its diverse applications in the field of implantology. Methods: This systematic review was conducted based on the PRISMA guideline. All articles up to 2025 were searched in the PubMed, Google Scholar, Scopus, Springer Link, Science Direct, and Wiley databases using the relevant keywords. Among 170 relevant articles, the abstracts of 49 articles with the highest relevance to the topic were studied, and 25 articles with the highest relevance were selected and reviewed.  Results: This study categorized the diverse applications of PEEK in implantology as follows: Implant fixtures, Temporary abutments, Permanent abutments, Scan bodies, Temporary implant prostheses, and Healing abutments. While numerous studies suggest that PEEK represents the future of dental materials science, further clinical research is warranted. Conclusion: The use of PEEK fixtures can prevent stress shielding due to its closer elastic modulus to the surrounding bone. However, the use of PEEK as an implant fixture faces challenges due to low osseointegration, and the use of surface coating is recommended. The probability of gaps in the abutment and implant margin in PEEK is higher than in titanium. Screw loosening in PEEK abutments is twice that of titanium types. But PEEK can be a good alternative for temporary abutments. Plaque accumulation to coarse PEEK particles is higher and is not recommended as a healing abutment. Due to the lack of light reflection, some believe that the PEEK scan body is more accurate than titanium types; however, studies have shown the opposite. Because PEEK is more flexible than titanium and moves during torque, it reduces the accuracy of the final scan.

Objective(s): Lichenoid and granulomatous stomatitis (LGS) is a rare inflammatory condition of the oral mucosa that clinically mimics oral lichen planus, posing diagnostic and therapeutic challenges. Case: This report described three cases of LGS in adults aged 55–63, each presenting with persistent burning sensations and chronic ulcers of the upper labial mucosa. Histopathologic evaluation in all cases revealed features consistent with lichenoid and granulomatous inflammation. Despite initial misdiagnosis and ineffective corticosteroid treatment, all patients showed marked improvement with chlorhexidine mouthwash. Conclusion: Accurate diagnosis of LGS is essential due to its resistance to standard corticosteroid therapies commonly used for similar lesions. Chlorhexidine may be an effective alternative, and early histopathological confirmation is recommended for proper management.