Journal of Dental Medicine

Oral health status and oral health related quality of life among patients with substance use in Isfahan province

Bahareh Tahani

Background and aims: Substance abuse is recognized as a serious public health issue. The aim of this study was to comprehensively assess the correlation between the substance use and oral health status as well as its impact on the quality of life of addicts in a multi-center approach.
Materials and Methods: In this cross- sectional and analytical study in year 2023, individuals with a history of addiction who visited addiction treatment centers in Isfahan province were recruited conveniently and examined through questionnaires (about demographic information, methods of substance use, oral health behaviors, the use of dental services, and perceived oral health) and clinical examinations. The oral health-related quality of life (OHQOL) was assessed using the OHIP-14 questionnaire. Clinical examinations assessed DMFT, gingival index, mucosal lesions, temporomandibular joint disorder, and treatment needs of the individuals. Data were analyzed using ANOVA, t-tests, and linear regression models (α=0.05).
Results: 232 individuals with age of 45 ± 9.9, mostly male (94.8%) and married (68.5%) were recruited. About 50% of individuals never brushed their teeth. A total of 123 individuals (53%) used substances with moderate harm intensity (opium, hashish and cannabis). Pigmentation was the most common oral lesion. The mean DMFT was 19.27 ± 3 and the perceived oral health mean was 4.53 ±2.98 (out of 10). A total of 187 individuals (80.6%) required prosthetic treatment. The mean OHQOL was 15.93 ± 11.6. Functional limitation had the lowest (1.53), and psychological discomfort had the highest score (3.31) among the seven domains of OHQOL. The linear regression model (P<0.001 and R2=24%) found that the use of high-risk psychoactive substances, oral health behaviors, and age contributed to changes in DMFT. The OHIP linear regression model (P<0.001 and R2=36%) revealed that the duration of addiction, perceived oral health, age, self-employment, government jobs, and retirement contributed to changes in OHIP.
Conclusion: Compared to the general population, addicts have poorer oral health behaviors and more oral health problems, which significantly reduce their oral health-related quality of life.

Evaluation of the accuracy of Trios5 intraoral scanner in determining the color of ceramic samples

Parisa Jafarzadeh Maleki

Background and Aims: Achieving reliable tools for accurate shade matching of ceramic samples is of great importance in restorative and aesthetic dentistry. This study aimed to evaluate the accuracy of the Trios5 intraoral scanner in determining the shade of ceramic samples using the Vita Classical Shade Guide (VC).
Materials and Methods: This in-vitro study involved scanning each ceramic sample 15 times by two independent observers using the Trios5 intraoral scanner. The detected shade of each sample was compared with the reference shades of the Vita Classical Shade Guide (VC) and the compatibility of the scanner’s results with the reference shades was assessed. The data were analyzed using SPSS24 software and Pearson correlation and paired t-tests and kappa coefficient at a significance level of 0.05.
Results: The highest accuracy of shade detection in both observers was found for shades A2, A3, A3.5, A4, B1, and C4, each with 100% accuracy. The lowest accuracy for both observers was noted for shade A1, with 0% accuracy. The mean overall accuracy for the first and second observers was 64.99% and 63.75%, respectively, with a total overall accuracy of 64.37%. A statistically significant interobserver agreement was observed (P≤0.005).for all shades except B2 (P=0.299).
Conclusion: The Trios5 intraoral scanner can be considered a useful adjunct tool for ceramic shade determination. However, for clinical applications, it is recommended to use it in conjunction with reference tools and complementary methods such as spectrophotometry or visual assessment by experienced clinicians.

Assessment of patients’ awareness regarding infection control principles in dental treatments

Meisam Moradi

Background and aims: Dental procedures carry a significant risk of transmitting viral and bacterial infections to both patients and healthcare personnel. Patients' awareness of infection control principles can play a crucial role in improving the safety of the clinical environment and promoting public health. This study aimed to assess the level of patients’ awareness regarding infection control principles in dental treatments.
Materials and Methods: This descriptive-analytical cross-sectional study was conducted in 2022 on 390 patients attending the Dental School Clinic of Babol University of Medical Sciences, Iran. Data were collected using a validated questionnaire consisting of 24 items related to infection control. Each correct answer was awarded one point. The total score and awareness level of participants were analyzed based on the gender, age group, educational level, and number of dental visits using independent samples t-test, chi-square test, and ANOVA in SPSS, with a significance level set at 0.05.
Results: The mean age of patients was 33.89 ± 13.24 years and 62.8% were female. The mean awareness score was 18.37 ± 3.21. A total of 76.4% of participants demonstrated a good level of awareness. The awareness mean score was higher in female than male patients (P=0.006). A statistically significant difference was observed in mean awareness scores educational level (P<0.001) and age group (P=0.01). However, no significant difference was found based on the number of dental visits (P=0.867).
Conclusion: Although, the overall level of patient awareness regarding infection control principles was acceptable, gaps remain in certain areas. The implementation of targeted educational programs is recommended to enhance patients’ awareness and to promote infection control practices in dental treatment settings.

Assessment of dental anxiety among patients attending general dental clinics in Babol in 2020

Meisam Moradi

Background and aims: Dental anxiety is one of the most common barriers to utilizing oral health services. It can lead to delayed dental visits, treatment avoidance, and worsening of oral health problems. This study aimed to assess the level of dental anxiety among patients visiting general dental clinics in Babol, Iran.
Materials and Methods: This descriptive-analytical cross-sectional study was conducted in 2020 on 400 patients over the age of 18 who attended private general dental practices in Babol and were selected through convenience sampling. Data were collected using the Persian version of the standard Dental Anxiety Inventory (DAI), consisting of 36 items rated on a five-point Likert scale (score range:
36-180), the validity and reliability of which have been confirmed in previous studies. Data were analyzed using independent samples t-test and analysis of variance (ANOVA) in SPSS, with a significance level set at 0.05.
Results: The mean age of participants was 31.61 ± 9.03 years, and 61.8% were female. The mean dental anxiety score was 129.52 ± 31.04 out of 180, indicating a relatively high level of anxiety among the participants. Dental anxiety was significantly higher in female (P=0.002) and single participants (P=0.007), while no significant differences were observed based on the age, occupation, education level, or number of previous dental visits (P>0.05).
Conclusion: The findings indicated a high level of dental anxiety among patients attending general dental clinics in Babol. It is recommended that educational, psychological, and communication-based interventions be implemented in dental settings to help the reduction of anxiety and improvement of patient care.

Comparison of the opinions of specialist dentists, general dentists, and general public regarding different labiopalatal tilt of maxillary incisor teeth on the beauty of a smile

Reza Faraji

Background and Aims: Dentists’(specialists and general practitioners) perceptions of smile esthetics, which are often shaped academically based on standard criteria and hard and soft tissue relationships, may differ from those of the general public and patients, potentially failing to meet patients’ expectations of treatment. This study aimed to assess and compare the views of dental specialists, general dentists, and members of the general public regarding the influence of different labio-palatal inclinations of maxillary incisors on smile esthetics.
Materials and Methods: This descriptive cross-sectional study was conducted in 2024 on general dentists, dental specialists, and laypersons. General dentists and specialists practicing in Mazandaran Province were recruited, while laypersons were selected through convenience sampling from patients attending the Faculty of Dentistry in Babol-Iran. One male and one female subject were chosen based on the clinical and lateral cephalometric criteria, and two photographs (neutral facial expression and smiling) were taken of each. After image editing, five final photographs of each subject were prepared and presented in a questionnaire to evaluate participants’ perceptions of smile esthetics according to different labio-palatal inclinations of maxillary incisors, rated on a five-point Likert scale. Data were analyzed using SPSS software with independent t-tests and ANOVA.
Results: A total of 92 laypersons, 47 general dentists, and 141 specialists (47 orthodontists, 47 restorative dentists, and 47 oral and maxillofacial surgeons) participated in this study. Across all three groups, the most attractive male smile was associated with the -5° inclination (medium negative), whereas, the most attractive female smile was rated at 0°. Conversely, the least attractive smile in all groups was the −10° inclination (severe negative) in female images. Photographs with −10° inclination received the lowest scores for both male and female subjects. Specialists assigned lower mean scores to the 0° inclination images compared to general dentists and laypersons.
Conclusion: The divergence between dentists’ and laypersons’ perceptions of the impact of different labio-palatal inclinations of maxillary incisors on smile esthetics highlights the need for greater attention to patients’ expectations and treatment goals.

Self-efficacy of dental students in dealing with oral pathologic lesions in Yazd dental faculty in 2023-2024

fatemeh owlia

Background and Aims: Student perspectives play a crucial role in evaluating educational systems. This study assessed the self-efficacy of dental students at Yazd Dental School in diagnosing and managing oral and maxillofacial pathological lesions.
Materials and Methods: This cross-sectional study was conducted among dental students from semesters 6 to 12. A total of 250 self-efficacy questionnaires, designed to evaluate students' abilities in lesion management, were distributed. The questionnaire covered biopsy procedures, differential diagnosis, and treatment planning. Data were collected using structured self-reporting methods and analyzed through SPSS version 16, employing descriptive and inferential statistics, including chi-square tests. The semester progression, gender, age, academic performance, and marital status were examined for their impact on self-efficacy. According to the mean and standard deviation obtained in this study, the scores were divided qualitatively.
Results: The response rate of the questionnaire was 91.6%. The average self-efficacy score was 80.30±14.72 (out of 150), indicating a moderate level of confidence. Performing biopsies had the lowest self-efficacy, while diagnosing and managing oral ulcers had the highest. Higher-semester students showed significantly greater self-efficacy (P=0.018), whereas variations based on gender, age, academic performance, and marital status were not statistically significant (P>0.05). Increased exposure to the clinical cases and theoretical knowledge contributed to a growth in self-efficacy over time.
Conclusion: Overall, the students demonstrated moderate self-efficacy in lesion management. Higher-semester students benefited from accumulated experience, though specific areas, such as biopsy procedures and lesion diagnosis, which require further emphasis. Future strategies should enhance teaching methods, clinical practice opportunities, and assessment approaches to prepare students for the practical challenges they will face.

Artificial intelligence in orthodontics: A narrative review

Yasaman Sanaee

Background and Aims: Artificial intelligence (AI) has emerged as a transformative force in various fields, including orthodontics. AI has demonstrated encouraging results in enhancing diagnostic precision, treatment decision, and outcome prediction. With the accessibility of different AI software, its utilization in orthodontics has grown significantly. In this review study, we examined various applications of artificial intelligence within the field of orthodontics.
Materials and Methods: A comprehensive search was conducted in the PubMed database using the keywords; “Orthodontics” and “Artificial intelligence” between 2020 and 2025. 643 articles were found in the initial search. After eliminating articles based on the inclusion and exclusion criteria, 293 articles remained for full-text review, and finally 38 articles were included in our review to obtain a comprehensive review of the applications of artificial intelligence in orthodontics.
Results: Today, artificial intelligence has been used in different stages of orthodontic treatment, including diagnosis, decision making, outcome prediction and education. It has shown high accuracy in many areas, including cephalometric analysis and treatment planning. However, enhancements are necessary in certain aspects, particularly in space analysis and the prediction of treatment outcomes.
Conclusion: Conducting systematic reviews focusing on each of these applications can provide a better perspective for clinicians to use this technology in their everyday practice.

Evaluation of stress resulting from mini-screw insertion and removal in the mandible using finite element analysis

Sousan Sadeghian

Background and Aims: Over the past two decades, the use of mini-screws in orthodontics has become increasingly common. Various factors such as design, length, diameter, and insertion angle of the miniscrew, as well as the quality and thickness of the patient's bone, would influence the success and stability of miniscrews. This study aimed to investigate the effects of miniscrew shape, cortical and cancellous bone thickness, and insertion/removal torque on the stress distribution in the mandibular bone surrounding the miniscrew.
Materials and Methods: This study was conducted using finite element analysis (FEA). Bone thickness parameters were extracted from the literature, and the mandibular bone along with cylindrical and tapered miniscrew models were simulated using ABAQUS software. By altering the relevant variables, the resulting stress were evaluated.
Results: An increase in both insertion and removal torque led to a corresponding rise in the stress around the miniscrew. Stress variations were more pronounced in tapared miniscrews in response to the changes in bone thickness and torque. The influence of cancellous bone thickness on stress distribution was found to be minimal.
Conclusion: Although, the tapered miniscrews offer greater retention and stability compared to the cylindrical types, their heightened sensitivity to variations in parameters such as bone thickness and torque necessitates cautious application.

Evaluation and comparison the effect of different polishing methods on surface roughness of two types of nano-hybrid composites

Alimohammad DoostHosseini

Background and Aims: Finding an appropriate method for polishing that can be used in dental practices to improve the longevity and ease of dental restorations is of great importance. The aim of this study was to evaluate the effect of different polishing methods on the surface roughness of two types of nano-hybrid composites, an in vitro study.
Materials and Methods: In this study, 42 samples in the form of discs (6 mm in diameter and 3 mm in thickness) of two nano-hybrid composites (Charisma Kulzer and EvoCeram Tetric IPS) were prepared. Each group had 21 samples (polymerized in a mold made of polyfluorohalide material) and were all shaded (A2 color). To prevent mirror-like reflections, each sample was covered. A 2 kg load was applied for 30 seconds on each sample, after which the composites were removed. The samples were stored for 7 days in deionized water at room temperature and in the dark. After this period, the samples underwent finishing and polishing procedures. Seven random samples from each composite group were polished using different methods: System Gloss Composite LUCIDA, EVE polishing discs, and EVE polishing discs + Cosmedent polish. The surface roughness was measured using a profilometer, and observations were made under a microscope. Data were analyzed using SPSS 25 software with t-tests, ANOVA, and the Bonferroni post hoc test.
Results: The two-stage method using EVE polishing discs showed significantly the lowest surface roughness in both types of composites (P<0.0001). The type of composite did not have a significant effect on initial surface roughness (P=0.067), but the polishing method had a significant effect on the surface roughness (P<0.0001). The difference in the mean surface roughness was statistically significant among different polishing methods for either type of composites (P<0.0001). The t-test analysis showed no significant difference in the surface roughness between the two types of composites with different polishing methods (P>0.05), except in the LUCIDA polishing system where a significant difference was observed in both groups.
Conclusion: The results showed that the polishing method had a significant effect on the surface roughness and not the type of composte. The use of EVE polishing discs effectively reduced the surface roughness in both types of nano-hybrid composites used in the present study.

Evaluation and comparison of quantity and quality of palatal bone in women and men for autogenous transplantation using CBCT imaging

Farzan Soltani

Background and Aims: Recently, the use of the palatal process as a source of autogenous bone graft has been considered. Given the anatomical limitations of this space, the assessment of available bone in this area can play an important role in the correct treatment plan. The aim of this study was to assess the amount and density of available bone for the preparation of autogenous graft from the maxillary palatal process using CBCT (Cone Beam Computed Tomography).
Materials and Methods: This cross-sectional analytical study was conducted by collecting CBCT images from 78 patients referred to one of the maxillofacial radiology clinics in Kermanshah in 2022 and 2023. All the patients had no signs of trauma, impacted teeth, pathological lesions, cleft palate, severe periodontitis, or extensive surgery, and also had all the teeth in the area of interest (right first premolar to left first premolar) and their bone growth was completed (age over 20 years). The CBCT images were collected and analyzed using the ondemand program. Different indices such as the area of each cross-sectional slice, bone volume (main variable) were measured with the help of mathematical formula, bone density, and incisive canal diameter. In order to test the hypotheses, the Smirnov-Kolmogorov test was used to check the normality of data, and since none of our variables were normal, we used Spearman and Mann-Whitney correlation tests.
Results: This study was conducted on 78 subjects with a mean age of 43 years, 39 of whom were female and 39 of whom were male. The mean bone volume obtained was 1.84 cm3. The highest bone density was observed in the lateral incisor region and the mean incisal canal diameter was reported to be 2.68 mm. According to the results of the Spearman test, none of the variables had a significant relationship with the age variable. According to the results of the Mann-Whitney test, there was no significant difference in bone density in the lateral, canine, and premolar tooth areas between men and women. However, available bone volume was associated with gender, and this amount was calculated to be greater in men than in women.
Conclusion: According to the findings of this study, the average bone volume in the anterior region of maxilla was 1.51 cm3 and the highest bone density was in the lateral tooth region. The average incisal canal diameter was 2.68 cm3 and the available bone volume was related to gender and this value was higher in men than that of women. However, there was no difference in the bone density between men and women.

Effect of methanolic extract of Zingiber officinale on expression of virulence genes of streptococcus mutans utilizing Real Time PCR

Narges Panahandeh

Background and Aims: To prevent dental caries, investigations have focused on finding new antibacterial and anti-biofilm agents without the drawbacks of the currently used synthetic agents. This study aimed to assess the effect of methanolic extract of Zingiber officinale (Z. officinale) on expression of virulence genes of Streptococcus mutans (S. mutans) using real-time polymerase chain reaction (PCR).
Materials and Methods: In this in vitro study, which was conducted in the year 1402, at the Microbiology Department of the Faculty of Medicine and the Faculty of Dentistry at Shahid Beheshti University of Medical Sciences, the methanolic extract of Z. officinale was obtained by the maceration technique. 10 clinical isolates of S. mutans were obtained from the patients with dental infection. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the extract against S. mutans were determined by the microtiter plate technique. The effect of extract on the expression of relA, comDE, brpA, gtfC, and spaP virulence genes by the clinical isolates was evaluated by the real-time polymerase chain reaction (PCR) technique. Data were analyzed by the Wilcoxon and Mann-Whitney tests (alpha=0.05).
Results: The mean MIC and MBC of the methanolic extract of Z. officinale against S. mutans were 32±11.8 and 64±26.12 mg/mL, respectively. The extract caused down-regulation of relA, comDE, brpA, and gtfC by 50%, 40%, 70%, and 70%, respectively. It also caused 4 times reduction in expression of spaP gene.
Conclusion: The methanolic extract of Z. officinale caused significant down-regulation of gtfC, brpA, relA, comDE, and spaP genes, indicating its optimal efficacy to control the virulence of S. mutans.

Effect of a corrective exercise course on thoracic spine alignment and balance in female dentists with increased thoracic kyphosis in Amol and Babol cities

Raheleh Ghaffari

Background and Aims: Musculoskeletal disorders are the most common and costly occupational injuries, and dentists are more prone to musculoskeletal problems than other medical professionals. This study aimed to investigate the effect of a course of corrective exercises on the alignment of the thoracic spine and balance in female dentists with increased kyphosis.
Materials and Methods: This research was a quasi-experimental study with a pre-test/post-test design, conducted in the field. Thirty female dentists from Amol and Babol cities (Iran) with increased kyphosis were selected using purposive sampling. The patients were randomly assigned into two groups: control (n=15) and intervention (n=15). In the pre-test, the thoracic curvature angle, static balance, and dynamic balance were assessed using a flexible ruler, the stork balance test, and the Y balance dynamic test, respectively. Then, the intervention group were assigned to perform the exercises for six weeks, while the control group only engaged in daily activities. After completing the exercises, the post-test was conducted. Paired t-tests and analysis of covariance were used to compare intra-group and inter-group differences.
Results: The statistical analysis showed a significant difference between the two groups in the thoracic curvature angle (P=0.001), static balance (P=0.001), and dynamic balance (P=0.001). The intervention group demonstrated significant improvement in these parameters compared to the control group.

Conclusion: Based on the results of this study, it is recommended that corrective exercises under the supervision of a specialist be included in the weekly exercise program of female dentists with increased kyphosis.

Evaluating the frequency of dental implants failure before and after prosthetic loading in several dental clinics in Yazd during 2018-2023

Mahnaz Hatami

Background and Aims: Despite significant advancements in rehabilitation of edentulism with implants, complications such as implant failure before and after prosthetic loading remain concerns. This study aimed to evaluate the frequency of dental implant failure before and after prosthetic loading in some of Yazd dental clinics between 2018 and 2023.
Materials and Methods: In this descriptive cross-sectional study, 1060 patients’ files from three public dental clinics were reviewed. These patients were treated by dental implants between April 2018 and June 2023. The collected data included patients’ age and gender, implant diameter, brand, and placement site, type of prosthesis, and fixture failure after surgical and prosthetic phases. Data were statistically analyzed by independent t-tests and chi-square tests.
Results: The mean age of patients was 55.25 ± 12.37 years and 56.3% were female. The frequency of overall implant failure was 3.4%. The implant failure rate after prosthetic loading was 2.8% in females and 2.3% in males (P=0.47). This rate was 2% and 1.9% for maxillary and mandibular implants, respectively (P=0.5). This amount was 2.4% in molar areas,1.7% and 1.8% in premolar and anterior regions, respectively (P=0.8). Implant failure rate was 1.3% in overdentures, 5.9% in cement-retained, and 3.2% in screw-retained prosthesis (P<0.001). This amount for implants with a diameter less than 3.75 mm was 2.6% and for those with a diameter more than 4.5 mm was 3.7% (P<0.001). Implants with a diameter less than 3.75 mm had a 2.6% failure rate, whereas those with a diameter greater than 4.5 mm had a 3.7% failure rate (P<0.001). The implants failure rate was 1.6% for Dio brand and 2.5% for Dentis (P=0.5).
Conclusion: The overall implant failure rate in this study was 3.4%, of which 1.5% occurred before and 1.9% occurred after prosthetic loading. The frequency of implant failure after loading was significantly associated with the implant diameter and prosthesis type. This was not related to the patient's gender, implant site, or the implant brand.

Prevalence measurement of musculoskeletal problems and its effect on quality of life in dental faculty members of Ahvaz University of Medical Sciences

hojatollah yousefimanesh

Background and Aims: A large number of dentists are exposed to all kinds of musculoskeletal disorders caused by this profession. This study was conducted with the aim of measuring the prevalence of musculoskeletal problems and its effect on the quality of life of faculty members.
Materials and Methods: The present study was a descriptive analytical study that was conducted by surveying faculty members of the Faculty of Dentistry, Ahvaz University of Medical Sciences in the form of a census. Standard Nordic questionnaires were completed to investigate musculoskeletal problems and quality of life questionnaire. Also, the dentists were asked to determine and mark the level of pain experienced based on the Visual Analogue Scale (VAS). Data was analyzed using t test and chi square test.
Results: In this study, 73 academic staff members were examined, 46 (63%) were women and 27 (37%) were men. The most pain and disorder in the past year was related to the neck (64.4%) and shoulder (56.2%) of participates. The participates that prevented from working because of back pain and of neck pain during the last 12 months were 32(43.8% ) and 31(42.5%), respectively. Most of them (63%) were under 40 years old and the majority have graduated from general and specialized courses, 57.5 % and 37%, respectively, for more than 10 years. In examining the quality of life, the highest score related to the physical function which was 76.98±25.38.
Conclusion: There was a significant statistical relationship between the gender, age and duration of graduation from general and specialized courses with the skeletal and muscular disorders. However, there was no significant statistical relationship between the different aspects of life quality and skeletal and muscular disorders.

A systematic review of dental caries detection on periapical radiography using machine learning

mehrdad Mehrdad Hosseini Shakib

Background and Aims: Dental caries is one of the most prevalent chronic oral diseases worldwide. Timely and accurate diagnosis of dental caries plays a crucial role in preventing lesion progression and reducing complications. This study aimed to systematically review the studies on dental caries detection using machine learning algorithms applied to periapical radiographs.
Materials and Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar databases up to the end of 2024. Inclusion criteria comprised studies using machine learning algorithms for detecting dental caries in periapical or intraoral radiographs. The quality of studies was assessed using the QUADAS-2 tool.
Results: From 825 initial articles, 13 studies met the inclusion criteria. All studies used Convolutional Neural Networks (CNNs) with various architectures including ResNet, VGG, Inception, DenseNet, and YOLO. ResNet-based models and their hybrid variants showed the best performance with diagnostic accuracy ranging from 82% to 98%. Comparison with human experts in 6 studies revealed that deep learning algorithms demonstrated similar or superior performance.
Conclusion: From the results, deep learning especially convolutional neural networks, had significant potential for improving dental caries detection in periapical radiographs. However, challenges such as limited high-quality training data and generalizability issues need further investigation.

Assessing the knowledge of dentists on dental adhesive system selection in Rafsanjan in 2023

Niloufar Jafari

Background and Aims: The development and regular use of adhesive systems has started to revolutionize many aspects of restorative and preventive dentistry. The success of adhesive restorations highly depends on correct application of them. Therefore, the present study was conducted with the aim of determining the knowledge of dentists in Rafsanjan city (Iran) in choosing correct dental adhesive systems in 2023.
Materials and Methods: In this cross-sectional descriptive study, all dentists working in Rafsanjan city were included. The data was collected by a valid and reliable electronic questionnaire, which included two parts of demographic information (gender, age, place of work and year of graduation) and the 12 multiple-choice questions aimed to assess respondents' knowledge regarding the selection of dental adhesive materials in combination with self-cure or dual-cure composites, anterior and posterior composite restorations, fiber posts, fissure sealants, primary teeth, anterior composite veneers, ceramic laminates, and non-carious cervical lesions. The scoring of this questionnaire was as follows: 0 to 3 correct answers = Low level of knowledge; 4 to 6 correct answers = Moderate level of knowledge; 7 to 9 correct answers = Good level of knowledge; 10 to 12 correct answers = Very good level of knowledge. The four answer choices included "etch-and-rinse (three-step)", "etch-and-rinse (two-step)", "self-etch (two-step)", and "self-etch (all-in-one bottle)". Then data were analyzed by parametric tests (ANOVA, t-test, and Pearson). The significant level was considered as P<0.05.
Results: Out of 91 dentists in Rafsanjan, 79 (86.8%) participated in the study, of which 35 (46.3%) were men. The average work experience was 3.49±3.96 years for men and 2.98±3.73 years for women. The average knowledge score was 4.38±2.16 out of 12 (4.29±2.23 in men and 4.45±2.12 in women). The results showed that there was no significant relationship between the knowledge score and the gender, age, work experience, and workplace (P>0.05).
Conclusion: According to the results which indicated the insufficient knowledge of dentists in choosing correct dental adhesive systems, it is suggested to pay more attention on teaching in this field at the dental schools. For graduate dentists, new and practical information about the choice of adhesive systems should be provided by continuous education programs.

The dual impact of artificial intelligence on human cognition: Balancing benefits and risks

Hadi Ghasemi

The rapid integration of artificial intelligence (AI) into various aspects of human life raises important questions about its potential benefits and drawbacks. As AI reduces our reliance on cognitive processes, we must consider its long-term effects on human cognition. While, the general use of AI is still relatively new, significant discussions and studies have begun to explore its impact on cognitive function. This letter aims to summarize findings from several studies, highlighting the dual nature of AI's cognitive effects and the necessity for a balanced and targeted approach to its use.
Some studies indicated that AI could enhance cognitive abilities. For instance, Haider et al. (1) conducted a cross-sectional study revealing that AI tools such as memory enhancement platforms and adaptive learning systems improved short-term and long-term memory, analytical thinking, and decision-making efficiency. A review (2) also found that AI-based interventions like brain training programs, promoted neuroplasticity and alleviate anxiety, particularly in older adults.
Conversely, another research highlights the negative effects of AI on cognitive function. Zhai et al. (3) conducted a systematic review demonstrating that prolonged use of AI conversational systems in education could hinder independent problem-solving and analytical reasoning, introducing risks such as algorithmic bias, privacy violations, and plagiarism. Furthermore, excessive reliance on AI has been linked to diminished critical thinking, creativity, and work ethic, potentially fostering psychological dependence and reducing motivation for deeper learning (1). Increased screen time and reliance on AI may also alter brain structure, resulting in reduced gray matter in frontal regions and impairing attention, memory, and socioemotional regulation (2).
The impact of AI varies across different age groups. In children, unsupervised AI use can impede language development and attention span. Among young people, social media and AI tools may contribute to anxiety, loneliness, and poor academic performance. For older adults, while cognitive training through AI shows promise, it necessitates support for digital literacy (2).
In summary, while AI can enhance cognition in certain contexts, its unchecked use poses risks to creativity, independent thinking, and ethical standards. For optimal outcomes, AI usage should be accompanied by human judgment and critical thinking skills must be integrated, and also overall screen time should be monitored and limited. Future research should prioritize prospective studies and develop specific guidelines for AI users across different ages and demographic groups, including students.

Assessing the relationship between temporomandibular joint disorder symptoms and sleep quality in dental students

Fatemeh Owlia

Background and Aims: Sleep quality may be a predictive factor for temporomandibular disorders (TMD) compared to other risk factors. Patients with TMD may experience quality-of-life problems such as sleep disorders and orofacial pain. Timely diagnosis of TMD can halt its progression in the initial stages and reduce its severity. This study aimed to investigate the frequency and severity of temporomandibular joint disorders and their co-occurrence with sleep quality among dental students in Yazd in 2023.
Materials and Methods: This descriptive study was conducted among 211 students at the Yazd Dental School. The Fonseca and PSQI questionnaires were used to determine the severity of TMD and sleep quality, respectively. Clinical examination was conducted to assess the symptoms of TMD. Additionally, demographic information such as gender, marital status, and place of residence was recorded. The data were analyzed using chi-square and t-tests.
Results: The final analysis was performed on 211 individuals, comprising 118 males (56%) and 93 females (44%). Among all the participants, 204 individuals (83.88%) had at least one symptom of TMD. The participants' most prevalent symptoms were jaw sounds, midline deviation, pain, and mouth opening limitation. There was no significant difference in the frequency of TMD symptoms, jaw sounds, jaw deviation, and limitation in opening, based on gender. Similarly, the prevalence and severity of TMD and their symptoms showed no significant association with residence or marital status (P>0.05). Although, a correlation was observed between the poor sleep quality and the severity of TMD, no association was found between the presence of TMD symptoms and poor sleep quality (P>0.05).
Conclusion: While, the frequency of TMD symptoms did not differ significantly between genders, the severity of TMD and jaw pain was significantly higher among female students. Individuals with poor sleep quality exhibited significantly higher severe degree of TMD.

Application of support vector machine for detection of unilateral posterior crossbite in children based on surface electromyography signal

Hadi Kalani

Background and Aims: Posterior crossbite is a common malocclusion disorder in the primary dentition that affects masticatory function. Therefore, early detection and treatment of crossbite teeth is essential to prevent further dental complications and guarantee proper jaw development. This study investigated a reasonable and computationally efficient diagnostic system for detecting characteristics between children with and without unilateral posterior crossbite in the primary dentition using the surface electromyography (sEMG) activity of masticatory muscles.
Materials and Methods: The present study was an experimental in vitro study that used sEMG signals and support vector machine (SVM) to develop artificial intelligence systems capable of decoding muscle activity for diagnosing the crossbite. The core idea of SVM is to find the optimal separating hyperplane that maximizes the margin between two classes (presence or absence of crossbite disease) in the sEMG signal. In this study, 40 children (4 to 6 years old) were selected and divided into unilateral posterior crossbite (UPCB) (n=20) and normal occlusion (n=20) groups. The sEMG activity of the bilateral masticatory muscles was recorded during two 20-s gum-chewing sequences. Then, the time domain and frequency domain features had been obtained. In this study, eighteen time domain features and nine frequency domain features were employed. Finally, these features were used as inputs to the SVM method for data classification and crossbite disease diagnosis. In this paper, four kernel functions of SVM including linear, 2nd order polynomial, 3rd order polynomial and radial basis function were considered.
Results: Based on the obtained results, the crossbite disease had a significant effect on the EMG signals. The results demonstrated that this disease affected the amplitude of the signal more than the frequency. Therefore, using the time features of EMG signals, the SVM method was able to provide a more accurate prediction of crossbite disease. The findings indicated that the mean absolute value feature achieved a 95% accuracy in predicting posterior crossbite. Finally, the results revealed that the RBF method could exhibit superior performance.
Conclusion: The proposed method can be utilized in clinical applications for diagnoses of unilateral posterior crossbite. The findings of the study showed an influence of crossbite on the electrical activity of the temporal and masseter muscles. Therefore, the crossbite problem can be reasonably diagnosed by an appropriate learning strategy using EMG signals.

Knowledge, attitude and practice of dental students at Arak University of Medical Sciences towards radiation protection principles in 2024

maryam mohebiniya

Background and Aims: Given the risks of repeated exposure to ionizing radiation in dentistry and its potential adverse effects on the health of patients, staff, and students, adherence to radiation protection principles is a fundamental priority in this profession. This study aimed to assess the knowledge, attitudes, practice, and behavioral predictors of dental students at Arak University of Medical Sciences regarding the radiation protection principles in 2024.
Materials and Methods: This cross-sectional analytical study was conducted as a census on 120 dental students during October 2024 to March 2025. Data were collected using a structured questionnaire, which included sections on demographic information, knowledge assessment (maximum score: 20), attitudes (maximum score: 55), and practice (maximum score: 16). The questionnaire used was a revised version of a standard instrument, the validity (CVR=0.62, CVI=0.79) and reliability (Cronbach's alpha >0.7 for all sections) of which were measured and confirmed. Data analysis was performed using SPSS27, with analytical tests including the Mann-Whitney U test, Kruskal-Wallis test, Spearman’s correlation, and predictive practice with asses test of linear regression.
Results: The number of 120 students with mean age of participants 23.59 ± 3.13 old years and 51.7% were male. The mean scores were as follows: knowledge (9.69 ± 2.51), attitude (27.88 ± 3.05), and practice (12.60 ± 1.06). A significant difference in knowledge was observed between the male and female students (P=0.035), which the male students’ scoring was higher. No significant differences were found in the attitude or practice between genders (P>0.05). Factors such as place of residence (dormitory or non dormitory), prior radiation protection training, age, GPA, and admission year showed no significant association with the knowledge, attitude, or practice (P>0.05). Based on the regression model, the greatest predictors of student performance were age (R2=0.247, P=0.015) and grade point average (R2=0.282, P=0.003).
Conclusion: While academic training effectively imparts knowledge of radiation protection, translating this knowledge into practical performance remains moderate and thus, highlighting the need for advanced hands-on training courses.

Comparison of oral health status, treatment needs, and oral health behaviors of 7–12-year-old orphan children in Esfahan with guardian children

Hajar Shekarchizadeh

Background and Aims: Orphaned children are one of vulnerable groups in society. The aim of this study was to compare oral health, treatment needs, and oral health behaviors of orphaned children under the protection of welfare organization with the guardian children.
Materials and Methods: In this historical cohort study, all 7–12-year-old children under the protection of welfare organization in Isfahan were compared with their classmates’ counterparts in 2019. Clinical examination recorded DMFT/dmft, plaque index, and treatment needs. Children were asked about their oral health behaviors including the frequency of tooth brushing, flossing, fluoride toothpaste, and snacking. Mann-Witney U test, Chi-Squared test, and Fisher's exact test served for analysis (P<0.05).
Results: The mean score of dmft and DMFT among orphaned children were 3.64±2.54 and 2.93±2.54, respectively, which showed no significant differences with comparison group (P>0.05). No significant difference revealed between the two groups in terms of mean number of deciduous teeth in need of treatment (P=0.175). Only the mean number of permanent teeth requiring treatment was higher in orphaned children (2.46) than that of the comparison group (1.28) (P<0.049). Also, the percentage of children with poor plaque index was higher in orphaned children (P=0.009). There was no significant difference between two groups regarding oral health behaviors (P>0.05).
Conclusion: No significant difference existed between orphaned children and their classmates’ counterparts in terms of dental caries index and oral health behaviors. Only plaque index and the number of permanent teeth requiring treatment was higher in orphaned children. Educational interventions are recommended to promote oral hygiene and to facilitate the orphaned children’s access to dental treatment.

A comparative study of the antibiotic prescription pattern used in the control of odontogenic infections between general dentists in Tehran and the pattern suggested by maxillofacial surgeons of Tehran University of Medical Sciences

nima dehghani

Background and Aims: Incorrect prescription of antibiotics for odontogenic infections can endanger patients' lives. This study aimed to determine the pattern of antibiotic prescription by general dentists in Tehran and to compare it with the guidelines recommended by maxillofacial surgeons at Tehran University of Medical Sciences in 2019.
Materials and Methods: A cross-sectional study was conducted on 141 randomly selected dentists in Tehran. The dentists reported their antibiotic prescriptions for various odontogenic infections by completing a questionnaire. The frequency of prescribed antibiotics was calculated considering the severity of the infection, penicillin sensitivity, pregnancy and lactation status of women, and children. These were compared with the guidelines suggested by 15 maxillofacial surgery specialists at Tehran University of Medical Sciences in 2019. Descriptive analysis and binary logistic regression were used. Data analysis was performed using SPSS software version 25.
Results: Among patients sensitive to penicillin with severe infection, 61% of the dentists prescribed the correct medication. The correct prescription rate was 0% in patients with severe infection, 24.82% in pregnant and lactating women with mild infection, 65.24% in children with mild infection, 62.41% in patients with mild infection and penicillin sensitivity, 36.69% in children with severe infection, and 33.82% in pregnant and lactating women with severe infection. The results showed that older dentists were significantly more likely prescribe antibiotics correctly for odontogenic infections (P=0.036, B=0.28).
Conclusion: General dentists in Tehran did not optimally prescribe antibiotics for odontogenic infections. Therefore, training courses to improve their clinical performance are essential.

Evaluation of diagnostic accuracy of panoramic radiography according to cone beam computed tomography in the detection of relationship between mandibular third molar teeth and inferior alveolar nerve

Aida Mehdipour

Background and Aims: Third molar teeth extraction is one of the common treatments procedure in dentistry. The proximity of mandibular third molar teeth to the inferior alveolar nerve canal may make the surgery challenging and cause adverse complications. The purpose of this study was to determine the accuracy of diagnostic and evaluation of panoramic radiography findings in two classification methods (Rood-Shehab and Tanaka) according to CBCT in mandibular third molar extraction surgery.
Materials and Methods: This cross-sectional analytical study was conducted on 65 patients of a private radiology clinic in Qom who had simultaneous panoramic and CBCT radiography. Panoramic and CBCT radiographs were imported into Scanora and Ondemand softwares, respectively. The relation of the mandibular third molar with the inferior alveolar nerve was evaluated according to Tanaka's classification and Rood-Shehab radiographic signs and compared with CBCT radiographs. Finally, the obtained data were analyzed by chi-square test, ROC curve and SPSS software version 24. The significant level was considered at P<0.05.
Results: Out of 65 samples, 23.1% were men and 76.9% were women. The mean age of participants was 26.9±8.77. There was a significant relation between the Tanaka's classification of panoramic radiographs and proximity to the nerve in CBCT radiographs (P=0.011). This relationship was significant when the number of radiographic signs of the Rood-Shehab classification increased (P=0.044). Root darkening and diversion of mandibular nerve canal signs of Rood-Shehab classification showed more diagnostic accuracy in the nerve canal contact determination than that of other signs.
Conclusion: The probability of contact of third molar root with the inferior alveolar nerve canal increases with increasing in the number of Rood-Shehab radiographic signs. The root darkening sign was more accurate and followed by mandibular canal diversion sign. Tanaka’s classification can be used in differentiating cases without contact to the nerve canal.

Evaluation of gutta-percha adaptation in curved canals prepared with M3 and Neoniti files by CBCT

Robab Farhang

Background and Aims: The foundations of a successful root canal treatment are adequate adaptation of the gutta-percha to the canal wall and the establishment of an impermeable apical seal. Despite the common use of M3 and Neoniti rotary files by dentists, no study has been conducted to examine the compliance of gutta-percha in curved canals prepared with M3 and Neoniti files using CBCT. The present study was designed and compiled with the aim of investigating the adaptation of gutta-percha in curved canals prepared with M3 and Neoniti files by CBCT.
Materials and Methods: This randomized controlled laboratory study was conducted ex vivo on 30 permanent human first molar teeth. The teeth were randomly divided into two groups (the first group with M3 and the second group with neoniti), after finding and fixing the appropriate canal path with the examined rotary files. All groups were filled with Single Cone method using F2 gutta-percha and AH26 sealer. Then, the gutta adaptation was assessed using clinical criteria (visual and radiographic) and after the specimens were evaluated using CBCT. All the images obtained from CBCT were converted into the JPEG format and then entered into image J software. The gap between the canal walls and gutta was measured in each canal, and the obtained data were analyzed using the Mann–Whitney U test.
Results: The results showed that the average and standard deviation of gap in M3 files (0.181 ± 0.089) was higher than that of Neoniti file (0.173 ± 0.033). However, no significant difference in the gutta-percha adaptation in curved canals prepared between the M3 and Neoniti files was observed (P>0.05).
Conclusion: Considering the acceptable adaptation of gutta-percha in canals prepared with M3 and Neoniti files, the use of these two files is recommended in curved canals.

A middle-aged man with rash and systemic inflammation: Diagnostic challenges revealing an occult dental abscess; Case report

Mohammad Rahimi

This article presents a challenging case of a 64-year-old man with episodic fever, urticarial rash, and arthralgia, prompting a detailed diagnostic process. Despite initial considerations of adult-onset Still's disease, the atypical symptoms led to further investigations, revealing a periapical abscess through a dental examination. The patient's symptoms significantly improved following dental intervention, challenging the initial diagnostic inclination towards a rheumatological disorder. This case underscores the importance of thorough physical examinations and interdisciplinary collaboration in reaching accurate diagnoses. The ultimate diagnosis of systemic presentation due to an occult dental abscess, highlights the need for a comprehensive approach to medical evaluations, considering various clinical aspects and avoiding diagnostics biases. This case study serves as a reminder of the evolving landscape of medical diagnostics and the continued significance of holistic patient assessments and physical examination as valuable practicing skills.

Assessment of anxiety and awareness of nursing and dental students at Isfahan University of Medical Sciences regarding COVID-19

Mohammad Hassan Samandari

Background and Aims: Due to their professional nature, dentists and nurses are in close proximity with patients and the droplets of infected patients can increase the risk of cross-transmission and viral diseases, especially COVID-19. Therefore, the purpose of this study was to evaluate the level of anxiety and awareness of the final two-year nursing and dental students at Isfahan University of Medical Sciences regarding COVID-19.
Materials and Methods: This descriptive, analytical, and cross-sectional study examined all the students studying in the last two years of dentistry and nursing, Beck Anxiety Inventory and online awareness questionnaire available to students were placed. The variables of this research included year of study, major, anxiety, and awareness. After collecting data using chi-square test and frequency distribution tables, the results were analysed using SPSS software version 23 and at an error level of 0.05.
Results: 429 students participated in the study, most of them were nursing students (58.7%) and the highest frequency of students was from the entry year of 2018 (29.6%). The average anxiety of nursing students in 2017 entry was 31.12 at severe level and in 2018 entry was 28.53 at moderate level. The average anxiety of dental students in 2015 entry was 33.93 at severe level and in 2016 entry was 36.65 at severe level. Also, the level of knowledge of nursing students was higher than that of dental students in most of the examined questions about corona virus and a significant difference was observed between students (P<0.05).
Conclusion: The level of awareness of nursing students was higher than that of dental students, and the level of anxiety in dental students was high. Recognizing the limitations of this cross-sectional study, itcan be concluded that only a small number of dental students had good knowledge about COVID-19. Students who had a higher year of education gave more correct answers. It is important to strengthen the knowledge about biosafety during the professional training of dental students in order to reduce the risks of contamination and cross-infection during patient care. It would be necessary to hold training courses to increase the level of awareness and to reduce students' anxiety.

Evaluation of the clinical consequence of untreated dental caries in visual impaired children in Isfahan-Iran

narjes Amrollahi

Background and Aims: The status of oral diseases in children with visual impairments is a topic of concern for dental researchers. The aim of this study was to evaluate the rate of dental caries in these children according to the PUFA index.
Materials and Methods: To evaluate the rate of tooth decay, sixty 6-12 year old children with visual impairments were selected by convenience sampling in 2022 in Isfahan-Iran. The examination and pufa/PUFA index (exposed pulp, residual root mucosal ulcers, fistulas, and abscesses) were recorded. Data were analyzed with Mann-Whitney tests (comparison of pufa/PUFA index according to gender, type of disorder and severity of disorder) and Spear-Man (examining the relationship between pufa/PUFA index and child age).

Results: The means of pufa/PUFA index in primary and permanent dental systشems were 0.89±0.68 and 0.44±0.2, respectively, of which the highest portion was related to the caries with pulp involvement. There was no significant relationship between the pufa and PUFA index according to gender, type of disorder, and severity of visual impairment (P<0.05). Also, only a significant and direct relationship was observed in pufa between the primary tooth system and age (P=0.042).

Conclusion: Untreated caries in children with visual impairment based on the PUFA index in primary and permanent dental systems had a relatively low prevalence. The highest PUFA index portion was related to the tooth decay with pulpal involvement. Furthermore, untreated caries in primary teeth were increased by increasing the children’s age.

Assessment of oral self-care among dentistry, nursing, and midwifery students

Hajar Shekarchizadeh

Background and Aims: Oral self-care among health care workers not only increases the oral health of individuals and their patients, but also improves the society's understanding of the prevention methods of oral disease. Therefore, this study aimed to investigate the oral self-care and compare it among dentistry, nursing, and midwifery students.
Materials and Methods: In this cross- sectional study in 2023, the HU-DBI questionnaire (Hiroshima University Dental Behavior Inventory) was applied to compare the oral self-care status among the first and final year students of dentistry, nursing, and midwifery. Volunteer students entered the study by a census sampling method. Data were analyzed using Spearman’s correlation coefficient, Kruskal-Wallis, and Mann-Whitney tests (P<0.05).
Results: In total, 348 students including 67% women participated in the study. No significant differences in the mean score of oral self-care were found (P=0.676) among the first-year dental students (5.01±1.71), nursing students (4.81 ±1.81), and midwifery students (4.79±1.63). The mean scores of oral self-care among the final-year students in dentistry, nursing, and midwifery were 6.71±1.59, 5.13±1.62, and 5.17±1.61, respectively. Dental students had a significantly higher score of oral self-care (P<0.001).
Conclusion: Oral self-care among medical students in Azad University of Isfahan was average. Although, dental students revealed a higher level of self-care compared to the nursing and midwifery students, more training in this field is necessary.

Investigating psychosocial effects and quality of life related to oral health in patients treated with composite veneers in Ahvaz in 2022-2023

neda Samie

Background and Aims: Oral health affects the quality of life and plays the main role in achieving optimal conditions of health and general well-being. Therefore, this study was conducted with the aim of investigating the psychosocial effects and quality of life related to oral health in patients treated with composite veneers.
Materials and Methods: In this cross-sectional study, 48 patients who referred to the restorative department of Jundishapur University of Ahvaz for composite veneer treatment were participated. The PIDAQ questionnaire was used to investigate the aesthetic effects of composite veneer treatment on the psychosocial conditions of the patients, and the OHIP-14 questionnaire was used to investigate the quality of life related to oral health. Patients were asked to complete both questionnaires before treatment and one month after composite veneer treatment. Also, demographic information including age, sex, education and marital status of the patients were recorded. The purpose and benefits of participating in this study were fully explained to the patients and the patients voluntarily participated in this study. Then, an informed consent form was given to the patients. In order to compare the scores before and after the treatment, the paired T-test and its non-parametric equation expression (Will-Coxon) were used, and P<0.05 was considered.
Results: According to the results, the average age of the respondents was 28 years. In terms of gender, 54.2% of the patients were male, and in terms of education, most of the participants in the study had a bachelor's degree (35.4%). The total score of OHIP-14 before treatment was 26 and after treatment 22. Also, the total score of PIDAQ before treatment was 49 and after treatment 28. Comparing the scores of psychosocial effects and quality of life related to the oral health before and after composite veneer treatment showed that there was a difference between the average score of psychosocial effects and quality of life. There was a significant difference related to the oral health before and after composite veneer treatment, which significantly decreased after treatment (P<0.05).
Conclusion: The present study showed that suitable veneer composite treatments could improve the oral health related to the quality of life of people. Also, treatment with composite veneers could have a significant effect on patients' self-confidence. Composite veneers could reduce social effects, psychological effects, and cosmetic concerns related to patients’ teeth.

Comparison of the general dental education program in Iran with several prestigious dental schools from Middle Eastern countries

Maryam Rabiei

Background and Aims: Educational planning is one of the main areas of education and training, which plays an essential role in the optimal training of human resources. The aim of this study was to compare the educational program (curriculum) of general dentistry in Iran with that of several prestigious dental schools in the Middle East countries.
Materials and Methods: This is a descriptive comparative study using the dental education curricula of six prominent countries in the Middle East in the field of dental sciences. Their selection was based on similarities and common cultural, economic and social characteristics. After collecting the selected curriculums, four steps including description, interpretation, juxtaposition and comparison were done. Tables were drawn based on goals such as the number of years of education, mission, general goals, and the role of graduates in the medical system of that country.
Results: The educational curriculum of the countries reviewed in the Middle East have many similarities in terms of the number of years of study in the field of dentistry, the general mission and goals, and the role of students in the medical system of that country. The main differences were in the number and type of teaching units in the curriculum of this countries. The method of teaching and the distribution of topics in the curricula of the countries differentiated them from each other. According to the results of this study, the curriculum of the countries of Iran, Saudi Arabia and the UAE were the most similar among the countries of the Middle East. The teaching method and distribution of topics in the curricula of countries distinguished them from each other.
Conclusion: Countries that are based on Russian language education have a shorter number of years of education and are similar to Russia. However, countries with an American educational base such as Saudi Arabia, the United Arab Emirates, and even Iran have a longer academic years and more general similarities in educational content.

Composite fiber membranes loaded with drugs in guided bone and tissue regeneration in periodontal diseases; A review

Zahra Mohammadi

Guided bone and tissue regeneration is a common technique used in the treatment of areas around teeth and dental implants. In this framework, barrier membranes are employed to create a suitable environment that promotes new bone growth while preventing the invasion of foreign cellular components into this specific setting. Attributes such as biocompatibility with living tissues, structural integrity, longevity, and user-friendliness constitute the principal criteria for selecting appropriate membranes for this particular application. Given the extensive diversity of membrane types concerning their sources, texture, architecture, and inherent properties, determining the most suitable variant depends on the clinical condition presented by the patient and the specific treatment modality, thereby emphasizing its considerable importance. In recent years, fibrous membranes have garnered particular attention due to their distinctive characteristics. These membranes, made of natural or synthetic fibers, typically exhibit high porosity, which facilitates the ingress of vascular structures and osteogenic cells. Owing to their porosity and flexibility, fibrous membranes are considered exceptionally suitable for the regeneration of maxillofacial and dental tissues, thereby contributing to increase bone volume, guide its growth, and at the same time prevent soft tissue encroachment into the restoration area, which ultimately has a favorable effect on treatment outcomes. On the other hand, due to the complexity and extent of oral infections, new nanotechnological approaches have been proposed in recent years to reconstruct infected sites in dentistry. These strategies, by targeting specific sites and having non-toxic properties, can help deliver antimicrobial molecules, regenerate tissue, and maintain oral health. In this context, nanofibrous membranes serve as multifunctional structures, both in the controlled release of antimicrobial agents and as scaffolds for the formation of nascent tissue. Overall, fibrous membranes, by mimicking the physiological conditions of the organism, create an ideal environment for the growth and healing of bone tissues, leading to improved effectiveness in dental procedures. This article is devoted in detail to a comprehensive review of polymeric and composite fibrous membranes with drug release potential.