Journal of Dental Medicine

Digital impression systems in prosthodontics: Current challenges, limitations, and future perspectives

Sareh Habibzadeh

Background and Aims: Digital impression systems have transformed prosthodontics by enhancing accuracy, efficiency, and patient comfort. Despite these advantages, their clinical adoption remains constrained by technical and operational challenges. This review aimed to critically evaluate the limitations of digital impression systems in the field of fixed and removable prosthodontics.
Materials and Methods: Relevant literature was searched in PubMed, Scopus, Web of Science, and Google Scholar databases. Scientific sources were reviewed for their contribution to understanding the limitations and challenges of digital impression systems in the field of fixed and removable prosthodontics. The selected studies were then analyzed descriptively, and their findings were interpreted to provide a comprehensive overview of the current challenges, limitations, and future perspectives of this technology.
Resulrs: Findings indicated that although digital impression systems could demonstrate high accuracy and reproducibility under controlled laboratory conditions, their clinical performance has been influenced by multiple factors. Operator experience, scanning strategy, and image stitching significantly could affect data accuracy. Environmental conditions such as moisture, light, and temperature might further compromise outcomes. Patient-related variables, including arch morphology, tooth preparation, implant presence, and restorative materials, also contributed to variability in results. Additionally, technical factors such as scanner design, software version, and scanning head size would play an imporant role.
Conclusion: Evidence suggests that while digital systems may outperform conventional impressions in controlled settings, clinical limitations persist. Therefore, optimized protocols and integration of digital and conventional techniques may enhance reliability and improve prosthodontic outcomes.

Identification of dental conditions in panoramic radiographs using a deep learning algorithm

Mehdi Akhoondzadeh Hanzaie

Background and Aims: Panoramic radiographs are routinely used for the assessment of dental conditions; however, their manual interpretation is time-consuming and highly dependent on the clinician's expertise. This study aimed to develop a deep learning-based U-Net framework for the automatic segmentation of four common dental conditions: dental caries, dental fillings, root canal-treated teeth, and impacted third molars.
Materials and Methods: This study was designed as the development of an applied model and was conducted in 2021 at the University of Tehran. Panoramic dental images were collected from publicly available sources. Two dentists collaboratively annotated the images and assigned labels corresponding to four dental conditions: dental caries, dental fillings, root canal treatment, and impacted wisdom teeth. To prevent data leakage, 10% of the entire dataset were initially reserved as an independent test set. Data augmentation were then applied exclusively to the training and validation data. Following augmentation, the remaining dataset were split into training and validation sets using an 80:20 ratio, respectively. A modified U-Net model was trained using preprocessed images resized to 512 × 512 pixels. Model performance was evaluated using Recall, precision, F1-score, and accuracy.
Results: The proposed model demonstrated promising performance in detecting the four target conditions. F1-scores, which were considered the primary performance metric because of potential class imbalance, were 73.56% for caries, 92.2% for fillings, 87.1% for impacted wisdom teeth, and 76.0% for root canal treatment. Precision values were 79.74%, 97.5%, 77.0%, and 61.2%, respectively, while accuracy values ranged from 98.4% to 99.5%.
Conclusion: The proposed U-Net-based framework demonstrated promising performance for the automated identification of dental conditions in panoramic radiographs and might facilitate computer-aided dental screening and treatment planning. Further validation using larger and more heterogeneous datasets are required to enhance the model’s generalizability.

Association between occlusal factors of primary teeth and bruxism in children aged 3–6 years old in Ilam city-Iran

maryam kazempour

Background and Aims: Bruxism or teeth grinding is a common parafunctional habit childhood that can lead to serious physical and mental complications. The etiology of bruxism remains unclear. However occlusal factors have been suggested as one of several possible contributors that may play a role in its onset.Therefore, the present study was designed to investigate the possible relationship between the occlusal factors and bruxism in children aged from 3 to 6 years old in the city of Ilam-Iran in 2022.
Materials and Methods: This cross‑sectional, descriptive‑analytical study was conducted in 2022. A total of 100 children aged from 3 to 6 years old were selected. During clinical examinations, the following occlusal factors were assessed in relation to bruxism: anterior and posterior crossbite, overbite, and overjet. In addition, a demographic checklist was completed by the parents. The statistical tests, Spearman's correlation index, trend test, and chi-square were used for data analysis in SPSS version 23, with a significance level set at 0.05.
Results: The results of this study showed that among 100 children with bruxism, 48% were boys and 52% were girls. There was a weak correlation between the age and gender with bruxism, which is not statistically significant (p=0.356) and (p=0.412). Flush terminal occlusion was observed in 42% of left-side and 39% of right-side occlusions, and the chi-square test revealed a significant association between this occlusal pattern and bruxism (p=0.001). The highest amount of dental facet (51%) was on enamel, with significant relationship observed between bruxism and anterior and posterior crossbite (p=0.663). However, a significant relationship was found between the bruxism, overbite, and overjet (p=0.003), demonstrating that the increased severity of overbite and overjet correlates with a higher rate of bruxism.
Conclusion: The study concluded that excessive overjet, normal overbite, flush terminal occlusion in both sides, and dental facet were significantly associated with bruxism among occlusal factors.

Investigation of the effect of temperature and time of hot-pressing operation on the structural and mechanical properties of lithium silicate blocks for dental applications

Mohammad Khodaei

Background and Aims: It is very important and practical to make machinable blocks with the ability to maintain the edge and at the same time have sufficient hardness for chewing. One of the most important groups of materials for making dental crowns and veneers for dentistry by CAD-CAM is lithium disilicate ceramics such that extensive research is being conducted in the field of modifying their structure and properties. All-ceramic restorations enhance the beauty of teeth due to their closeness to the tooth color and transparency. At the same time, these materials also have high biocompatibility. The main goal of this study was to evaluate the effect of hot-pressing temperature on the microstructure and mechanical properties of the lithium disilicate block fabrication.
Materials and Methods: The present laboratory study was conducted on the lithium disilicate blocks produced by powder metallurgy at Islamic Azad University, Khomeini Shahr Branch. In this regard, initially, the raw materials (including: Tetraethyl orthosilicate, Lithium nitrate, Triethyl phosphate, potassium nitrate) were processed by sol-gel method and the resulting frit (the glassy state of a ceramic) was crushed by a ceramic mortar. Then, the 3 groups of samples (n=3) were subjected to the hot-pressing at different temperatures of 750 and 900 °C for 60 minutes at a constant pressure of 200 kPa. Subsequently, the microstructure and elemental phases of lithium silicate samples were examined using scanning electron microscopy (SEM) and X-ray diffraction (XRD). Statistical analysis of the results was performed using one-way analysis of variance (ANOVA). A p-value of less than 0.05 was considered significant.
Results: X-ray diffraction results on the resulting powder before hot pressing showed the formation of a glass phase with lithium metasilicate and after hot pressing, the formation of a lithium disilicate phase. The results also showed that in all samples, the lithium disilicate phase was formed and had some porosity. In addition, with increasing the pressing temperature, the size of lithium disilicate particles increased. However, with increasing the hot-pressing temperature from 750 to 900°C, the amount of porosity decreased from about 23% to 20%.
Conclusion: The hot-pressing temperature had a significant effect on the microstructure and phases present in the produced ferrite sample. It was concluded that by changing the hot-pressing temperature, the microstructure and consequently the properties of the lithium disilicate blocks can be modified to achieve improved properties for dentistry applications.

Comparative analysis of crestal bone loss and Periotest Value in implants adjacent to edentulous areas, endodontically treated teeth with crowns, and healthy teeth

Ehsan Rafie

Background and Aims: Considering the importance of long-term implant stability and the potential influence of adjacent tooth and bone conditions, this study aimed to compare the crestal bone loss and Periotest Value in implants adjacent to edentulous areas, endodontically treated teeth with appropriate crowns, and healthy teeth.
Materials and Methods: This prospective cohort study was conducted at 1404 on 42 patients who attended Khorasgan Dental School (Iran) and required single-tooth implant treatment. The patients were enrolled through convenience sampling and allocated into three groups according to the condition of the adjacent tooth: Group A, implants adjacent to edentulous areas; Group B, implants adjacent to endodontically treated teeth with appropriate crowns; and Group C, implants adjacent to healthy teeth. Age and gender were matched among the groups. Three months after implant placement and healing abutment connection, standardized parallel periapical radiographs were obtained. Crestal bone loss was evaluated by comparing the baseline and follow-up radiographs. In addition, Periotest values (PTV) were recorded three times for each implant at a standardized buccal site after healing abutment placement, and the mean value was used for statistical analysis. Data were entered into SPSS 27 software and statistical analyses were performed using one-way ANOVA and Chi-square tests at a significance level of 95%.
Results: The distribution of patients in terms of gender and age was similar between the three groups (p≥0.05). The implant crestal bone loss in groups A, B and C was 0.72 ± 0.37, 0.68 ± 0.36 and 0.68 ± 0.39 mm, respectively. Also, the implant periosteum value in groups A, B and C was
-2 ± 0.55, -3.29 ± 3.52 and -2.5 ± 3.35 mm, respectively. No statistically significant difference was observed in the mean bone loss (p=0.939) and periosteum value (p=0.618) of the implant between the three groups of patients.
Conclusion: Based on the results of this study, it can be concluded that implant stability (based on crestal bone loss and Periotest value) did not differ in various regions adjacent to edentulous areas, endodontically treated teeth with appropriate crowns, and healthy teeth. Other factors are likely to have a greater impact on the implant stability.

Sol-Gel ceramic nanolayers on restoratives: Adhesion, optics, and antibiofilm performance; A review article

MohammadReza Rahimi Ghajour

This review article elucidates sol-gel thin films as an engineering tool for the targeted tuning of restorative interphases within the structure-process-property-performance framework. The primary focus is placed on how low-temperature solution routes, through precursor selection, adjustment of deposition parameters, and control of condensation schedules, can lead to network organization, pore distribution, and the formation of surface functionalities; the components that play a decisive role in interfacial adhesion, light transmission, and initial microbial adhesion. In the adhesion domain, siliceous interphases generated via surface infiltration or overlapping thin coatings create silanol-rich surfaces on yttria-stabilized tetragonal zirconia, thereby enabling durable bonding with methacrylate-based systems. Concurrently, the design of zirconia-silica mixed oxides mitigates local incompatibilities and facilitates uniform primer spreading. In the optical domain, refractive index engineering is pursued through the incorporation of porous silica or nanoscale organic-inorganic networks, strategies that target antireflective behavior, preservation of surface gloss, and increased tolerance to layer thickness variations via gradient structures. In biofilm control, visible-light-responsive titania coatings exhibit effective performance under clinical illumination conditions. In contrast, the siliceous matrices or ion-doped organic-inorganic systems provide localized release of silver or zinc ions and light-independent antibacterial effects. Key challenges reported for these approaches include balancing refractive index reduction and hardness retention, improving hydrolytic stability to mitigate the risk of embrittlement, and preventing undesirable photocatalytic effects on surface color and gloss. From a clinical translation perspective, reproducibility remains dependent on defining narrow processing windows, precise monitoring of layer thickness and surface roughness, alignment with common airborne-particle abrasion and silanization workflows, and judicious adjustment of light dose. Overall, sol-gel nanolayers provide a modular engineering toolbox for selective interphase reinforcement, optical tuning, and surface bioactivation, provided that layer structure and quality control are considered as central design variables.

Simultaneous occurrence of huge odontogenic keratocyst and vitiligo in a 12 year-old boy: A Case Report

zahra Gorji

Introduction: Odontogenic keratocyst (OKC) is an odontogenic lesion with aggressive biological behavior, which occurs mainly in the posterior region of the mandible. Late diagnosis and treatment of this lesion is a significant diagnostic challenge.
Case report: The patient was a 12-year-old boy with complaints of progressive and painful swelling in the mandible for the past two months. The lesion ranged from the right first molar to the left first molar of the mandible. Panoramic radiography revealed a large multilocular radiolucent lesion with well-defined borders, which had caused bone loss and displacement of adjacent teeth. Considering the extension of the lesion in the midline region, the young age of the child along with other clinical and radiologic findings, the diagnosis of OKC was suggested which was ultimately confirmed by histopathologic examination.
Conclusion: The extensive spread of the lesion in an unusual site of OKC occurrence, its growth pattern, and the simultaneity of its occurrence with vitiligo in this case highlight the importance of reporting this case.

Evaluation of the effect of vacuum-formed retainers (Essix) thicknesses on occlusal characteristics in patients undergoing fixed orthodontic treatment

Reza GhorbanipouR

Background and Aims: Post-treatment relapse is one of the common challenges in maintaining orthodontic results, and the selection of the type and characteristics of retainers plays a crucial role in treatment stability. Vacuum-formed retainers (Essix) are widely used due to their ease of fabrication, esthetics, and high patient acceptance. However, the effect of different thicknesses of these retainers on the preservation of occlusal characteristics has not been fully elucidated. The aim of this study was to evaluate the impact of Essix retainer thickness on maintaining occlusal characteristics.
Materials and Methods: This prospective cohort study was conducted in 2025 on 30 patients (23 females and 7 males) who had completed fixed orthodontic treatment at the Department of Orthodontics, Babol University of Medical Sciences, Iran. Patients were randomly assigned to two groups receiving Essix retainers of different thicknesses (1.5 mm and 1 mm) under similar retention protocols. The variables of overjet, overbite, inter-canine width, inter-molar width, upper arch length, and the dental irregularity index were measured immediately after debonding at 6 and 9 months of the retention phase. Data were analyzed using repeated measures ANOVA, and comparisons were made between the two groups.
Results: The results demonstrated that the use of 1.5 mm thickness of Essix retainers led to a significant increase in overjet over time (p=0.04), whereas the 1 mm thickness showed no significant change (p=0.22). Changes in overbite were not significant in either group (p=0.60) and the difference between the two groups at 9 months was also not significant (p=0.23). Inter-canine width (p=0.38) and inter-molar width (p=0.13) did not change significantly over time and the difference between groups at 9 months was not significant (p>0.05). Regarding the arch length, the 1.5 mm thickness showed significant changes (p=0.04), whereas the 1 mm thickness did not (p=0.16). However, the difference between groups at 9 months was not significant (p=0.44). The dental irregularity index decreased significantly in both groups (p≤0.001), but the degree of change between groups was not significant (p=0.35).
Conclusion: Based on the findings of this study, clinically, the thinner Essix retainers did not result in greater relapse compared to the thicker Essix retainers. Therefore, the selection of Essix retainer thickness can be based on the patient preference and clinician judgment, without a need to recommend a specific thickness definitively. However, further studies with longer follow-up periods are suggested to evaluate the long-term stability of treatment outcomes.

Letter to Editor: artificial intelligence in dental science: Machine learning perspective

Sajjad Bahariniya

Artificial intelligence as one of the transformative technologies of the present era, plays an increasing role in medical sciences, especially dentistry. Among the various branches of artificial intelligence, machine learning with its ability to analyze complex data, extract patterns, and provide accurate predictions, has provided a suitable platform for the development of smart dentistry. Modern dentistry faces challenges such as interpreting a large volume of radiographic images, early detection of lesions, selecting an appropriate treatment plan, and managing patient information. Challenges that can be largely resolved use machine learning algorithms. Today, deep learning models and artificial neural networks have found widespread use in analyzing dental images, diagnosing caries, predicting the success of restorative and implant treatments, designing prostheses, and supporting clinical decision-making. In addition, the integration of machine learning with technologies such as robotics, digital design, and intelligent patient monitoring systems has paved the way for precise and personalized dentistry. Despite the significant benefits of this technology, challenges such as data quality dependency, ethical issues, and the need for clinical validation has remained. Overall, machine learning has the potential to revolutionize the future of dentistry by increasing diagnostic accuracy, reducing human error, saving time and money, and improving the quality of service.

Evaluation of the educational environment of Ilam Dental School based on the DSLES questionnaire in 2023

Negin Neshanifard

Background and Aims: The learning environment is defined as anything that happens in a classroom or educational group, faculty or university. Evaluation of dental students’ opinions about their learning environment, can help those responsible to provide solutions for improving the quality and quantity of clinical education. One of the tools that quantitatively measures the environment and atmosphere governing dental education is DSLES (Dental Student Learning Environment Survey). Therefore, the aim of this study was to evaluate the educational environment of the Ilam School of Dentistry based on the DSLES questionnaire.
Materials and Methods: This descriptive-cross-sectional study was conducted on 114, clinical and pre-clinical students of the Ilam School of Dentistry were enrolled in the study in 2025. Data were analyzed using SPSS software (version 24). Total scores were analyzed using Student's
t-test and the significance level was set at p<0.05.
Results: The results showed that the educational environment of the dental school was in the medium to relatively desirable range in various dimensions, but none of the components reached the excellent level. The highest score was related to the "relationships between students" and the lowest score was related to the "flexibility of the educational program". "Relations between students" was the highest score among the components (p=0.002). Curriculum flexibility had the lowest score among the components (p=0.000). The results of the study indicated statistically significant differences between the preclinical and clinical students' perceptions of the educational environment (p<0.05).
Conclusion: The educational environment of the school of dentistry had a suitable basic structure but needed to be transformed. Focusing on increasing the flexibility of educational programs, strengthening responsiveness to students' needs (especially in the clinical period), and maintaining existing gender equity can lead to improving the overall quality of educational environment.

The relationship between oral and dental health information literacy of parents and dental caries index of permanent teeth in primary school students in city of Isfahan in 2024-2025

Firoozeh Nilchian

Background and Aims: Dental caries is a multifactorial chronic disease that affects the majority of the population, causing a very serious health problem worldwide This population-based cross-sectional study was conducted with the aim of evaluating the incidence of dental caries, parents' understanding of children's oral health, and factors affecting the use of dental services in the population of primary school children.
Materials and Methods: This descriptive-analytical cross-sectional study was conducted and the desired information was collected using the OHL-AQ questionnaire, the validity and reliability of which was confirmed in the previuos study. A total of 400 students between the ages of 6 and 12 were included in the study. The decay, missing, filling (DMFT) Index was used for calculating dental caries index. The statistical population of this research were the parents and students of the primary level of education in the six districts of Isfahan city in the academic year of 1402-1403. The sampling method was random cluster sampling. Then, the data collected from the examinations and questionnaires were analyzed by correlation tests, Independent Samples
T-Test and linear regression using SPSS software version 26, and the error level was 0.05.
Results: Among 400 students, the highest frequency (20.8%) was related to the second grade and the lowest frequency (12.5%) was related to the sixth grade of education. The average age of students' parents was 39.8 years. In most cases (56%) parents had university education. The educational level of students and the level of parents’ education had a significant relationship with the DMFT score (P<0.001). The average oral health information literacy score and average age of the parents had a significant relationship with the DMFT score (P<0.001). In this study, the average oral health information literacy score of parents was estimated to be 9.1.
Conclusion: In the present study, the information literacy score of the parents was evaluated as average and showed a significant relationship with the DMFT index. Also, the educational level of the student and the level of parents’ education had a significant relationship with the DMFT score. Therefore, it can be concluded that promotion of the level of education in the society is necessary as it can affect the level of oral health of children.

Statistical analysis of scientific research flow related to marketing strategies in dentistry in databases: A bibliometric analysis

Nasrin Razi

Background and Aims: The growing growth of dental services and the increasing competition among businesses in this field have made attracting new customers and retaining them a very difficult yet vital task for dental professionals. This has led to the emergence of the marketing function in dentistry and a look at international dental journals shows that in the past decades, researchers have paid increasing attention to the role of marketing in dentistry. They have examined and tested the impact and also how to formulate dental marketing strategies through theoretical studies and various scientific methods. For this reason, the purpose of the present study was to statistically examine the global trend of scientific productions related to marketing strategy in dentistry.
Materials and Methods: This research is a descriptive-analytical research in terms of its purpose, which was conducted using scientometrics and bibliometric analysis. In terms of time of this research, it is a cross-sectional research and based on the type of data, it is a quantitative research. The documents examined included all scientific articles published in English in the field of marketing strategy in dentistry, which were written by all researchers throughout the world until the end of 2025 and indexed in the PubMed, Web of Science, and Scopus databases. This research was conducted in January 2026.
Results: The results of the study indicated that the number of research related to the topic of "marketing strategies in dentistry" published in the PubMed, Web of Science, and Scopus databases from the beginning to 2025 was 365 documents and the dynamics of these researches were from 2017 to 2025. The largest number of researches was from 2025 with 40 works. The largest work in the field of marketing strategies in dentistry was by a researcher named Ball R with 10 scientific works. The British Dental Journal had the largest scientific production in this field with 23 works published. The largest number of researches in this field had been conducted in the United States with 225 works.
Conclusion: The results of the research indicated that marketing strategies today have taken a position beyond a mere marketing concept and have gradually emerged as a key process in dental research. The significant focus of scientific production on marketing studies, marketing strategies, and related outcomes in dentistry shows that marketing strategies play an important role in attracting patients, their satisfaction, the profitability of dental businesses, and the general health of society.

Assessment of relationship between maxillary and mandibular base length and dental crowding in individuals with different sagittal skeletal patterns in northern Iran

niki

Background and Aims: Dental crowding is considered a significant factor in the development of malocclusion. Identifying the factors contributing to its formation aids in selecting appropriate treatment strategies and achieving stable post-treatment results. Since the relationship between jaw base length and this factor remains unclear, the objective of this study was to investigate the association between the jaw base length and dental crowding in individuals with different skeletal patterns in the sagittal dimensio in north of Iran.
Materials and Methods: In this cross-sectional study, 42 individuals from each skeletal class (I, II, and III) were enrolled based on crowding of >4 mm and ≤4 mm, selected through census from all patients referred to the Orthodontic Department of Babol Dental School (Iran) between 2011 and 2025. These samples were examined for the association between jaw base length in each skeletal classification and dental crowding. Lateral cephalograms from before treatment were used to measure the jaw base length. T-tests, one-way ANOVA, and Bonferroni post hoc tests were employed to examine the desired associations, with a significance level of 0.05.
Results: A total of 126 patients (64.3% female) were evaluated. The relationship between jaw base length and crowding was not significant with respect to age, but it was reported as significant in females in the mandible (P=0.024). The present study indicated that the length of the maxillary and mandibular bases in the entire sample did not show a direct and significant correlation with the degree of dental crowding. However, subgroup analysis based on skeletal classes revealed significant differences in maxillary and mandibular base lengths between skeletal classes I, II, and III at both crowding levels (≤4 mm and >4 mm) (P=0.008, 0.011, and P<0.001, respectively). In the mandible, class III had the greatest length and class II had the shortest. In the maxilla, class III had the shortest length and class II had the greatest.
Conclusion: These findings suggest that sagittal skeletal patterns play a significant role in the dimensional changes of the jaws. Furthermore, in classes I and III, examining the mandibular base length is more important, as its reduction may be associated with more severe crowding. The maxillary and mandibular base lengths in the entire sample did not exhibit a direct and significant correlation with the severity of dental crowding. These variables were not significant with respect to age but were reported as significant in females in the mandible. Therefore, a single anatomical index like base length cannot solely predict the severity of crowding.

Application of plant-derived polyphenolic compounds in dental materials: Functional modulators for durability, biocompatibility, and biofilm control

Babak Akbari

This narrative review provides a comprehensive overview of the potential of plant-derived polyphenols in restorative and preventive dentistry. As natural bioactive compounds such as polyphenols reshape the oral microbial ecology by attenuating virulence, inhibiting quorum-sensing communication, disrupting extracellular polymeric substance (EPS) formation, and reducing acidogenicity within dental biofilms. Beyond their antimicrobial effects, polyphenols can protect host tissues, namely, enamel, dentin, and gingiva, by cross-linking collagen fibrils, suppressing matrix metalloproteinase (MMP) activity, and modulating inflammatory pathways. Experimental, in situ, and clinical evidence consistently demonstrated improved bond durability at the dentin–resin interface. The most compelling data support the use of primers containing proanthocyanidins, quercetin, epigallocatechin gallate (EGCG), and resveratrol. In preventive applications, catechin-based varnishes have demonstrated remineralization effects comparable to those of fluoride varnishes. Conversely, pomegranate extract–enriched mouthrinses, in the presence of fluoride, could enhance both anti-demineralization and antibiofilm activity. In the context of implants and dental prostheses, the polyphenol-functionalized coatings, particularly those based on tannic or caffeic acid, would reduce biofilm formation and provide corrosion resistance for metallic surfaces. Nevertheless, several formulation challenges remain, including rapid oxidation, limited solubility, and discoloration, all of which require careful management. Strategies such as dose optimization, solvent selection, covalent stabilization, and microencapsulation are recommended to overcome these limitations. For broader and more effective clinical translation, standardization of multispecies laboratory models and harmonization of clinical endpoints are essential. Furthermore, future longitudinal trials are needed to bridge the gap between laboratory findings and clinical performance. Ultimately, with the design of innovative delivery systems and long-term monitoring of parameters such as restoration survival, secondary caries, periodontal health, and color stability, polyphenols hold promise to define a new generation of antibacterial, biocompatible, and aesthetically stable dental materials.

Evaluation of the effect of tranexamic acid with Gelfoam carrier in preventing dry socket syndrome following surgical removal of impacted mandibular third molars

Masoud Hassanzadeh

Background and Aims: Dry socket is one of the most common complications following dental surgery. Therefore, effective prevention of dry socket can significantly improve patient recovery after tooth extraction. The aim of this study was to evaluate the effect of tranexamic acid combined with a Gelfoam carrier on the prevention of dry socket following surgical removal of impacted mandibular third molars.
Materials and Methods: This parallel randomized clinical trial was conducted in 2023 on 72 patients (40 in the intervention group and 32 in the control group) at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Islamic Azad University, Tehran Unit. In the intervention group, 250 mg of tranexamic acid powder was placed into the extraction socket and covered with Gelfoam, whereas the control group received sterile gauze only. The diagnosis of dry socket was made 2–3 days postoperatively by an independent surgeon. Statistical analysis was performed using the chi-square test, likelihood ratio, and Fisher’s exact test, with a significance level set at P<0.05.
Results: The incidence of dry socket was 7.5% in the intervention group and 34.4% in the control group. All statistical tests demonstrated a significant reduction in the occurrence of dry socket in the intervention group (P≤0.005). These findings are consistent with the physiological mechanism of tranexamic acid in inhibiting fibrinolysis and stabilizing the blood clot, resulting in a marked reduction compared with the control group.
Conclusion: Topical application of the tranexamic acid in combination with Gelfoam following extraction of impacted third molars is an effective, simple, and cost-effective method for the prevention of dry socket. For broader clinical recommendation, further studies with larger sample sizes, comparisons with existing standard preventive methods, and longer follow-up periods are suggested.

Survey of the level of awareness of parents of 6-12-year-old children in Khorramabad schools about fissure sealants in the academic year 2021

Samad Darabian

Background and Aims: Many oral health problems, including tooth decay mostly begin in childhood. Since decay in pits and fissures accounts for a higher percentage, it is of great importance to expand fissure sealant therapy, raise awareness and parents' attitudes towards preventive methods, especially fluoride and fissure sealant therapy. Therefore, the aim of the present study was to evaluate the awareness of parents of 6-12 year old children in Khorramabad city in Iran about the fissure sealant method for preventing tooth decay.
Materials and Methods: The present study was descriptive-analytical. In this study, 601 parents of 6-12 year old children in Khorramabad schools were evaluated using cluster sampling in the academic year 2021. The designed questionnaire included demographic information and questions that estimated the level of parental awareness about fissure sealants. Then, data were analyzed by the SPSS version 23 software and Pearson correlation, ANOVA, and T-test statistical tests.
Results: The mean age of the participants was 40.54 ± 8.09. 339 of the subjects had a bachelor's degree or higher. 17.3% of parents had a good level of knowledge. In this study, a statistically significant relationship was observed between the knowledge score and the variables of education level (P<0.02), oral hygiene education history (P<0.001), and time of visiting the dentist (P<0.05). However, no significant relationship was observed between the age, parental relationship, and economic status (P>0.05).
Conclusion: The findings of this study showed that the awareness score of most of the individuals participated in the study was low about fissure sealants, especially in the individuals with low level of education or no education. Therefore, more attention and serious attempts should be done to increase the parental awareness in this regard.

An investigation of the impact of oral health in children under six years old on family quality of life and its associated factors in Qazvin city, 2022

Razie Hosseininavaz

Background and Aims: Oral health is recognized as an integral component of general health andlike other health aspects, can significantly impact the quality of life of both the individual and their family. Due to their rapid physical and psychological development, children are particularly vulnerable to the adverse consequences of oral health problems. Accordingly, the present study aimed to investigate the impact of children's oral health on family quality of life and the factors influencing this relationship among children under six years old in Qazvin, Iran.
Materials and Methods: This cross-sectional study was conducted on the parents of 80 six-year-old children in Qazvin city in 2022. A convenience sampling method was employed, recruiting participants from among those attending the Dental School of Qazvin University of Medical Sciences. Initially, the child's demographic information (age, gender, birth order, and family socioeconomic status) was collected from the parents. Subsequently, they completed the Family Impact Scale (FIS) questionnaire. This questionnaire assesses the impact of a child's oral and dental problems on the family, utilizing four subscales. Subsequently, questions were asked regarding general health, oral and dental health, dental visits, and the services received. The collected data were then analyzed using descriptive and analytical statistics including variance, Pearson correlation, and T tests.
Results: 80 parents were enrolled in the study of whom 39 had a son and 41 had a daughter. The mean age of the studied children was 4.72±1.06 years, with an age range of 3 years (the youngest being 3 and the oldest 6 years old). Among the dimensions of family quality of life (FIS), the family finances subscale had the highest mean score (0.53 ± 0.68), while the family conflict subscale had the lowest (0.73±0.44). The overall mean score for family quality of life was 0.52±0.6. No statistically significant relationship was found between the outcome variable (oral health-related quality of life) and the independent variable of family economic status (P>0.05). However, a statistically significant relationship was observed with the independent variable of the child's birth order (P=0.002), indicating that the impact of the child's oral health on family quality of life would increase with a higher birth order. Furthermore, a significant relationship was found between the child's age and two subscales of family quality of life: family activity (P=0.03) and family conflict (P=0.006). Specifically, a younger child's age was associated with a greater impact of their oral health on the family's quality of life. There was a significant relationship between the child's general health and oral/dental health from the parents' perspective and the impact of the obtained FIS score (P=0.001 and P=0.04, respectively).
Conclusion: The findings indicated that a child's oral health status could impact the family quality of life, and this impact was associated with the child's age and birth order.

Investigation of the prevalence of missed MB2 canals in root canal-treated maxillary first molars using CBCT in patients referred to Borujerd dental school (2014-2018)

Hiva Ebrahimi

Background and Aims: Identification of the second mesiobuccal canal (MB2) in maxillary first molars is considered one of the major challenges in endodontic treatment. This study aimed to investigate the prevalence of missed MB2 canals using cone-beam computed tomography (CBCT).
Materials and Methods: This descriptive-analytical retrospective study was conducted on CBCT images taken in years between 2014 and 2018. The images were selected from patients who had undergone treatment on the maxillary first molars and had visited the radiology department of Borujerd dental school. Inclusion criteria were adequate image quality and presence of root canal treatment, while exclusion criteria included incomplete images and teeth lacking complete treatment. Image analysis was performed by an oral radiology specialist. Sample size was calculated using a statistical formula considering confidence level and study power. Data analysis was performed using descriptive statistics and Spearman’s correlation test in SPSS (version 18) at a significance level of P<0.05.
Results: Out of 90 patients examined, 59 cases (65.5%) had an MB2 canal, of which 56 cases (62.2%) had not been identified during initial treatment. The prevalence of MB2 canals was significantly higher in males than in females (P<0.01). No statistically significant association was found between the presence of periapical radiolucency and MB2 canals. In most cases, the MB2 canal orifice appeared as a separate opening.
Conclusion: The results of this study indicated a high prevalence of missed MB2 canals during initial endodontic treatment. The use of CBCT can play an effective role in detecting these canals and improving the success rate of endodontic therapy. Considering individual characteristics such as gender may aid in more accurate diagnosis.

Occurrence of ameloblastoma in an old man in an unexpected site: A case report

kimia mashayekh

Ameloblastoma is one of the most common benign tumors originating from odontogenic tissues. Despite being benign, it has a locally aggressive behavior and a high tendency to relapse. While, this tumor is mainly found in the posterior region of the mandible, its occurrence in the maxilla is rare and is associated with more diagnostic and therapeutic challenges. This report presents a rare case of ameloblastoma in the maxilla of a 64-year-old male patient who presented with painless swelling and significant extension of the lesion to the midpalate. Clinical, radiological, and histopathological findings were reviewed and after necessary evaluations, the diagnosis of ameloblastoma was confirmed. The anatomical complexity of the maxilla, proximity to vital structures, and surgical limitations make the management of these tumors more difficult. The present report emphasizes the importance of early diagnosis, careful histological examination, and the need for a multidisciplinary therapeutic approach in dealing with this type of tumor.

Awareness, performance and oral health behaviors among pharmacists and pharmacy staff in Isfahan regarding oral health

Background and Aims: Pharmacies can serve as an appropriate setting for the provision of oral health care, including preventive services, early detection, and referrals. The present study aimed to assess the awareness, performance and oral health behaviors as well as self-perceived oral health among pharmacists and pharmacy staff in Isfahan.
Materials and Methods: This cross-sectional study was conducted in 2024 using a random sampling method across pharmacies in Isfahan. In total, 176 pharmacists and pharmacy staff completed a standard self-administered questionnaire in person, regarding their awareness, performance, and behaviors related to oral health, as well as their self- perceived oral health. Data were analyzed using Chi-square test, Mann–Whitney U test, and Spearman correlation coefficient in SPSS software version 27 (P<0.05).
Results: Oral health knowledge was rated as poor in 34 individuals (19.3%), moderate in 89 (50.6%), and good in 53 (30.1%). Pharmacists’ knowledge score was significantly higher than that of other pharmacy staff (P=0.002). The most commonly reported service provided to clients by participants was offering analgesics for pain relief (61.9%). While, less than half of the participants reported providing information on oral hygiene (36.9%) or referring clients to a dentist (40.9%). Oral health behaviors including brushing teeth at least twice a day (80.4%), regular use of fluoride toothpaste (97.2%), visiting a dentist during the past year (55.1%), and non smoking (67.0%) were favorable among most participants. However, flossing (50.6%) and frequent snacking (65.3%) were unfavorable in majority of individuals.
Conclusion: Considering the moderate level of oral health knowledge and the presence of some unfavorable behaviors such as insufficient use of dental floss and frequent snacking, it is recommended to implement educational programs to improve knowledge and promote positive oral health behaviors

Assessment of anterior and overall Bolton ratios in various vertical skeletal patterns in population from northern Iran

Reza Faraji

Background and Aims: Bolton ratios—the anterior and overall ratios—are important indicators for assessing the dental proportionality between the maxilla and mandible, playing a crucial role in achieving ideal occlusion and successful orthodontic outcomes. Given individual variations in facial growth patterns and their potential influence on these ratios, the present study aimed to evaluate the relationship between Bolton ratios and vertical skeletal patterns in the population from northern Iran, as well as to investigate the effect of gender on these ratios.
Materials and Methods: In this observational-analytical study, 173 Class I orthodontic patients
(121 females and 52 males) with a mean age of 16.02 ± 4.51 years were evaluated. Based on the vertical facial pattern using the Jarabak index, the subjects were categorized into three groups: short face (n=52), normal face (n=67), and long face (n=54). The anterior and overall Bolton ratios, and overbite were measured from dental casts. Data were analyzed using Chi-square, ANOVA, t-test, and Pearson’s correlation coefficient in SPSS ver. 26, with a significance level set at 0.05.
Results: No statistically significant differences were found in the anterior and overall Bolton ratios among the three vertical facial groups (P=0.062 and P=0.36, respectively) or between genders (P=0.53 and P=0.42, respectively). In contrast, the mean overbite significantly differed among the groups (P<0.001). Comparison of the anterior (79.16 ± 3.88%) and overall (90.09 ± 6.89%) Bolton ratios with the original Bolton standards revealed statistically significant differences (P=0.001 and P=0.02, respectively).
Conclusion: According to the findings, neither the vertical skeletal pattern nor gender had a significant effect on Bolton ratios. Nevertheless, the observed differences between the ratios in this northern Iranian population and the original Bolton standards underscore the importance of using population-specific norms in orthodontic treatment planning.

Detection of SARS-CoV-2 RNA in aerosols of clinical and non-clinical areas of a dental clinic during the post-pandemic period

Seyed Hamed Mirhoseini

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Background and Aims: The SARS-CoV-2 virus, capable of airborne transmission through aerosols, poses a significant challenge in clinical settings such as dental clinics. The use of high-speed instruments, including handpieces and ultrasonic scalers, generates considerable aerosols that, if contaminated, may facilitate infection transmission. This study aimed to detect the presence of the SARS-CoV-2 virus in the clinical and non-clinical areas of a dental clinic.

Materials and Methods: In this cross-sectional study, 20 air samples were collected from various sections of the Dental School of Arak University of Medical Sciences. Sampling was performed using a pump equipped with a filter for two hours at a flow rate of 5 L/min and a height of 1.5 m above the floor. The samples were transported under a cold chain, the viral RNA was extracted, and then were analyzed using a specific RT-PCR kit.

Results: Out of 20 collected air samples, 3 samples (15%) tested positive for SARS-CoV-2 RNA. Two from clinical departments (restorative and fixed prosthodontics) and one from a non-clinical area (pre-clinic).

Conclusion: The findings of this study indicated that SARS-CoV-2 RNA was detectable in some air samples from both clinical and non-clinical areas of the dental clinic. These results highlight the importance of strict adherence to infection control protocols across all sections of dental clinics to minimize the risk of airborne transmission.

Prevalence of ponticulus posticus in different skeletal malocclusions types in population from northern Iran

Reza Faraji

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Background and Aims: Ponticulus posticus is a bony anomaly in the atlas vertebra that may have significant clinical implications, particularly when extreme head movements are required during treatment. The present study aimed to evaluate the prevalence of ponticulus posticus in different types of skeletal malocclusions in the population from northern Iran.

Materials and Methods: In this observational-analytical study, 246 lateral cephalometric radiographs of eligible individuals referred to two oral and maxillofacial radiology centers in Babol, northern Iran, in 2021, were included using convenience sampling and evaluated. Skeletal classification was determined using the ANB angle and Wits analysis. The presence of ponticulus posticus was evaluated across different skeletal classes, genders, and age groups. Data were analyzed using the Chi-square test in SPSS software with a significance level set at 0.05.

Results: Among the total sample, ponticulus posticus was observed in 104 cases (42.3%), of which 62 cases (25.2%) were of the partial type and 42 cases (17.1%) were of the complete type. The prevalence of this anomaly was significantly higher in males than in females (P<0.001). However, there was no statistically significant association between the presence of ponticulus posticus and skeletal class (P=0.222) or age group (P=0.483).

Conclusion: The findings of the present study indicated that ponticulus posticus was a relatively common anomaly, with a higher prevalence in males, and therefore should be taken into consideration. However, this anomaly neither appear to be a result of age-related calcification, nor can be used as a predictive indicator for determining skeletal class type.

Evaluation of the prevalence of root resorption in teeth adjacent to impacted maxillary canines using cone-beam computed tomography

Reza Faraji

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Background and Aims: Root resorption of teeth adjacent to impacted canines, although relatively uncommon, is a potentially harmful condition that may lead to tooth loss. Early diagnosis and the use of accurate imaging techniques play a crucial role in preventing from root resorption complications. This study aimed to evaluate the prevalence of root resorption in teeth adjacent to impacted maxillary canines using cone-beam computed tomography (CBCT) images.

Materials and Methods: In this retrospective observational-analytical study, 60 CBCT images of patients with impacted maxillary canines (15 bilateral case and 45 unilateral cases) were examined using a convenience sampling method among those referred to oral and maxillofacial radiology clinics in northern Iran, Babol, in 2023. Variables such as age, gender, position and direction of canine eruption, presence of root resorption in adjacent teeth, type of affected tooth, severity, and location of resorption were evaluated. Data were analyzed using the chi-square test in SPSS software at a significance level of 0.05.

Results: Among the studied CBCT (66.7% female; 70% over 18 years of age), 75 cases of impaction (41 cases on the right and 34 cases on the left) were observed. Root resorption in the teeth adjacent to the impacted maxillary canines was observed in only 7 patients (11.7%). All resorptions were mild and observed in the lateral incisors. In terms of vertical position, 85.7% of the cases occurred in the middle third of the root. There was no statistically significant association between root resorption and gender, age, or the position or direction of canine eruption (P>0.05).

Conclusion: Given the potential for root resorption in lateral incisors and in the middle third of the root, it is recommended that oral and maxillofacial surgeons and orthodontists perform a thorough initial evaluation of the canine’s position and adjacent teeth using CBCT imaging prior to treatment to prevent possible complications.

The effect of first premolar extractions on overall and anterior Bolton ratios in patients with bimaxillary dentoalveolar protrusion

Reza Faraji

Background and Aims: Bimaxillary dentoalveolar protrusion (BDP) is a common orthodontic anomaly characterized by protrusive dental arches and lip prominence. Extraction of the first premolars is a frequently employed treatment approach in these patients. However, the effect of this intervention on Bolton ratios-particularly the overall and anterior ratios-remains unclear. This study aimed to evaluate the impact of first premolar extractions on Bolton ratios in patients with BDP.
Materials and Methods: This experimental study was conducted on archived physical models of 34 Class I patients with BDP and functional lip incompetency (>4 mm) accompanied by lip protrusion, available at the Orthodontics Department of School of Dentistry, Babol, in 2024. All patients had a full complement of teeth from the first incisor to the first molar in each quadrant. After digitizing the models, mesiodistal tooth widths and the overall and anterior Bolton ratios were calculated. Digital simulation of first premolar extraction was performed, followed by reassessment of Bolton ratios. Pre- and post-treatment values were statistically compared using paired t-tests in SPSS (significance level set at 0.05).
Results: Among 34 studied casts, 67.6 % belonged to females. The mean overall Bolton ratio decreased significantly from 90.33 ± 2.23% to 87.72 ± 2.39%, and the anterior ratio declined from 78.19 ± 2.96% to 77.85 ± 3.03% (P<0.001). Additionally, 15 patients exhibited residual space post-treatment, primarily in the mandibular arch.
Conclusion: Based on the results of the present study, first premolar extraction significantly reduced both the overall and anterior Bolton ratios in patients with bimaxillary dentoalveolar protrusion. However, the likelihood of residual space—particularly in the lower arch-should be carefully considered during orthodontic treatment planning to ensure long-term stability and success.

Comparison of the effects of different adhesive systems on the bond strength of repaired composite restorations

Solmaz Charmi

Background and Aims: Repairing existing composite restorations, rather than replacing them entirely, is regarded as a conservative and tissue-preserving approach in restorative dentistry. However, achieving a durable bond between the aged and newly applied composite resin remains a significant clinical challenge. This study aimed to compare the shear bond strength of repaired composite restorations using three different adhesive systems.
Materials and Methods: In this in vitro study, which conducted at the Faculty of Dentistry, Urmia University of Medical Sciences, 60 disk-shaped composite specimens were fabricated with standard dimensions. After undergoing artificial aging (storage in distilled water for 6 months), their surfaces were roughened mechanically using a diamond bur. The specimens were randomly divided into three groups (n=20) and repaired using fifth-generation (Adper Single Bond), seventh-generation (OptiBond All-In-One), and universal (Single Bond Universal) adhesives, followed by the application of new composite. All specimens were subjected to thermocycling, and the shear bond strength was measured using a universal testing machine. Fracture patterns of the samples were also examined using a stereomicroscope to determine the modes of failure. Data were analyzed using one-way ANOVA and Chi-square tests in SPSS at a significance level of 0.05.
Results: The mean shear bond strengths were 15.22 ± 4.47 MPa for Adper Single Bond, 14.05 ± 4.66 MPa for OptiBond All-In-One, and 13.44 ± 4.68 MPa for Single Bond Universal. No statistically significant differences were found among the groups (P=0.468). Fracture pattern distribution was also not significantly different (P=0.453), with predominantly cohesive or mixed failures observed across all groups. No adhesive failures were observed.
Conclusion: Under standardized surface preparation, none of the tested adhesive systems demonstrated a statistically significant advantage in the shear bond strength between the aged and new composite. Therefore, the choice of adhesive in composite repair procedures can be guided by practical considerations such as product availability, ease of application, and dentist preference.

Prevalence of work-related musculoskeletal disorders among dentists in Babol

Meisam Moradi

Background and Aims: Musculoskeletal disorders (MSDs) are among the most common occupational health problems faced by dentists. Given their impact on dentists’ health and performance, the present study aimed to investigate the prevalence of MSDs among general and specialist dentists practicing in Babol, Iran.
Materials and Methods: In this cross-sectional study, the standardized Nordic questionnaire, consisting of general and specific sections, was distributed in person among dentists practicing in Babol, based on data obtained from the local Medical Council. Distribution was carried out after a telephone invitation and confirmation of willingness to participate. The questionnaire included items regarding pain and discomfort in different body regions such as the neck, shoulders, and lower back. The frequency of participants with MSDs was assessed based on gender, right/left handedness, specialty, playing sports, and participating in a specific sport. The mean age, weight, height, body mass index, weekly working hours, and work experience of dentists with and without MSDs were also compared. Data were analyzed using SPSS software version 22, employing independent t-tests, Chi-square tests, and Fisher’s exact test, with a significance level set at 0.05.
Results: Of the 182 dentists approached, 17 declined participation and 5 met the exclusion criteria. A total of 160 dentists (mean work experience: 15.65 ±9.26 years) were included in the study; of these, 100 (62.5%) were male, 95 (59.4%) were general practitioners, and 65 (40.6%) were specialists. The overall prevalence of MSDs in this population was reported to be 90%. The most commonly affected region was the neck (76.4%), while the least affected was the ankle (3%). A statistically significant association was found between engaging in a specific type of regular physical activity and a reduced incidence of MSDs (P<0.001). No significant associations were observed with other variables such as gender, handedness, specialty, or field of specialization (P>0.05). Furthermore, no significant differences were found in the mean height, weight, body mass index, weekly working hours, or years of experience between dentists with and without MSDs (P>0.05).
Conclusion: Musculoskeletal disorders are highly prevalent among dentists in Babol. Given this high prevalence, the development and implementation of educational programs on ergonomics, along with recommendations for targeted physical activity appear to be essential.

Evaluation of the anti-viral effects of combinations of cetylpyridinium chloride and nano-silver colloid on herpes simplex virus type 1

Elaheh Beyabanaki

Background and Aims: Despite documentation on the antiviral effects of cetylpyridinium chloride (CPC) and nano-silver colloid (Ag) on herpes simplex virus type 1, the synergistic effect of these two materials at different concentrations is unknown. This study aimed to evaluate the antiviral effect of various concentration combinations of cetylpyridinium chloride and nano-silver colloid on herpes simplex virus type 1.
Materials and Methods: This laboratory study conducted at the molecular virology department of Iran Pasteur Institute in the year 1400. After testing the cytotoxicity of different concentrations of CPC and Ag, the disinfecting effect of safe concentrations of each substance individually and also in the form of three compounds, was examined on the cells infected with herpes simplex virus type 1. The study groups included groups 1 to 6 with 0.01 µg/ml to 1000 µg/ml of Ag, groups 7 to 12 with 0.1 µg/ml to 10000 µg/ml of CPC, and combination groups of Ag 10 µg/ml + CPC 10 µg/ml (G13), Ag 10 µg/ml + CPC 1 µg/ml (G14), and Ag 1 µg/ml + CPC 10 µg/ml (G15). Data were analyzed using One-Way ANOVA and Games-Howell and Tukey HSD pair comparison tests at a significance level of 0.05.
Results: Based on the MTT test and the cell viability exposed to herpes simplex virus type 1, the highest number of living cells belonged to the 10 µg/ml Ag group, followed by 10 µg/ml CPC, 10 µg/ml Ag + 10 µg/ml CPC, 1 µg/ml Ag + 10 µg/ml CPC, and 10 µg/ml Ag + 1 µg/ml CPC groups. In terms of antiviral effect, there was a significant difference between group 1 and groups 3, 4, 5, 6, and 10 (P<0.001), between groups 2 and 3 (P=0.40), between groups 2 and 4 (P=0.041), between group 2 and groups 5 and 6 (P=0.035), between group 7 and groups 10, 11, and 12 (P<0.001), between group 8 and groups 10, 11, and 12 (P<0.001), and between group 9 and groups 10, 11, and 12 (P<0.001). Among combination groups, the most antiviral effect and the least cell toxicity was found in the 10 µg/ml Ag + 10 µg/ml CPC group, while the least antiviral effect was observed in the Ag 10 µg/ml + CPC 1 µg/ml group.
Conclusion: The highest cell viability rate belonged to the 10 µg/ml Ag group, followed by the 10 µg/ml CPC group, and their combination resulted in a reduction of its effect in this area. The antiviral effect of these materials individually was greater than in their combined state. Additionally , the most antiviral effect and the least cell toxicity was found in the 10 µg/ml Ag + 10 µg/ml CPC group among the combination groups.

New perspective of dentistry: Artificial intelligence and its role in the diagnosis of dental diseases; A review article

Mona Fazel Ghaziani

Background and Aims: In recent years, the use of artificial intelligence (AI) has become increasingly common in dentistry because it facilitates the process of diagnosis and clinical decision-making. It is necessary for dentists to be aware of the advantages and disadvantages of artificial intelligence before implementing it. The present study aimed to comprehensively review the various applications of artificial intelligence in the diagnosis of dental diseases along with its challenges and disadvantages.
Materials and Methods: For this review article, a complete search was conducted on the PubMed and Google Scholar databases and studies published in recent years as well as studies published in 2024 were collected using the keywords "artificial intelligence," "dentistry," "diagnosis." Finally, the relevant articles were selected and evaluated, focusing on artificial intelligence in dentistry and the diagnosis of dental diseases.
Results: Advances in artificial intelligence in dental imaging, particularly through machine learning (ML) and artificial neural networks (ANN), have dramatically transformed the way dental disease is diagnosed. These technologies help dentists to analyze complex information and produce more accurate results by using algorithms that allow systems to learn and respond to data. The most recent development in this area is deep learning (DL), which uses multiple layers of neural networks to process unlabeled data and predict outcomes. These techniques are used in various fields such as diagnostic imaging, periodontology, dental caries detection, and osteoporosis screening, which help to improve the quality of dental services. Despite the benefits of AI in clinical dentistry, three controversial challenges remain and need to be addressed: ease of use, return on investment, and evidence of performance, or reliability.
Conclusion: Based on the results, the most important advantage of AI is the diagnosis of dental diseases. AI has great potential to reduce the pressure on health systems by automating routine tasks and improving patient care. However, this technology can never replace human expertise and must be guided by ethical principles. Ultimately, AI is recognized as a valuable tool in dentistry and the final decision-making always remains with the dentist.

The impact of orthodontic treatment-related pain on patients’ orthodontic quality of life in Babol

Meisam Moradi

Background and Aims: Despite the functional and aesthetic benefits, orthodontic treatment is often associated with pain and discomfort that can adversely affect patients’ quality of life. Given the growing emphasis on the patient-reported outcomes in clinical care, this study aimed to investigate the association between the pain intensity caused by orthodontic treatment and orthodontic-related quality of life in patients undergoing fixed orthodontic therapy.
Materials and Methods: This descriptive-analytical cross-sectional study was conducted in 2022 on patients receiving fixed orthodontic treatment with a metallic MBT system (slot 0.022 inch) at a private clinic in Babol, Iran. A total of 85 patients aged 15–25 years were selected using convenience sampling. Pain intensity was assessed using a visual analog scale (VAS) ranging from 0 to 10. Quality of life was evaluated using the persian version of the Orthodontic Quality of Life questionnaire, with a scoring range of 22 to 88. Data were analyzed using independent samples t-test and Pearson’s correlation coefficient in SPSS, with a significance level set at P<0.05.
Results: Among the participants, 72.9% were female, 68.2% were under the age of 20, and 31.8% were aged between 20 and 25 years. The mean pain score was 4.75 ± 1.91, and the mean Oral Health Related Quality of Life (OHRQoL) score was 37.95 ± 9.51. A significant negative correlation was found between the pain intensity and overall OHRQoL, as well as all of its subdomains (oral function, social impact, dentofacial aesthetics, and self-awareness of appearance) (P≤0.001). No statistically significant differences in pain or OHRQoL scores were observed based on gender or age group (P>0.05).
Conclusion: Orthodontic pain has a significant negative impact on patients’ quality of life. Early pain management strategies and supportive interventions during the initial phases of orthodontic treatment can enhance patients’ overall treatment experience and improve compliance.

Assessment of awareness and attitudes of general dentists in Yazd toward digital dentistry: Emphasis on educational needs

Fatemeh Karamad

Background and Aims: Given the rapid growth of digital technologies in dentistry, assessing dentists’ awareness and attitudes toward this transformation is essential. This study aimed to evaluate the awareness and attitudes of general dentists in Yazd-Iran toward digital dentistry in 2025.
Materials and Methods: In this descriptive-analytical study, 135 general dentists in Yazd-Iran were selected through convenience sampling. Data were collected via an online questionnaire including demographic information and the questions related to awareness and attitude. Dat were analyzed using SPSS version 27 and the statistical analysis tests were Mann-Whitney, Kruskal-Wallis, and Chi-square to examine the variables.
Results: A total of 59 men and 76 women with a mean age of 31.92 ± 7.87 years participated in the study. The mean knowledge score was 7.76 ± 2.77 out of 12. Higher knowledge and a more positive attitude were significantly associated with older age, longer work experience, and male gender (P<0.05). Overall, 74.1% of participants were unaware of the well-known CAD/CAM system, 74.8% were unfamiliar with digital implant software, and 60% did not have adequate knowledge of correct application of intraoral scanners. While, 81.5% reported an overall positive attitude, only 11.9% considered their knowledge to be aligned with modern digital technologies.
Conclusion: General dentists demonstrated a moderate level of awareness and the existing knowledge gaps warrant greater attention in both undergraduate and continuing education. Enhancing knowledge among specific groups-such as younger, less experienced, and female dentists—is essential. Significant differences in attitudes were observed according to the age, gender, and years of professional experience.