Journal of Dental Medicine

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.