Journal of Dental Medicine

Background and Aims: Considering the regulatory role of vitamin D3 in the immune system, this vitamin may be able to prevent autoimmune diseases by modulating the immune system, so this study was conducted with the aim of comparison of the serum level of vitamin D3 in patients with oral lichen planus and healthy persons.
Materials and Methods: In this case-control study, the serum vitamin D3 level of 80 people, including 40 patients referred to Guilan dental school who were suffering from oral lichen planus and 40 healthy individuals referred to the laboratory for routine check-up, after matching for age and gender, was investigated. Data based on the type of variable were analyzed using independent t-tests, Mann-Whitney, Chi-square test, and Fisher's exact test using SPSS26 software at a significance level of 0.05.
Results: In this study, 80 person participated, including 29 women (72.5%) and 11 men (27.5%) in each of two groups of patients with an average age of 52.17 ± 12.12 years and healthy people with an average age of 52.10 ± 12.23 years. The average serum level of vitamin D3 in the control group was significantly higher than the case group (P=0.006). There was no statistically significant relationship between the vitamin D3 serum level and different types of oral lichen planus, gender, duration of disease, and age.
Conclusion: Considering the significant lower mean serum level of vitamin D3 in people with oral lichen planus; vitamin D3 may be effective as a supplement in the healing process of patients' lesions.

Background and Aims: To be successful in root canal therapy, the dentists must be aware of the possible variation in the root canal and should know not only the natural anatomy of the pulp, but also a variety of possible morphologies. Frst of all, the dentists should be familiar with the possible anatomy of the root canal and then with the extraction of organic tissue from pulp chamber and root canal, increasing the chances of treatment success. Therefore, in this study, we decided to investigate the internal anatomy of root canals in the maxillary permanent molar teeth in Khoy city. Materials and Methods: In this in vitro study, 100 extracted human molars in Khoy city in West Azerbaijan province were collected. In all teeth, the access cavities were prepared, then they were decalcified and colored with India ink and evaluated by clearing technique. Data were collected based on Vertucci's classification which entered into SPSS23 software. The descriptive statistics in the form of numbers and percentages in tables and graphs were used to analyze the data. Results: The most common type observed in the mesiobuccal root of the first molars was type IV by 44%, in distobuccal root was type I by 92%, and in palatal root was type I by 94%. Also, in the mesiobuccal root of the second molars, the most common type was type I by 70%, in distobuccal root was type I by 94%, and in palatal root was type I by 96%. Conclusion: The mesiobuccal root of the first molar had the most variation in the internal anatomy. Also, the most common type of Vertucci in the mesiobuccal root of first molar was type IV and in the other roots of the first and second molar teeth was type I.

Background and Aims: Nowadays, the requirement of any policy-making at the national and regional level is to know the level of knowledge of people about oral health and ways to prevent dental caries.  This study examined the habits, actions and economic level of elementary school students in Qazvin city in 2017-2018.  Also, the effects of peer group social network on behaviors related to oral health and obesity was investigated in order to find the way for interventions making it more effective in this social group. Materials and Methods: In this descriptive-analytical study, 145 students participated. They were in the 3nd and 6th grades of elementary school in the academic year of 2017-2018. The questionnaire used in this study had 20 questions and 4 main sections. The main parts of this questionnaire included demographic characteristics, behavior and habits related to oral health, oral health knowledge of students and families, and socio-economic status. Data were collected through clinical examinations and through valid questionnaires and evaluated using SPSS and Excel software. Results: According to the results of Pearson's correlation analysis, a significant correlation was observed between the health knowledge scores of individuals and their friends between both groups of casual and close friends (P<0.01). The correlation between the knowledge of individuals and close friends was significantly stronger (P<0.01). Also, there was a significant relationship between socio-economic status and behaviors related to oral health (P<0.05). There was also a significant positive relationship between the number of times close friends brushing their teeth in a social network (P<0.001). This connection was not observed in the friends’ network. Conclusion: This study determined that close friends can be effective in determining the oral hygiene behaviors of elementary school students.

Background and Aims: Multiple sclerosis (MS) is an autoimmune disease. Oral manifestations in these patients include paralysis or spasm of facial muscles, temporomandibular joint disorders (TMJ), trigeminal neuralgia, dysphagia, or dysarthria. The aim of the study was to investigate the characteristics of orofacial pain in patients with MS.
Materials and Methods: The current cross-sectional study was conducted on 250 patients with a definite diagnosis of MS referred to Iran MS Association and Iran MS Research Center. The patients were in the age group of 17 to 57 years and were selected completely randomly. Data were obtained based on two checklists and clinical examination. Finally, DC/TMD criterion was used to check TMD problems. Then the data was analyzed by SPSS version 26 software and by Fisher's Test.
Results: The prevalence of MS disease was higher in women and the average age of patients was 37 years and the average duration of MS disease among patients was 8 years. The most common pain was related to shooting and shock-like pain with a frequency of 40.4% and the lowest quality was related to dull and diffuse pain with a frequency of 5.3%. In total, 24.5% of patients with buccal-oral pain had TMD, and in this case, the DC/TMD criterion was used.
Conclusion:  Temporomandibular disorders and shooting and shock-like pains are usually observed in a number of patients with MS.  As a result, dentists should be aware of the presence of these pains in the patient, the pain trigger, and the drugs used by the patients, in order to provide medical services and being aware of drug interactions.

Background and Aims: Idiopathic osteosclerosis is an asymptomatic local growth of cortical bone and is discovered incidentally on panoramic radiographs. The purpose of this study is to evaluate the frequency of idiopathic osteosclerosis and its radiographic features in panoramic images of patients referred to the Department of Maxillofacial Radiology, Faculty of Dentistry, Arak University of Medical Sciences (Iran) in 2022-2023.
Materials and Methods: In this cross-sectional study, 460 panoramic images from the radiology department of Arak Faculty of Dentistry were randomly selected and analyzed. The demographic information of patients, frequency of idiopathic osteosclerosis, location, and also its relationship with adjacent teeth in terms of proximity to lamina dura and periodontal ligament and radiographic features in terms of size and morphology were evaluated. The data were analyzed using the SPSS24 software.
Results: Panoramic images of 460 patients (266 men and 194 women) with an average age of 38.12 (11.75) years were evaluated. The frequency of idiopathic osteosclerosis was 6.1% (28 images). 92.9% of the lesions were in the lower jaw and 46.4% of them were near the premolar teeth. In 39.3% of the cases, the lesion was adjacent to the periodontal ligament and laminadora of the tooth. In 3.6% of the cases, it was associated with a small displacement of the adjacent tooth, and 17.9% was associated with tooth root resorption. According to the results, there was no correlation between the incidence of this lesion with age and gender (P>0.05).
Conclusion: According to the findings of this study, the frequency of idiopathic osteosclerosis in the patients referred to Arak dental school was reported as 6.1%. Most of these lesions were observed in the back of the lower jaw and thus, it is important to be able to distinguish this lesion from the radiopaque lesions of the jaw which need treatment.

Background and Aims: Oral health literacy plays an important role in reducing oral health disparities. Evaluation of oral health literacy can be done at individual and population levels. This study was conducted with the aim of investigating oral health literacy among students of Shiraz University of Medical Sciences in 2023. Materials and Methods: This study was descriptive, applied and cross-sectional. The research population included the students of different academic levels of Shiraz University of Medical Sciences, except the final semester students. The sample size was calculated based on the total number of students studying at different levels at Shiraz University of Medical Sciences in the second half of the academic year in 2023 using an appropriate statistical formula. Sampling was done in a stratified-random manner according to faculty, field, and level of education. The oral health literacy of the participants based on education level, age, and gender was measured by the oral health literacy adult questionnaire (OHL Adults Questionnaire: OHL-AQ). Data analysis was done using SPSS 27 software and descriptive statistics (mean, standard deviation, percentage), independent t-test, Kruskal-Wallis, and Tukey test. Results: The findings indicated that the average oral health literacy score of students was 14.75±1.37. Also, there was a statistically significant relationship between the average oral health literacy score of students and the parameters of education level, gender, and age of students (P-value < 0.05). This indictaed that the oral health literacy of students increased in the doctoral level and also with increasing age. In addition, the female students had higher oral health literacy. Conclusion: Based on the results, the oral health literacy among Shiraz medical students was high. People with higher education level and age had higher level of oral and dental health literacy than people with lower education level and age. Oral and dental health literacy level was higher in girls than boys. It can be suggested that a 1) suitable platform be provided in order to improve the level of education of the society, leading to the improvement of the oral health literacy of the people; 2) regular dental examinations in order to increase the oral health literacy of the society is encouraged and promoted, especially in lower year students; and 3) research in effective training in the field of oral health literacy to increase the oral health literacy of people in the society.

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.

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.

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.

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.

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.

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.

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.

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.

 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.

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.

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.

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.