Tehran University Medical Journal

Background: Using alcohol is one of the most important death factors that can be prevented. Lifestyle-related diseases are at the top cause of mortality and burden of disease, whereas most of them can be prevented. Considering the growing importance of diseases related to lifestyle (including alcohol abuse), providing evidence-based clinical guidelines for diseases and life-style related conditions which are in accordance with the newest scientific findings and with cultural and economic conditions in each country are required. The aim of this study was to develop a clinical guideline for prevention and control of alcohol consumption.
Methods: The type of study is initiation of a method or a scientific/administrative system (health system management studies) that uses the National Pattern of Localization of Clinical Guidelines in 2017 in Taleghani Hospital of Shahid Beheshti University of Medical Sciences, Tehran, Iran, by using the reviewed clinical guidelines, which was conducted by the end of 2017 based on organizational criteria, the availability of the full version of the clinical guideline and its up-to-datedness, and the appraisal of guidelines for research and evaluation (AGREE) scoring system. This clinical guideline was developed based on 5A Model (Assess, Advise, Agree, Assist and Arrange).
Results: In order to prevent and control alcohol abuse, a clinical guideline was developed based on five clinical guidelines including United States Preventive Services Task Force (USPSTF), Healthy lifestyle guideline (ICSI), the guidelines for preventive activities in general practice in Australia (RACGP), The Australian population health guide to risky behavioural risk factors in general practice (SNAP), and the guidelines related to lifestyle and wellbeing by the National Institute of Clinical Excellence of England (NICE) in the form of 5A model.
Conclusion: The best practice is according to the existing clinical guidelines for prevention and control of alcohol use screening, brief intervention (1-2 sessions) and behavioral counseling, treatment with cognitive behavioral interventions (2-6 sessions) and, if necessary, referrals to higher treatment centers. Referral is recommended for patients who have signs of substance dependence and need a level of care beyond brief service.

Background: The mandibular first molar teeth are the most common teeth that undergo endodontic treatment and are anatomically very challenging. Adequate knowledge of the danger zone in the mesial root of the first mandibular molars helps reduce the risk of misdiagnosis of perforation during treatment. The aim of this study was to compare the dentin thickness of the danger zone in the mesial canals of the mandibular first molar in CBCT(Cone Beam Coomputed Tomography) images at intervals of 3, 4, 5 mm below the orifice canal.
Methods: In this study, CBCT images of 144 mandibular first molars from 74 patients aged 18 to 66 years were examined. Mean orifice to Furcation was calculated and mean distal dentin thickness of mesiobuccal and mesiolingual canals was measured at 3, 4 and 5 mm below the orifice. The mean thickness of the distal dentin was examined in terms of age, sex and maxillary side.
Results: The lowest mean distal wall thickness of mesiobuccal and mesiolingual canals was 5 mm below the orifice of the canal. The mean distal wall thickness of mesiobuccal and mesiolingual canals were higher in men than women (P <0.05). The mean distal wall thickness did not show a significant relationship with age. (P=0.745) except in the area of 3 and 5 mm below the orifice in the mesiobuccal canal which was significantly associated with age (P=0.01). No statistically significant difference was observed between the two mandibular sides (P=0.543) except in the 4 mm area below the orifice in the mesiolingual canal (P <0.05).

Conclusion: The present study showed that the danger zone is observed in the distal dentin of the mesiobuccal and mesiolingual canals of the mandibular first molar teeth in men and women 5 mm below the orifice of the canal. The mean dentin thickness of the distal wall was lower in women than in men.