Background: Oral health-related quality of life (OHRQoL) assesses the subjective perception of oral health and its impact on the quality of life. The aim of this study is to measure the OHRQoL and its determinants among adult people living in Kerman, Iran. Materials and Methods: In this cross-sectional study, a total of 5657 adult people (18–64 years) residing in the Kerman district, both in the rural and urban areas, were enrolled in the study between September 2014 and April 2018. The Oral Health Impact Profile (OHIP-14) and the oral health indices, such as the total decayed, missing, filled teeth (DMFT), community periodontal index (CPI), gingival index (GI), and xerostomia, were measured by an experienced dentist. The demographic variables of gender, age, educational status, and marital status were also recorded. The impact of the studied variables on OHRQoL was evaluated with multiple logistic regression. Results: Participants were 2239 (39.58%) men, and average age was 45.39. The mean scores for OHRQoL, DMFT, CPI and GI were respectively: 24.07 (7.76), 10.7 (6.86), 0.76 (0.96), 0.63 (0.8). The frequency of people with xerostomia was 37.4. 301 (53.3%) of people had poor quality of life related to oral health. In multivariable analysis, there was a statistically significant increase in OHRQoL with an increase in the DMFT (P < 0.001), xerostomia (P < 0.001), CPI, (P < 0.001). Men had a significantly higher OHIP score than women (P < 0.001). Conclusion: According to the results of this study, DMFT, xerostomia, and CPI scores are strongly related to OHIP scores. In addition, between CPI and GI scores, the CPI score is the better predictor.

Ewing's sarcoma (ES) is an aggressive, poorly differentiated round cell tumor in bone or soft tissues. This rare neoplasm is found primarily in the long bones of limbs and flat bone of pelvis with a predilection in the second decade in life. Primary ES of the maxillofacial region is exceptional and constitute 1% ± 4% of all cases. This case report is aimed at highlighting a very rare clinical presentation of extraosseous ES of the chin region-a first of its kind.

Background: This systematic review aimed to evaluate the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACPF) varnish for remineralization of white spot lesions (WSLs) “in vitro” in human teeth. Materials and Methods: Literature search included three databases, namely Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Google Scholar from 2010 to January 2021. The studies assessing WSL depth, calcium, phosphate ion release, and microhardness due to artificial demineralization or remineralization were considered for review. Reference articles were retrieved, and a customized risk assessment tool was used. The Cochrane risk of bias assessment tool was used to generate the risk of bias summary graph. Meta-analysis was performed using RevMan 5.4. Heterogeneity was evaluated by Cochrane's test, and random effects model was used to pool estimate of effect and its 95% confidence intervals (CIs) for surface microhardness. Results: Eighteen studies were selected for review based on the eligibility criteria. Four studies showed superior remineralizing effect of CPP-ACPF compared to fluoride varnishes. Four studies involving 120 human permanent teeth samples were included in the meta-analysis. Efficacy of CPP-ACPF varnish was equivalent to other fluoride varnishes in improving surface microhardness after remineralization during 7-day period (mean surface microhardness: 3.94, 95% CI [−9.08–1.21], I^2: 75%, P = 0.13). Major risks of bias associated with the studies included in the review were inadequate sample size, improper sample preparation, and unexplained blinding. Conclusion: CPP-ACPF varnish appears to be equally effective as other fluoride varnishes in remineralizing artificially induced WSLs, but quality of evidence is low.

Child's uncooperative behavior can impede the efficient delivery of dental care. Therefore, in spite of exceeding availability of behavior management techniques there is a need to search for a psychological behavior management technique that effectively reduces fear and anxiety during dental treatment and instill a change in child's attitude toward the treatment and is also acceptable by the parents. The aim of our systematic review is to determine the efficacy of various psychological behavior management techniques in managing a child's behavior in pediatric dentistry by assessing the fear and anxiety levels, ease of use by the clinician, application in various operative procedures, and parental acceptance. A systematic search was conducted by two reviewers in databases PubMed, Google Scholar, Scopus, Web of Science, and Cochrane for the studies published from January 1, 2011, to December 31, 2020. Studies included were clinical studies which evaluated the efficacy of various psychological behavior management techniques by evaluating the fear and anxiety levels and the changes in behavior during dental treatment in children aged between 4 and 14 years. The studies selected were then assessed for quality with the help of predetermined criteria which categorized the studies into high, medium, and low. Through search strategy, 7147 articles were yielded. After screening through titles and abstracts, 60 nonduplicated articles were selected which were further screened for full text. At the end, 15 articles were included in systematic review and 3 articles for meta-analysis. It was concluded that all the psychological behavior management techniques aided in reduction of fear and anxiety. In noninvasive procedures, conventional psychological behavior management techniques can be effective but in invasive procedures other newer psychological behavior management techniques showed better results. The aspect of parental acceptance regarding various techniques was not discussed in any of the included studies.

Background: The aim of this study was to evaluate the rate of apical microleakage following the fracture of five types of nickel–titanium rotary file systems (ProTaper Universal, Mtwo, RaCe, Revo-s, HeroShaper) in the apical one-third of the canal. Materials and Methods: In this laboratory experiment, 49 mandibular premolars were collected and randomly divided into seven groups. Root canal treatment was performed by five different rotary file systems with different cross-sections. All files, except in the control groups, were scratched at the 3-mm end by a handpiece. After separation of the apical end of the file in the root canal, the apical seal was measured, using the fluid infiltration technique. Data were analyzed in SPSS, using one-way ANOVA and Tamhane's T2 tests at P < 0.05. Results: The Hero Shaper and RaCe files showed the highest (3.14 μL/min) and the lowest (2.51 μL/min) rates of microleakage over time, respectively. There were significant differences between the Hero Shaper and RaCe files and between Hero Shaper and ProTaper files in terms of microleakage (Tamhane's T2 tests, P < 0.05) Conclusion: The presence of a separated file and its cross-section type affects the apical microleakage.

Background: Polyether ether ketone (PEEK) was recently introduced to dentistry. However, difficulty in provision of a strong durable bond is its main drawback. Thus, precise surface treatment and use of a suitable luting agent are imperative for bonding of PEEK restorations. This study aimed to assess the effect of type of luting agent on shear bond strength (SBS) of PEEK. Materials and Methods: In this in vitro study, 60 square-shaped PEEK samples were fabricated and sandblasted with 110 μm Al₂O₃ particles. The samples were then divided into four groups based on the type of cement used (n = 15): zinc phosphate cement, Panavia F2, Panavia V5, and resin-modified glass-ionomer (RMGI) cement. After bonding, the samples were thermocycled for 5000 cycles. The SBS was measured by a universal testing machine. The surface of samples was inspected under a video measuring machine to determine the mode of failure. Data were analyzed using the Kruskal–Wallis test via SPSS version 24 (α = 0.05). Results: RMGI did not bond to PEEK. The SBS values were 4.02 ± 2.87 megapascals (MPa) for Panavia V5, 10.84 ± 6.05 MPa for Panavia F2, and 10.50 ± 2.88 MPa for zinc phosphate. The SBS in the Panavia V5 group was significantly lower than that in the Panavia F2 (P = 0.001) and zinc phosphate (P < 0.001) groups. No significant difference existed between the Panavia F2 and zinc phosphate groups in this respect (P > 0.05). Conclusion: Panavia F2 resin cement and zinc phosphate conventional cement provided the highest bond strength to PEEK, while RMGI did not bond to PEEK.

Background: Considering the increasing demand for tooth-colored restorations, this study sought to assess the micro-shear bond strength (μSBS) of composite to deep dentin by using mild and ultra-mild universal adhesives. Materials and Methods: This in vitro, experimental study evaluated 75 sound third molar teeth randomized into five groups (n = 15) of Clearfil self-etch (SE) Bond (control), Tokuyama Universal Bond (TUB), and All-Bond Universal (ABU) in etch and rinse (E and R) and SE modes. The occlusal surfaces of the teeth were trimmed to expose deep dentin at 0.5 mm distance from the pulp chamber. Adhesives were applied on the dentin surface according to the manufacturers' instructions, and Z350XT composite cylinders were bonded to dentin using Tygon tubes (0.9 mm internal diameter, 2 mm height). After incubation at 37°C and 100% humidity for 24 h, the teeth underwent μSBS test in a universal testing machine. The mode of failure was also determined under a stereomicroscope. Analysis of variance, Bonferroni test, and Fisher's exact test were applied for data analysis (alpha = 0.05). Results: TUB in E and R mode (13.78 MPa) and ABU in SE mode (7.85 MPa) yielded the maximum and minimum μSBS values, respectively. No significant difference was noted in μSBS of tested universal adhesives in E and R and SE modes to deep dentin (P > 0.05). TUB yielded significantly higher μSBS than ABU (P < 0.05). No significant difference was noted in mode of failure of the groups (P > 0.05). Conclusion: Type of adhesive affected the μSBS but etching mode of universal adhesives had no significant effect on their μSBS to deep dentin.

Background: Over the past year, patients infected by severe acute respiratory syndrome coronavirus-2 presented with severe gustatory dysfunction, the prevalence of which varies among different populations. Furthermore, there have been sporadic reports of oral ulceration observed in coronavirus disease-19 (COVID-19) patients due to varied reasons. The aim of this study was to investigate and characterize the presence of gustatory disorders, oral ulceration, and other oral changes in patients with laboratory-confirmed COVID-19 infection. Materials and Methods: In this cross-sectional observational study, a total of 402 participants who were detected COVID-19 positive by reverse transcription–polymerase chain reaction were included. Their demographic and clinical data were recorded through hospital records. The participants were interviewed either in person or on the telephone to record any change in taste and/or changes within the oral cavity. t-test for independent means was used to compare mean age, while other characteristics were compared by Chi-square test and Z-score test. P < 0.05 was taken as significant. Results: Out of the total sample of 402 individuals, 262 were male and 140 were female. The prevalence of gustatory dysfunction and oral ulceration was 43.53% and 15.67%, respectively, in the studied sample. Significantly more females had gustatory dysfunction than males and older subjects more commonly than younger. The symptom of loss/change of taste and oral ulceration were more probable to occur together. In addition, the tongue was the most common site for ulceration in our studied sample. Conclusion: Loss of taste is a common symptom of COVID-19 patients, whereas oral ulceration is not so commonly reported. However, the presence of both these symptoms could impair the quality of life of patients and hamper adequate nutritional uptake.

Background: Dental trauma is a common problem in children, which mostly occurs at school. Traumatic dental injuries often cause unpleasant experiences for children, and immediate and appropriate measures are needed. Its prognosis depends on immediate posttraumatic measures, and schoolteachers can play a key role in the treatment of children. The current study aimed to investigate teachers' knowledge about dental injuries in primary school children in the city of Isfahan. Materials and Methods: Following a cross-sectional design, the current study was conducted on 248 elementary school teachers who were selected using the simple two-stage random cluster. Then the teachers' knowledge was measured based on a four-choice questionnaire consisted of two parts. According to this questionnaire, teachers were divided into five categories based on their knowledge score which was consist of strongly high knowledge, high knowledge, average knowledge, low awareness, and strongly low knowledge. Data were analyzed using the Spearman correlation coefficient and independent t-test. Statistical significance was considered when P < 0.05. Results: The total knowledge score of teachers was 45.9%. About 61% of the teachers had a history of exposure to dental injuries. Furthermore, 49.6% of them believed milk was the best environment to keep the avulsed teeth. There was no significant association between teachers' knowledge and education level, history of previous trauma, or participation in a training course, but there was a direct association between teachers' knowledge and their work experience (P < 0.05). Female teachers' knowledge score was significantly higher than their male counterparts (P < 0.001). Conclusion: Participants had a moderate level of knowledge about the management of dental traumas. Hence, it is suggested to develop educational programs to increase teachers' awareness about this issue.

Background: This study aimed to assess the relationship between the osteoporotic condition and periodontitis in postmenopausal women. Materials and Methods: Ninety-four women aged 50–80 years were studied in this cross-sectional study. Bone mineral density (BMD) of lumbar vertebra BMD (LBMD), total hip BMD (HBMD), and neck of femur BMD (NBMD) was assessed using standardized dual-energy X-ray absorptiometry (DXA) (normal: T-score ≥−1, osteopenic: −2.5 ≤ t-score <−1, osteoporotic: T-score <−2.5). Bleeding point index (BI), O'Leary plaque index (PI), and clinical attachment loss (CAL) were recorded. Cementoenamel junction, alveolar-crest distance (CEJ-AC) was measured from cone-beam computed tomography images. Periodontitis severity was represented by CAL and CEJ-AC distance. One-way analysis of variance followed by Post hoc Tukey was performed for examining differences among the groups for different variables. Pearson correlation coefficient® and backward regression analysis were used to investigate the effect of confounding variables on CEJ-AC as the dependent variable. Significance was considered at P < 0.05. Results: Mean CEJ-AC was significantly higher in the osteoporotic and osteopenic groups compared to the normal group (P = 0.001). There was a significant positive correlation between CEJ-AC and NBMD and LBMD (P < 0.001). The associations between LBMD and CEJ-AC existed even after adjusting for confounding factors (P = 0.002). The differences in BI, PI, and CAL were not statistically different between the groups (P > 0.05). Conclusion: Although osteoporosis is not the main cause of periodontitis, it can indirectly affect periodontal status by increasing CEJ-AC. Early diagnosis of osteoporosis followed by early referral to a dentist for the treatment of potential existing periodontal diseases is important to avoid complications among postmenopausal women