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Background: Oxidative stress has a role in many pathologic conditions, including oral diseases and temporomandibular joint disorders (TMDs) pathophysiology. This study compared the selected oxidative biomarkers' levels in TMD patients and healthy controls in a systematic review and meta-analysis. Materials and Methods: Medline/PubMed, Scopus, Web of Science, Google Scholar, and Embase were systematically searched for English articles up to October 2022 using MeSH and free keywords. Joanna Briggs Institute checklist was used to assess the risk of bias. Differences between biomarker levels in TMD patients were compared to the control group. Results: Ten case-control studies were included based on inclusion and exclusion criteria with a total of 659 patients: 314 with TMD and 345 healthy controls. The studies investigated 15 markers, including total oxidant status (TOS), total antioxidant status, and malondialdehyde (MDA). There was a significant difference in the salivary MDA of patients with TMD in comparison with healthy people; standard mean difference = 3.22 (95% confidence interval [CI]: 0.28-6.16); I² = 96.0%). The Antioxidant status in serum was significantly lower in patients with TMD in comparison with healthy people; weighted mean difference = -0.52 (95% CI: -0.90 to -0.14; I² = 97.0%). The result of TOS was inconclusive. Conclusion: Salivary MDA and serum total antioxidative status measurements may be used as a biomarker for diagnosing TMD. Due to the lack of sufficient evidence, it is not possible to express a definite relation between the amount and type of marker and TMD diagnosis, which suggests that more case-control studies with larger sample sizes are required. [ABSTRACT FROM AUTHOR]

Background.: Ulcers caused by mucosal irritation of fixed orthodontic appliances remain an unsolved problem, and more research is needed to improve the pain caused by orthodontic appliances to provide more comfortable treatment for these patients. This study investigated the effect of probiotic Lactogum on pain and ulceration in patients undergoing fixed orthodontic treatment. Methods.: In this study, 64 patients over 12 years of age and candidates for fixed orthotic treatment were divided into case and control groups (n=32). The control group received orthodontic waxes, and the case group received the same orthodontic waxes and "Lactogum" probiotic lozenges from the beginning of the treatment. The number of ulcers, the amount of pain, and the location of the ulcer were recorded and compared between the two groups. An independent-sample t-test was used to compare the pain level and number of ulcers between the two groups. A significance level of 0.05 was considered for all tests. SPSS 17 was used for data analysis. Results.: The mean number of ulcers in the case group was significantly lower than the control group (P <0.001).>P<0.001).> Conclusion.: Lactogum probiotic lozenges can reduce traumatic oral ulcers and pain levels in patients undergoing fixed orthodontic treatment. However, larger clinical trials are encouraged to confirm these findings. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Low marginal adaptation and therefore micro-leakage, is one of the weaknesses of bulk fill resin composites. Pre-heating of composite resins reduces their viscosity, thus, increasing the marginal adaptation and decreasing their micro-leakage. OBJECTIVES: The aim of this study was to examine the effect of pre-heating on micro-leakage of bulk fill composite resins in dentin margins of class II restorations. MATERIAL AND METHODS: This in-vitro study was conducted on 39 extracted human molars. Class II cavities were prepared on teeth's proximal surfaces. Teeth were divided randomly into three groups, which were restored using three different composites: Group 1 -- X-tra fil composite; Group 2 -- Opus Bulk Fill composite; and Group 3 -- Gradia Posterior composite. Each group included 2 sub-groups: at room temperature and after one pre-heating cycle at 50°C. The teeth were placed in fuchsin solution for 24 hours and were examined for micro-leakage under a stereoscopic microscope. Mann-Whitney U and Kruskal-Wallis tests were applied with SPSS 16 software. P-value of less than 0.05 was considered significant. RESULTS: Pre-heating reduced micro-leakage significantly (p < 0.001). There was no significant difference in micro-leakage of different composites (p < 0.05). CONCLUSIONS: Pre-heating to 50°C decreases micro-leakage in the dentin margin of class II restorations in bulk fill composites (X-tra fil and Opus Bulk Fill) and conventional composite (Gradia Posterior). Investigating the effect of various pre-heating procedures, such as different temperatures, duration, and repeated pre-heating on physical and mechanical features of bulk fill materials, is suggested for future studies. [ABSTRACT FROM AUTHOR]

Context: Early diagnosis of head and neck squamous cell carcinomas (HNSCC) is critical for preventing further disease progression. This study aimed to compare the serum folate and homocysteine levels in patients with HNSCC and healthy controls through a systematic review and subsequent meta-analyses. Evidence Acquisition: The research question was: Is there a difference between serum folate and homocysteine levels (O) of patients with HNSCC (E) compared to healthy controls (C)? To conduct a systematic review, keywords were first identified and then searched in Medline/PubMed, Web of Science, ProQuest, EMBASE, Scopus, and Google Scholar databases within the period from January 2000 to November 2023. The searched studies were screened based on inclusion and exclusion criteria, and after assessing the quality of the selected articles using the Joanna Briggs Institute assessment checklist, 10 articles were finally included in the meta-analysis (nine articles for serum folate and eight for homocysteine). Due to the heterogeneity of studies, meta-analyses were conducted according to the random-effects model. Several meta-analyses were carried out because the selected articles were not uniform regarding smoking habits. Results: Regardless of smoking conditions, the serum folate levels of the HNSCC patients were significantly lower than those of the control groups. Similarly, the serum homocysteine levels were significantly higher in the patient groups compared to the control groups. Conclusions: The meta-analyses in this study showed an association between serum folate and homocysteine levels with HNSCC, indicating their possible use as biomarkers for the early detection of HNSCC. [ABSTRACT FROM AUTHOR]

Background: Radiation-induced hyposalivation is a common complication of radiotherapy for head and neck cancers. The most commonly prescribed medication for hyposalivation is pilocarpine. However, due to the numerous systemic side-effects associated with pilocarpine, there has been a proposal to use it as a mouthwash. This study aimed to evaluate the impact of 1% pilocarpine mouthwash on salivary flow in patients with radiation-induced xerostomia. Method: This double-blind, randomized clinical trial involved 63 patients with radiation-induced xerostomia. The patients were randomly allocated into the pilocarpine hydrochloride 1% mouthwash group and the placebo one. Patients were instructed to use these mouthwashes four times a day, with 30 drops each time, for two minutes. Unstimulated saliva production in patients was measured using the spitting method at three stages: two weeks before the commencement of radiotherapy, two weeks after, and four weeks after the completion of radiotherapy. These measurements were then compared between the two groups. Statistical analysis included chi-square, independent t-test, and Analysis of Variance (ANOVA) with repeated measures and the Sidak post hoc test. Statistical analysis was conducted using SPSS 17, and a significance level of P < 0.05 was applied. Results: A comparison of saliva secretion between the pilocarpine mouthwash group and the control group at various time points after radiotherapy revealed that saliva secretion in the control group significantly decreased compared with the pilocarpine mouthwash group (P < 0.001). Conclusion: 1% pilocarpine mouthwash is recommended for managing radiation-induced xerostomia. [ABSTRACT FROM AUTHOR]

Objectives: Sublingual varices are characterized by abnormally dilated veins. Some systemic conditions such as cardiovascular disease have been suggested to be associated with sublingual varices. Due to the convenience in examining the sublingual area, the present study aimed to assess the relationship between sublingual varices and hypertension. Materials and Methods: In this descriptive-analytic study, 500 patients were categorized into two groups: those with sublingual varices and those without. Two oral medicine specialists assessed the lesions, and the blood pressure of all patients was measured while they were in a relaxed sitting position. Age and gender data were recorded for all participants. Statistical analysis included t-test, chi-square, and logistic regression, with significance set at P<0.05. Results: The frequency of sublingual varices was 21.8%. Mean systolic blood pressure was 139.68±19.01mmHg in patients with sublingual varices and 118.09±13.78mmHg in patients without the lesions (P=0.561). Mean diastolic blood pressure was 100.45±17.81mmHg and 80.31±12.08mmHg in patients with and without sublingual varices, respectively (P<0.001). Smoking was significantly more prevalent among patients who had the lesions (P<0.05). Gender (P=0.686) and age (P=0.875) showed no significant relationship with sublingual varices, while smoking and blood pressure levels were significantly associated with these varices (P<0.001). Conclusion: It is advisable to monitor and manage blood pressure in patients with sublingual varices who may not be aware of their blood pressure status. Our results showed that smoking could be one of the predictive factors for sublingual varices. [ABSTRACT FROM AUTHOR]

Background.: When bleaching agents contact dental structures, they act on restorative materials and adhesive interfaces. This study investigated the effect of "at-home" and "in-office" bleaching on the microleakage of composite resin restorations performed with different universal adhesives in self-etch and etch-and-rinse modes. Methods.: Class V cavities were prepared in 132 premolars. The samples were divided into four groups (n=33). All Bond Universal adhesive was used in the first and second groups, and G-Premio Bond adhesive was used in the third and fourth groups. The total-etch mode was used in the first and third groups, and the self-etch mode was used in the second and fourth groups. The samples were divided into three subgroups (n=11). In the first subgroup, home bleaching was used, and in the second subgroup, office bleaching was used. In the third subgroup, bleaching was not performed. The specimens were examined under a stereomicroscope for microleakage. Ordinal regression analysis was applied (P <0.05).> Results.: The adhesive type, application method, and margin type significantly affected microleakage (P <0.05).>P>0.05). Conclusion.: Based on the results of the microleakage test, bleaching after composite resin restorations did not significantly affect the microleakage of Class V restorations. [ABSTRACT FROM AUTHOR]

Objectives: Due to the important influence of glycemic control on oral health, this study aimed to compare the gingival index and decayed, missing, filled teeth (DMFT) in participants with type 2 diabetes mellitus receiving insulin and metformin. Materials and Methods: In this cross-sectional study, 130 participants with type 2 diabetes mellitus treated with insulin and metformin were studied in two groups based on the type of treatment. The information for DMFT and gingival indices were obtained using the oral examination. In the insulin group, participants received insulin Lantus 0.2 unit/kg once daily, and in the metformin group, participants received metformin tablets 500 mg every 12 hours. Glycosylated hemoglobin A1c (HbA1c) was measured by lab test in all participants. Finally, HbA1c, the information of DMFT, and gingival indices were compared between the two groups. Results: The results showed that there were no statistically significant differences in decayed, missed, and restored teeth, as well as the overall DMFT index between the two groups. The gingival index was significantly higher in the insulin group (P = 0.046). Conclusions: Gingival health of insulin users is poorer than metformin users, but it seems that type of diabetes treatment does not affect the DMFT index. [ABSTRACT FROM AUTHOR]

Context: Salivary cortisol could be a good marker for temporomandibular joint disorders. This article aimed to study the association between salivary cortisol and temporomandibular joint disorders (TMD). Methods: PubMed, Web of Science, Scopus, and Embase were searched according to the PRISMA guidelines without restricting the publication start date until October 2022. Only case-control studies were included in the study. The critical appraisal checklist of the Joanna Briggs Institute was utilized to appraise the selected articles. Results: Of 1173 articles found, 23 studies were eligible, and 18 were meta-analyzed. A total of 696 TMD patients and 785 controls were included. Meta-analysis showed that salivary cortisol was significantly higher in patients with TMD than the controls. Meta-regression showed that the difference in mean salivary cortisol decreased significantly between the two groups with increasing age. Conclusions: The salivary cortisol in patients with TMD is significantly higher than in the controls. As the heterogeneity among the studies was high, more studies are required to verify this association. [ABSTRACT FROM AUTHOR]

Background.: Oral lichen planus (OLP) and one of its main presentations, desquamative gingivitis, are common diseases with no definite treatment. Zinc deficiency has a critical role in the pathogenesis of oral mucosal diseases. The current study systematically reviewed the effect of zinc in addition to topical corticosteroids in the treatment of OLP. Methods.: English articles in PubMed, Web of Sciences, Embase, and Scopus were searched until August 2022. The differences in symptoms were analyzed, including pain, burning sensation, and lesion sizes in patients with lichen planus receiving zinc supplementation as an adjuvant to corticosteroid treatment. Results.: A total of 148 articles related to the searched keywords were found. Eventually, two clinical trials were selected. The total population of studied individuals included 60 patients. Due to the high heterogeneity between the studies, meta-analysis was not possible. Administering zinc, in addition to corticosteroids, did not improve the symptoms compared to corticosteroid monotherapy. Conclusion.: Considering the limited number of studies and lack of sufficient evidence, it is not currently possible to reach a definite conclusion regarding the effects of zinc on OLP. [ABSTRACT FROM AUTHOR]

Background. This systematic review aimed to evaluate the available scientific evidence concerning the effects of topical fluoride treatment on the bond strength of pit and fissure sealants. Prevention of dental caries is one of the crucial issues in pediatric dentistry. Pit and fissure sealant and fluoride therapies are two caries prevention procedures that may be performed in one session. However, fluoride therapy may affect the bond strength of pit and fissure sealants. Methods. An electronic search for in vitro studies published in English and Persian on topical fluoride therapy and the bond strength of pit and fissure sealants was performed via PubMed/ Medline, Web of Science, Google Scholar, Embase, and Scopus databases until May 2022. The articles were independently reviewed for quality by two reviewers. Textual data were analyzed manually, and the bond strength of sealants placed after fluoride application was compared with control groups. Results. A total of 8482 articles were initially identified and reviewed by two independent reviewers, and 13 were selected for full-text evaluation. Finally, six articles were included in the systematic review. A total of 250 teeth were studied, 148 of which were in the case group (fluoride group) and 102 in the control group. Tensile and shear bond strengths were compared between groups in the studies. Conclusion. In the studies in which the tooth surfaces were washed after applying fluoride, there was no change in the fissure sealant bond strength. However, in studies in which fluoride was not washed, the bond strength decreased significantly, independent of the fluoride type. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Xerostomia is a subjective sensation of dry mouth considered as a complex state affecting multiple oral functions. Pilocarpine may be a useful medication for the treatment of xerostomia, but its side effects limit its use under certain conditions. Recent studies have focused on the pilocarpine mouthwash as an alternative. Purpose: We have undertaken this study to review the latest available scientific evidence systematically, concerning the effects of pilocarpine mouthwash on salivary flow rate in patients with xerostomia. Materials and Method: An electronic search for randomized controlled trials published in English until September 2021 related to pilocarpine mouthwash and salivary flow rate in patients with dry mouth was performed in PubMed/Medline, Web of Science, Google Scholar, Embase, and Scopus. A random-effects meta-analysis was conducted to evaluate the relationship between the groups. Results: Two papers with 86 patients were selected for the final review based on strict eligibility criteria. According to the results of the meta-analysis, the mean visual analogue scale in the patient treated with pilocarpine mouthwash was 0.88 unit lower than that of the control group in the fourth week follow; however, it was not statistically significant (pooled mean difference=-0.88, 95% CI = (-2.72; 0.95), p= 0.34). Conclusion: It seems that the use of pilocarpine mouthwash can increase the salivary flow rates; however, no optimal dose and application regimen can currently be suggested due to the high heterogeneity of the data. Regarding the relief of the symptoms using pilocarpine mouthwash, the existing evidence does not support its effectiveness. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has widely affected education, and different types of virtual education have been widely used. Objectives: This study aimed to investigate the challenges and opportunities of E-learning from the perspective of dentistry, students of Tabriz University of Medical Sciences, during the COVID-19 pandemic. Methods: This descriptive cross-sectional study was performed on all dental students in clinical wards. The research tool was a researcher-made questionnaire. The collected data were analyzed using SPSS software version 17, and descriptive statistical methods and Kruskal-Willi's test were used. Results: A total of 167 students participated in this study, and 73% were satisfied with virtual education during the COVID-19 pandemic era. In addition, 76% of the students were confident with the quality of offline educational content. The students' satisfaction rate with interacting with the professors in the virtual education system was 78%. Students mentioned that the most crucial advantage of offline virtual education was the possibility of studying several times and at any time, and the most significant drawback was the lack of eye contact with professors. Conclusions: Based on the results, online education in dentistry could be helpful. A variety of E-learning methods encourage student-based education. Therefore, reducing the cognitive burden of educational content and increasing interactive activities are recommended to improve the quality of education. [ABSTRACT FROM AUTHOR]

Chloroform is used widely in endodontic treatments for solving gutta-percha points, but it can have destructive effects if it comes in to contact with oral mucosa. This article presents a case of necrotic ulcer of palatal and buccal mucosa due to injudicious use of chloroform in endodontic treatment, which has caused severe destruction in maxilla. A conservative treatment method of repeated curettage and irrigation was used and although the lesion healed completely, it had major effects on the patient's quality of life including loss of two teeth. It is important that dentist be aware of the devastating effects of imprudent application of various chemicals used in dentistry. The conservative treatment used for this case can be helpful option for similar cases. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the antibacterial effects of calcium hydroxide, curcumin, and Aloe vera as an intracanal medicament on 6-week-old Enterococcus faecalis biofilm. Materials and Methods: In this in vitro study, the solution containing E. faecalis ATCC® 29212™ was inserted into the canals of 72 single-rooted teeth to produce biofilm. The samples were divided into four groups, and the antibacterial agent as an intracanal drug was used for 1 week. Calcium hydroxide, curcumin, and A. vera were used as intracanal medicaments in three groups, respectively, and the fourth group was irrigated with normal saline. The collected debris was cultured by spread plate method for the bacterial count by colony count machine, and the number of bacteria in each sample per ml was reported in colony-forming unit per ml (CFU/ml). The data were analyzed using SPSS software. KruskalWallis and MannWhitney U-tests were used for comparison of CFU/ml between the study groups. P <0.05 was considered significant. Results: The mean CFU/ml in the groups of calcium hydroxide, curcumin, and A. vera were 749.44, 630.55, and 1529.16, respectively. Compared with the control group, curcumin, calcium hydroxide, and A. vera showed 99.5%, 99.41%, and 98.79% antimicrobial effects, respectively. All three groups were significantly effective than the control group (P = 0.023, P = 0.023, and P = 0.024, respectively) but were not significantly different from each other (P = 0.057). Conclusion: All three groups showed significant antibacterial activity compared to the control group, curcumin had the most significant effect, followed by calcium hydroxide and A. vera. Therefore, herbal materials can be considered safe alternatives to synthetic medicaments for intracanal usage. [ABSTRACT FROM AUTHOR]

Introduction: Direct Observation of Practical Skills (DOPS) tests is a valuable method for clinical assessment. This study aimed to implement the DOPS test to assess the procedural skills of community dentistry courses and its effects on mastery learning and satisfaction of professors and students at Tabriz faculty of dentistry in 2021-2022., Methods: In a quasi-experimental study, 60 dentistry students of a class were assigned into two study (n=30) and control (n=30) groups by Permuted block randomization. In the case group, the skills were related to Fluoride therapy, fissure sealant therapy, and health education evaluated by DOPS. In the control group, these skills were evaluated by traditional evaluation methods. Each test was repeated three times. Finally, the satisfaction of students in the case group was assessed by a questionnaire. The chi-square test was used to compare qualitative variables. Repeated measure ANOVA test was used to compare the mean scores in three stages and two groups. P value less than 0.05 was considered significant. Data were analyzed using SPSS 16 software., Results: A significant difference in the mean score of Fluoride therapy, pit and fissure sealant therapy, and health education was seen between the case and control groups (P<0.001). Also a significant increase in these skills in the third stage of assessment in the case group was observed (P<0.001). The professors and students' satisfaction was considerably high on the DOPS test., Conclusion: The DOPS method had more impact on Fluoride therapy, pit and fissure sealant therapy, and health education's learning process in dentistry students than the conventional evaluation. The professors and students' satisfaction level was high regarding DOPS. The advantages of the DOPS method are student-centeredness, objectivity, and appropriate feedback., Competing Interests: The authors declare no conflicts of interest., (Copyright: © Journal of Advances in Medical Education & Professionalism.)

Genetic factors may influence sleep bruxism's pathogenesis. Even though the association between the, 5-hydroxytryptamine 2A (5-HTR2A) serotonin receptor gene polymorphism and sleep bruxism has been investigated, inconsistent findings have been discovered. As a result, meta-analysis was performed to gather complete results on this topic. PubMed, Web of Science, Embase, and Scopus databases were searched for all papers containing English abstracts until April 2022. Medical Subject Heading (MESH) terms plus unrestricted keywords were used in the searches. The Cochrane test and the I 2 statistic were used to determine the heterogeneity percentage in numerous researches. Comprehensive Meta-analysis v.2.0 software was used to conduct the analyses. Five properly fitting papers were chosen for meta-analysis from the 39 articles acquired during the initial search. The meta-analysis revealed that the 5-HTR2A polymorphism has no link with sleep bruxism susceptibility across the models studied (P-Value > 0.05). The combined odds ratio analysis revealed no statistically significant association between the 5-HTR2A gene polymorphism with sleep bruxism. Nonetheless, these findings require confirmation through researches with large sample sizes. Identifying genetic markers for sleep bruxism may help clarify and expand our current knowledge of bruxism physiopathology., Competing Interests: Conflicting Interest None., (Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)