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Background and purpose: Vestibular Schwannoma (VS) is a lesion in peripheral vestibular system that leads to reduction of Vestibulo Ocular Reflex (VOR) gain and incidence of corrective saccades. Researches showed that the result of Video Head Impulse Test (VHIT) is positive in peripheral vestibular system disorders and negative in central vestibular system disorders. The aim of this study was to evaluate and compare the results of VHIT in patients with vestibular schwannoma and patients with central vestibular system tumors. Materials and methods: A descriptive-analytic study was conducted in 12 patients with unilateral VS tumor and 15 patients with unilateral central vestibular system tumors in Iran Gamma-Knife Center (December 2014-September 2015). The patients were selected based on diagnosis of neurosurgeon and their complaints from vertigo, imbalance, and dizziness. Assessment of VHIT was performed using horizontal and vertical head impulses. Finally, the amount of VOR gain and the corrective saccade ratio were evaluated in two groups of patients with tumors. The gain of VOR ≤0.80 was considered as abnormal criterion. Results: Mean VOR gain in effective side was 0.38 in patients with VS tumor, and 0.96 in patients with central vestibular system tumors (P= 0.001). Also, corrective saccades ratio was 30.34 in patients with VS and 3.44 in patients with central vestibular system tumors (P= 0.007). Conclusion: The results of VHIT improved differential diagnosis of peripheral vestibular system tumors from central vestibular system tumors. [ABSTRACT FROM AUTHOR]

Diabetes is a highly prevalent metabolic disease with macrovascular and microvascular complications. Insulin resistance plays a major role in the pathogenesis of atherosclerosis in type 2 diabetes patients. The risk of atherosclerosis progress in diabetes is of 2-4 orders of magnitude. Early atherosclerosis can be detected by carotid intima-media thickness (cIMT) ultrasonography. There is an inverse relationship between intima-media thickness and physical activity. The aim of this study was to investigate the effects of an 8-week aerobic exercise program on the vascular structure in different segments of the carotid artery. This study was a randomized control trial. Thirty individuals were selected out of 642 volunteers who fulfilled the inclusion criteria. They were randomly divided into aerobic exercise and control groups by a block randomization method. This study was carried out during May-October 2016 in Iran. The aerobic protocol comprised of 24 sessions of aerobic exercise on a treadmill for 30 min per session, 3 days a week. The intensity of the training protocol was 50-70% of the patient’s max heart rate. Measurements of vascular parameters were evaluated by the same person, before and after the 24-session intervention. There were no significant differences between anthropometric, sex, age, diabetic history, and cardiac ejection fraction, compared to baseline characteristics. Intima-media thickness (0.52 ± 0.12), intima-media/lumen (0.07 ± 0.02) in bulb carotid, common carotid, and internal carotid, as well as bulb wall, were reduced significantly in the training group compared to the control group after 8 weeks (p < 0.05). Twenty-four sessions of aerobic exercise improved vascular parameters in type 2 diabetics. [ABSTRACT FROM AUTHOR]

Forward head posture (FHP) is considered to be one of the most common postural disorders in the spinal column. Recently studies have reported impaired proprioception to be one of the results of prolonged FHP. Studies have suggested that vibration stimulus is capable of improving joint proprioception. Thus the aim of this study was to investigate the effects of one session of whole body vibration (WBV) training in standing position on cervical joint position sense in individuals with FHP. Thirty (12 females and 18 males) individuals with FHP were randomly assigned to a vibration (experimental) or non-vibration (control) group. The vibration group experienced 5 sets of WBV while holding the head and neck in retraction. The non-vibration group held the same position for the same time without any vibration. Four target angles were established to assess the absolute and constant joint position sense (JPS) errors for each individual. Results showed significant reduction (P<0/05) in JPS absolute errors in 2 target angles in the vibration group when compared to the non-vibration group. It was concluded that relative improvement in cervical JPS could be achieved when adding additional sensory input from WBV stimulus to the head and neck retraction exercise. [ABSTRACT FROM AUTHOR]

Introduction: Dysmenorrhea is one of the most common gynecologic disorders that affects women's quality of life and social activities. Lifestyle, eating behaviors, and general health are essential to the management of menstrual symptoms. This study was conducted to examine the relationship between lifestyle and primary dysmenorrhea in students at Sari University of Medical Sciences in 2015 in order to facilitate the performance of lifestyle-improving interventions among young women. Methods: This study was conducted on 250 students with and without primary dysmenorrhea at Sari University of Medical Sciences in 2015. Data were collected using personal-social and lifestyle questionnaires (addressing nutrition, physical activity, stress, social relationships, improper health behaviors, and self-care). The data were analyzed by SPSS software, version 18, using the independent-samples t-test, the chi-squared test, and logistic regression analysis. Results: Given the scores obtained on the lifestyle questionnaire, significant differences were observed between the groups with and without dysmenorrhea in terms of eating behavior (p=0.008), physical activity (p=0.011), stress (p=0.041), and social relationships (p=0.000). No differences were observed in terms of self-care (p=0.115) and smoking, drinking, and drug use (p=0.355). According to the logistic regression analysis, age (OR=1.208, p=0.014), physical activity (OR=1.008, p=0.040) and social relationship (OR=0.952, p=0.002) were different in the two groups, but there was no statistical differences in their eating behavior, self-care, and stress. Conclusion: To prevent and reduce the incidence of primary dysmenorrhea, knowledge and awareness should be raised in young women through proper lifestyle education and health promotion measures. [ABSTRACT FROM AUTHOR]

Background: Gait initiation (GI) can be divided into three sections according to the center of pressure (COP) trace (S1, S2, and S3). Almost all studies do not separate each phase of the GI profile in postural control assessment and muscular investigation, whereas differences in the COP and muscles are found in each phase of the GI profile in people with gait problems., Methods: Twenty individuals with CAI and twenty healthy controls were included in the present study. A force plate synchronized with Qualisys motion analysis, MEGAWIN electromyography, and a pair of auditory cues were used for data capture. The participants carried out five trials of GI with the affected leg (dominant leg). The peak and mean COP excursions; the mean and maximum velocities of COP excursion during S1, S2,, S3, and the total phases in the mediolateral (ML) and anterior‒posterior (AP) directions; the root mean square (RMS); and the onset activity of the Tibialis Anterior (TA) and Soleus (SOL) muscles for both legs were used for statistical analysis. Independent t tests and Mann‒Whitney U tests were used for statistical analysis on the basis of a significance level of ≤ 0.05., Results: Compared with those of healthy controls, independent t tests revealed a significant decrease in the peak COP excursion in the AP direction during S2 (P = 0.021) and in the mean velocity of COP excursion in the AP direction during S1 (P = 0.044) in the CAI group. Additionally, there was a significant increase in the duration of S1 in the GI profile (P = 0.045) in the CAI group compared with the healthy control group. There was no significant difference in the other COP variables, TA or SOL RMS or onset activity for either leg during S1, S2, or S3 between the two groups (P > 0.065)., Conclusion: Individuals with CAI exhibit increased stiffness in the AP direction in the injured ankle. This leads to a reduction in the velocity and peak of COP excursion, as well as an increase in the time required for postural control adjustment. These findings highlight the challenges individuals with CAI may face in meeting postural demands when trying to unload the affected foot., Ethical Code: IR.SBMU.RETECH.REC.1402.095, 2023-5-28., Competing Interests: Declarations. Ethics approval and consent to participate: Initially, the aim of the study was explained to the participants. They were assured that their information would remain confidential. They were also informed that participation was completely voluntary and that they had the right to withdraw from the study whenever they wished. Informed consent was obtained from each participant prior to study participation. The study was approved by the Ethics Committee at the Shahid Beheshti University of Medical Sciences (IR.SBMU.REC.1402.095) and was carried out in accordance with the principles of the Declaration of Helsinki. Consent for publication: The participant gave written informed consent for her/his personal or clinical details along with any identifying images to be published in this study. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Objectives: To assess the differences between adjunctive therapy with Concentrated Growth Factor (CGF), Platelet-rich Fibrin (PRF) membranes, and available control groups in the clinical outcomes of root coverage., Materials and Methods: Randomized controlled clinical trials (RCTs) were identified in Pubmed/Medline, Scopus, and ISI Web of Science databases to assess the treatments after 6 months using a Bayesian random-effect network meta-analysis (NMA) framework regarding reduction in pocket depth (PD), clinical attachment loss (CAL), recession depth (RD), and width (RW), as well as, keratinized tissue width (KTW) and thickness (KTT) gain, and complete (CRC) and mean (MRC) root coverage percentages., Results: Thirty-two RCTs were included, from which 27, 18, 12, eight, one, and one studies investigated PRF, connective tissue graft (CTG), flap alone, CGF, enamel matrix derivative (EMD), and dehydrated amniotic membrane, respectively. Thirty studies comprising CTG and flap-alone arms other than CGF and PRF were added to NMA. No significant difference has been found between CGF and PRF; however, CGF have a higher probability of being a better treatment than PRF in PD, CAL, and RW reduction and KTW gain, and PRF has a higher probability for being better in MRC, CRC, KTT gain, and RD reduction. PRF was significantly superior to flap-alone in terms of KTT gain and RD reduction. CGF had the highest probability of being the best treatment in PD and RW reduction, but in other outcomes, CTG was superior. PRF was significantly superior to flap-alone in terms of KTT gain and RD reduction., Conclusions: Both adjunctive CGF and PRF demonstrated improvements regarding root coverage outcomes. Although there is no significant difference between PRF and CGF, these two membranes might have different impacts on different outcomes. Further studies are required for a more comprehensive conclusion, especially on CGF., Clinical Relevance: CTG is recommended for achieving ideal results in root coverage procedure. Since PRF and CGF both have a higher probability for being superior to flap alone, both could be suggested in cases which less than ideal outcomes are acceptable and minimization of patient discomfort is necessary., Competing Interests: Declarations. Ethical approval: Not applicable. Informed consent: Not applicable. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Many stroke patients suffer from dysfunction in their upper limbs, which can lead to difficulties in performing activities of daily living (ADL) as well as social and work interactions. This is particularly true for patients whose dominant side has been affected. The aim of the current study was to explore how effective visual biofeedback could improve fine motor function in the hand and ADL for people suffering from a stroke., Methods: Ten individuals who had experienced a stroke with aged from 60 to 74 years old (mean: 64.3 years) were randomly divided into two groups. Patients in study group (n: 5) received 15 sessions of visual biofeedback therapy along with routine occupational therapy. Control group (n: 5) received only routine occupational therapy. Fine motor function was measured by Fugl Meyer Scale (FMS), box and block test (BBT), and Purdue pegboard test (PPBT). Also, ADL was measured by functional independence measure (FIM). These clinical outcomes were evaluated before, after, and 1.5 months following the interventions., Results: The results showed that the study group experienced a significant increase in fine motor function after receiving visual biofeedback, compared to the control group. The ADL also improved in both the study and control groups after the intervention, but there was no significant difference between the two groups during the intervention and follow-up stages for ADL., Conclusion: It seems that combining biofeedback with routine occupational therapy could be a promising method to enhance fine motor function in individuals with stroke., Competing Interests: Declaration of competing interest The authors whose name are listed immediately below certify that they have no affliction with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine via primary intraosseous (IO) injection with the QuickSleeper device vs inferior alveolar nerve block (IANB) for mandibular first molars diagnosed with symptomatic irreversible pulpitis (SIP)., Methods: Sixty-four patients with a first mandibular molar with SIP were randomly divided into 2 groups: IO (n = 32) and IANB (n = 32). Each received either an IO injection with the 5th generation QuickSleeper device or a conventional IANB with 1.7 mL 4% articaine with 1:100,000 epinephrine. Success was defined as no/mild pain upon the access cavity preparation and initial filing. Injection pain, anesthetic onset, heart rate (HR) change, HR recovery time, and duration of anesthesia were also recorded and analyzed., Results: The success rates were 40.6% for IANB and 81.2% for IO (P < .001). IO exhibited a significantly lower injection pain (P = .027), a shorter onset of action (P < .001), a greater heart rate increase (P < .001), a faster heart rate recovery time (P < .001), and a shorter duration of action (P < .001) vs IANB., Conclusion: Primary IO anesthesia using the fifth generation of the QuickSleeper device was more successful than IANB when using 4% articaine with 1:100,000 epinephrine to anesthetize mandibular first molars with SIP. The QuickSleeper device appeared to be a viable alternative to IANB for mandibular anesthesia.

Purpose: One of the most obvious functional effects of aging on the cognitive and processing processes of spatial hearing is the localization problem and the disorder of speech perception in noise. The purpose of the present study is to investigate the performance of dynamic spatial auditory processing in the elderly., Methods: This descriptive and analytical study was conducted on 60 young participants aged from18 to 25 years old and 60 elderly participants aged from 60 to 75 old years, using speech, spatial, and qualities of hearing scale (SSQ) questionnaire, binaural masking level difference (BMLD) and dynamic quick speech in noise (DS-QSIN) tests., Results: Comparing the average scores of the tests and the questionnaire using the independent t test showed a significant difference between the two groups ( p  < 0.001). It was also found that gender had no effect on the results ( p  > 0.05)., Conclusions: Aging is accompanied by different structural and functional changes in the auditory central nervous system, which leads to a decrease in speech perception in challenging listening environments, as well as a decrease in sound localization abilities, due to the reduction of temporal and spectral information. This problem affects the determination of the source of sound and the spatial cognition of the elderly and leads to a disturbance in the awareness of the auditory environment. Therefore, auditory rehabilitation programs can cause the improvement of spatial auditory processing performance and improve speech perception in noise in the elderly., Competing Interests: Conflict of InterestThe authors declare that they have no competing interests., (© Association of Otolaryngologists of India 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Pregnant women have poor knowledge of oral hygiene during pregnancy. One problem with the follow-up of dental caries in this group is zero accumulation in the decayed, missing, and filled teeth (DMFT) index, for which some models must be used to achieve valid results. The studied population may be heterogeneous in longitudinal studies, leading to biased estimates. We aimed to assess the impact of oral health education on dental caries in pregnant women using a suitable model in a longitudinal experimental study with heterogeneous random effects., Materials and Methods: This longitudinal, experimental research was carried out on pregnant women who visited medical centers in Tehran. The educational group (236 cases) received education for three sessions. The control group (200 cases) received only standard training. The DMFT index assessed oral and dental health at baseline, 6 months, and 24 months after delivery. The Chi-square test was used for comparing nominal variables and the Mann-Whitney U test for ordinal variables. The zero-inflated Poisson (ZIP) model was applied under heterogeneous and homogeneous random effects using R 4.2.1, SPSS 26, and SAS 9.4. The level of significance was set at 0.05., Results: Data from 436 women aged 15 years and older were analyzed. Zero accumulation in the DMFT was mainly related to the filled teeth (51%). The heterogeneous ZIP model fitted better to the data. On average, the intervention group exhibited a higher rate of change in filled teeth over time than the control group ( P = 0.021)., Conclusion: The proposed ZIP model is a suitable model for predicting filled teeth in pregnant women. An educational intervention during pregnancy can improve oral health in the long-term follow-up., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or nonfinancial in this article., (Copyright: © 2024 Dental Research Journal.)

Background: Proprioception is critical for older adults to maintain their balance and prevent falling. However, massage is a convenient intervention that its beneficial effect on the proprioception is suggested., Purpose: This study aimed to determine whether one session of stimulating massage of the muscles around the knee joint improves position sense in older adult men., Methods: Twenty healthy older adults participated in this blind, randomized, crossover trial. The two treatment phases were massage and rest. The washout period between interventions was a 1-week interval. The massage protocol was as follows: deep effleurage, petrissage, and tapotement for 5 minutes for the anterior (tensor fascia lata, quadriceps, sartorius, and gracilis) and posterior (hamstrings) muscles of the knee (10 minutes in total)., Results: Outcome measures were absolute, constant, and variable errors (AE, CE, and VE). Participants were assessed immediately before and after the intervention by a blinded investigator. Independent t -tests were used for statistical analyses. Massage reduced absolute error (2.77°, p = 0.01)., Conclusion: The finding of this study confirms the beneficial impact of the massage on the joint position sense in healthy older adult men., Competing Interests: CONFLICT OF INTEREST NOTIFICATION: The authors declare there are no conflicts of interest., (Copyright© The Author(s) 2024. Published by the Massage Therapy Foundation.)

Fatigue and balance disorders are common challenges experienced by Multiple Sclerosis (MS) individuals. The purpose of this study was to compare the concurrent effects of cerebellar and prefrontal anodal trans-cranial direct current stimulation (a-tDCS) with postural training on balance and fatigue in MS patients. 51 patients were evaluated to randomly allocation to a-tDCS over cerebellum, a-tDCS over dorsolateral prefrontal cortex (DLPFC) and sham group. 46 individuals (n = 16 in experimental groups and n = 14 in control group) followed treatment. All the groups received 10 sessions of postural training. The experimental groups underwent a-tDCS with a current of 1.5 mA for a period of 20 min. While, in the sham group, tDCS was only activated for 30 s and then turned off. The treatment included 10 sessions for four weeks. Before and after intervention, fatigue and balance were assessed using Fatigue Severity Scale (FSS), Timed Up and Go (TUG) test and Berg Balance Score (BBS), respectively. There was found a significant reduction in fatigue in the group receiving a-tDCS over the prefrontal cortex with postural training compared to the other two groups (P < 0.001). Additionally, a significant improvement was found in balance in the group receiving a-tDCS over the cerebellum concurrent with postural training in comparison to the other two groups (P < 0.001). Besides, in the sham group, the significant results were not reported in the variables. (P > 0.001). The results demonstrated that a-tDCS enhances the effects of postural training on balance and fatigue in MS patients., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Convergence insufficiency is a common issue in the field of binocular vision. Various treatment options have been suggested for managing this condition, but their efficacy in individuals with presbyopia remains unclear. The objective of this study is to compare the effectiveness of home-based vision therapy and prism prescription, in presbyopic patients with convergence insufficiency., Methods/design: It is a randomized, prospective, double-blind clinical trial, with total of 150 participants randomly assigned to the three groups. The Control Group will receive a new near glasses as a conventional prescription, along with aimless and random eye movement exercises that do not have any convergence or accommodation effects. The Home Vision Therapy Group will receive new near glasses with accommodative and convergence eye exercises. The Prism Group will receive a near prismatic glasses prescribed using the Sheard's criterion. All treatments will be administered for a period of 2 months, and measurements of the modified convergence insufficiency symptoms survey (CISS), near point convergence, near phoria, and positive fusional vergence will be taken at baseline, one month later, and at the end of the treatment., Discussion: We aim to identify which component - either the prism prescription or the home vision therapy - is more effective in improving binocular abilities and reducing patients' symptom scores., Trial Registration: ClinicalTrials.gov NCT05311917 with last update on 04/22/2023., (© 2024. The Author(s).)

Objectives: To evaluate a modified two-step buccal infiltration (MBI) of 1.7 mL 4% articaine as primary or supplemental anesthesia in mandibular first and second molars diagnosed with symptomatic irreversible pulpitis (SIP)., Materials and Methods: One hundred and eight patients with SIP were randomly assigned to one of three groups (n = 36). They were given an inferior alveolar nerve block (IANB) of 2% lidocaine with 1:80.000 epinephrine or a primary MBI of 4% articaine with 1:100.000 epinephrine in the IANB and MBI groups, respectively. Patients in the IANB + MBI group received an IANB followed by an MBI. Pain levels during the injection, access cavity preparation, and initial filing were recorded on the Heft-Parker visual analog scale (HP-VAS). No or mild pain (HP-VAS ≤ 54) upon access cavity preparation and initial filing was considered a success. Chi-square and Kruskal-Wallis tests were used to analyze the data., Results: MBI (77.8%) and IANB + MBI (94.4%) had both significantly higher success rates than IANB (50.0%) (P < .001). However, when the Bonferroni adjustment was applied, there was no statistically significant difference between the MBI and IANB + MBI techniques (P = .041 > .017). MBI was associated with significantly less injection pain than IANB (P < .001)., Conclusions: Both primary and supplemental MBI with 4% articaine were superior to IANB with 2% lidocaine in mandibular first and second molars diagnosed with SIP. Further research may be needed to confirm the findings of this study., Clinical Relevance: The findings of this study suggest that supplemental or primary MBI can be a clinically viable alternative to IANB, which has a relatively low success rate when managing mandibular molars diagnosed with SIP., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: The aim of this ecological study was to assess the association between behavioral, social position, circumstance factors, and caries experience in 35- to 44-year-old adults in Iran at a provincial level., Materials and Methods: The data from the 2011 Iranian Oral Health Survey were obtained from all 31 provinces across Iran on the population level. Oral health status was measured as the number of decayed, missing (MT), and filled (FT) teeth and the percentage of the population who were edentulous. Data were also gathered from each province on the percentage of smokers (Non-Communicable Diseases Risk Factors Surveillance Provincial Report 2009), per capita consumption of free sugars, concentration of fluoride in the drinking water (National and Sub-national Burden of Disease (NASBOD) Survey), number of dentists per 10,000 people, mean years of schooling of adults, expected years of schooling of children, life expectancy at birth and Gross National Income (Integrated Public Use Microdata Series, Global Data Lab). The data were analyzed using simple and multiple linear regression (α = 0.05)., Results: Mean DMFT was positively associated with the percentage of smokers (B = 0.01 95%CI 0.01-0.14), and negatively with fluoride concentration (B =-2.6 95%CI -4.3- -0.96). The edentulousness percentage was positively associated with smoking (B = 0.2 (with 95%CI: 0.07-0.37) and negatively with mean years of education (B =-1.08 (with 95%CI: -2.04- -0.12). DT was associated with expected years of schooling (B =-0.6 (with 95%CI: -1.07- -0.17), negatively. Mt was negatively associated with life expectancy (B =-0.5 (with 95%CI: -1.1- -0.007), fluoride concentration (B =-3.4 (with 95%CI: -4.5- -1.5) and number of dentists per 10,000 people (B =-0.4 (with 95%CI: -0.8- -0.01). Mean Years of Schooling (B = 0.5 (with 95%CI: 0.2-0.8) and number of dentists per 10,000 people (B =-0.62 (with 95%CI: 0.51 - 0.48) were positively in associated with FT., Conclusions: The present findings indicate that there were differences in the oral health measures and their social determinants among the provinces of Iran. Regarding the limitations of the study especially the limitation of the number of independent variables, it seems, this discrepancy could be better explained by social variables of the provinces such as income than by environmental factors., (© 2023. The Author(s).)

Introduction: This study aimed to assess the alveolar bone thickness (ABT) and labiolingual inclination of maxillary and mandibular central incisors in patients with Class I and II skeletal patterns with normal-angle, high-angle, and low-angle vertical patterns., Methods: The study sample consisted of 200 cone-beam computed tomography scans of patients with skeletal Class I and II malocclusions. Each group was further divided into low-angle, normal-angle, and high-angle subgroups. Labiolingual inclinations of maxillary and mandibular central incisors and ABT were measured at 4 levels from the cementoenamel junction in the labial and lingual surfaces. The Kolmogorov-Smirnov test, independent t test, 2-way analysis of variance, and Spearman's correlation test were applied for statistical analyses., Results: The only significant difference between Class I and II groups regarding the ABT was found at the labial side of the maxillary central incisor, 9 mm apical to the crest. At this level, the mean ABT was 0.87 mm in patients with a skeletal Class I malocclusion, which was significantly greater than that in patients with a skeletal Class II malocclusion with a mean ABT of 0.66 mm (P = 0.02). Comparisons among the vertical subgroups revealed that on the labial and lingual sides of the mandible, as well as the palatal side of the maxilla, significantly thinner alveolar bone was found in patients with high-angle growth patterns than those with normal-angle and low-angle patterns in both sagittal groups (P <0.05). Significant weak to moderate correlations were found between ABT and tooth inclination (P <0.05)., Conclusions: Significant differences in ABT covering central incisors between patients with skeletal Class I and II malocclusion are merely observed at the labial surface of the maxilla, 9 mm apical to the cementoenamel junction. Compared with patients with normal-angle and low-angle, those with a high-angle growth pattern and Class I and II sagittal relationships have thinner alveolar bone support around maxillary and mandibular incisors., (Copyright © 2023 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: The concept of minimally invasive endodontics recommends less-invasive vital pulp therapy (VPT) modalities over more aggressive traditional endodontic approaches in mature permanent teeth with carious pulp exposure, including irreversible pulpitis (IP) cases. Consequently, VPT needs to be compared with root canal therapy (RCT) in terms of treatment outcomes. This randomized clinical trial compares the results of full pulpotomy using two calcium-silicate cements, i.e., mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement, with RCT in mature permanent teeth., Materials and Methods: A total of 157 carious pulp exposure cases in two academic centers with/without established IP were selected/included/randomly appointed to three study arms; (i) RCT (n = 51) as the reference treatment, (ii) pulpotomy with ProRoot MTA (PMTA; n = 55), and (iii) pulpotomy with CEM cement (PCEM; n = 51) as two alternative VPT treatments. Two-year clinical/radiographic results were the outcomes of interest. Data were statistically analyzed through the analysis of variance, chi-square, Fisher exact test, and Kruskal-Wallis., Results: At 2-year recall, 147 teeth were examined (6.4% dropout). All molars, except for one, were clinically functional/symptom-free, and there was no statistical difference between the three study arms (p = 0.653). The radiographic success rates in RCT, PMTA, and PCEM arms were 98%, 100%, and 97.9%, respectively, without statistically significant differences (p = 0.544)., Conclusion: In the management of mature permanent teeth with/without established IP, all experimental groups exhibited equivalent/comparable results., Clinical Relevance: Simple VPT using MTA/CEM can be suggested/recommended as a viable advantageous alternative to RCT for the management of carious pulp exposures with/without sign/symptoms of IP., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Abstract: Visual impairment due to refractive errors and color vision deficiency (CVD) can affect the visual abilities of workers in workplace. Identifying the prevalence of common visual problems helps us to prevent and treat occupational ocular problems.This study was conducted on 2600 males referring from companies for a routine medical exam to Occupational Medicine Center. In all subjects, visual acuity and refraction were measured. Assessment of color vision was performed by Ishihara color test. In present study, right eyes of subjects were selected to statistical analysis.The mean spherical equivalent was -0.19 ± 1.39 diopter with a range of -11.00 to +10.00 diopter. Whereas 71% of persons were emmetropic, 20% and 9% of them were myopic and hypermetropic, respectively. From a total subjects, 164 of them had CVD with prevalence of color blindness of 6.3%. In comparison with normal subjects, CVD had no significant effect on refractive findings of our subjects (P > .05).Our data present the prevalence of refractive errors and color blindness among Iranian industry-workers. Compared with other studies, our subjects have a lower prevalence of refractive errors, and similar rate of prevalence of color blindness., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: To evaluate the correlation between the angle of deviation in different gazes and the amount of head tilt in patients with congenital unilateral superior oblique muscle palsy (SOP)., Methods: This case series study was performed on 20 consecutive SOP patients with head tilt. Based on the Bielschowsky three-step test, the angle of deviation was measured in different gazes. Furthermore, the hypertropia difference between the two lateral gazes (gaze difference) and the two head tilt sides (bilateral head tilt difference) was calculated. For measuring head tilt, close-up pictures from 40 cm with a habitual abnormal head position were captured and analyzed by the Corel Draw X7 software., Results: The mean age of patients was 13 ± 9 years (range, 2.5-31 years). The mean angle of hypertropia in ipsilateral and contralateral head tilt was 24.5 Δ ± 7.1 Δ and 6.5 Δ ± 4.2 Δ, respectively ( P < 0.001), and in ipsilateral and contralateral lateral gaze positions, it was 8.2 Δ ± 5.5 Δ and 22.5 Δ ± 6.1 Δ, respectively ( P < 0.001). The mean of bilateral head tilt hypertropia difference was 18 Δ ± 5.3 Δ and gaze hypertropia difference was 14.3 Δ ± 6.16 Δ. There was a positive correlation between bilateral head tilt hypertropia difference and the amount of head tilt ( R = 0.609, R 2 = 0.371, P = 0.004, the amount of head tilt = 0.39 × [Bilateral head tilt hypertropia difference] +1.77). The amount of head tilt also had a positive correlation with the gaze hypertropia difference ( R = 0.492, R 2 = 0.242, P = 0.028, the amount of head tilt = 0.27 × [gaze hypertropia difference] +4.81)., Conclusion: In SOP patients, the amount of head tilt had a positive correlation with bilateral head tilt hypertropia difference and also gaze hypertropia difference., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Current Ophthalmology.)

Background and Aim: Considering the importance of non-specific low back pain (NSLBP) and its increasing spread, the need for instruments for the accurate diagnosis of back pain is evident in order to offer more effective treatment. One such instrument is the STarT Back Screening Tool (STarT) which is examined by numerous studies, while some of its psychometric dimensions still require attention. Therefore, the objective of this study was to assess the internal consistency and construct validity of this questionnaire to propose a modified version., Method: In this cross-sectional study, the data of 295 patients with NSLBP were analyzed. Cronbach's alpha was used to assess internal consistency, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess construct validity. The Χ2/df, GFI, CFI, and RMSEA indices were also utilized as the goodness-of-fit criteria. Data analysis was performed in SPSS, AMOS, and EQS programs., Results: Goodness-of-fit indicators were calculated for the original Persian version of the questionnaire, showing an improper fit (RMSEA = 0.162). According to the measures of sampling adequacy (MSA) of the questions, Questions 1 and 8 were deleted, resulting in an improved index (RMSEA = 0.062). All the regression coefficients in the CFA model were significant (p < 0.001for all 7 parameters)., Conclusion: Based on the results, the modified Persian version of the STarT is simpler and more practical than the previous version, serving as a valid and reliable tool for assessing patients with low back pain. With respect to the goodness-of-fit indices, we recommend that more studies with larger samples be conducted on different populations., Competing Interests: Declaration of competing interest This study was supported by the Vice-Chancellor of Research Affairs, Shahid Beheshti University of Medical Sciences (grant code: 8). The Authors declare no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Primary palmar hyperhidrosis (PPH) is a disorder related to sympathetic dysfunction. Iontophoresis can be used to reduce sweating rate. Sympathetic skin response (SSR) is commonly used to evaluate the sympathetic system. However, scarce evidence exists about the reliability of SSR parameters., Objective: To assess the relative and absolute reliability of SSR before and after the application of iontophoresis with aluminum chloride hexahydrate (ACH) gel or tap water in subjects with PPH., Methods: Twenty subjects were randomized to receive either iontophoresis with ACH gel or tap water. Three SSRs (amplitude and latency) with 5 s intervals from both hands in both groups were recorded before and after the application of iontophoresis for 30 min. Reliability of amplitude and latency of the SSR was assessed using intraclass correlation coefficient (ICC) with 95% confidence intervals, standard error of measurement (SEM), and minimal detectable change (MDC)., Results: Amplitudes and latencies of SSR showed good to excellent test-retest reliability for ICC in both groups before iontophoresis. Except for right hand latency which was moderate (0.5-0.75). After iontophoresis, the ACH gel group still showed good to excellent agreement for SSR parameters, while the reliability of SSR parameters in the tap water group was reduced., Conclusion: Subjects with PPH showed high intra-rater reliability for SSR parameters which was maintained after ACH gel iontophoresis and decreased after tap water iontophoresis. It seems that media used for iontophoresis or the state of media (gel vs liquid) may affect the reliability of SSR. Further research is recommended., Competing Interests: Declaration of competing interest No funding sources or conflicts of interest were reported for this study., (Copyright © 2020. Published by Elsevier Ltd.)

Objectives: The purpose of the present study was to determine the short and medium effects of dry needling (DN) on myofascial trigger points (MTrPs) in individuals with symptomatic hallux valgus (SHV)., Methods: A total of 30 female volunteers, aged 25-60, with hallux valgus (HV) were randomly divided into two groups: DN group (n = 15) and control group (n = 15) who received sham dry needling. The outcome measures were pain intensity (Visual Analogue Scale, VAS), Foot Function Index (FFI), hallux valgus angle (HVA), and first metatarsophalangeal joint radiography., Results: At the end of the intervention, the HVA showed a significant decrease in the case group (P < 0.001); however, statistically no significant difference was found in the pain intensity and foot function between the two groups (P > 0.05). These findings were maintained for a week and a month during follow-ups., Conclusion: According to the findings, dry needling can be recommended for improving first metatarsophalangeal joint alignment in the mild to moderate SHV individuals., Competing Interests: Declaration of competing interest I would like to mention that all authors of this manuscript have no conflict of interest in the submitted article., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: Macronutrients and micronutrients present in different types of diet could influence different aspects of both inflammatory and immune responses; thereby, diets could influence oral health and the periodontal condition. The raw vegan diet is a subset of vegetarianism in which only uncooked plant-derived foods are consumed. The present study's aim was to evaluate the effect of the raw vegan diet on periodontal and dental health parameters., Materials and Methods: A total of 118 participants (59 raw vegans and 59 controls) were interviewed about their level of education and oral health habits. Samples of unstimulated whole saliva were collected for pH analysis, and dental and periodontal parameters were examined. Then, statistical analysis was performed., Results: Raw vegans had better oral hygiene ( P = 0.001). The decayed-missing-filling indices were relatively equal in both groups. The probing depth, bleeding on probing (BOP), and simplified oral hygiene index were significantly lower in raw vegans ( P = 0.047, P = 0.017, and P = 0.001, respectively). Multiple regression analyses disclosed that probing depth and BOP were significantly related to debris index., Conclusion: Based on this study's results, it can be presumed that the better periodontal condition in raw vegans is a result of their better oral care and lifestyle., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Tzu Chi Medical Journal.)

Background: Since the introduction of resin composites, the staining of resin-based materials by colored solutions such as coffee, tea, chlorhexidine (CHX), and other beverages has become a common concern., Aim: The aim of this study was to evaluate the effect of home and office bleaching as a treatment for discoloration of composite after immersion in coffee or CHX., Materials and Methods: A microhybrid composite (Z250), nanohybrid composite (Z550), and nanofill composite (ultimate, body shade) were selected. Forty disk shape specimens (8 mm diameter and 2 mm thickness) for each composite were prepared then divided into two groups according to staining solutions (25 g of coffee in 250 ml water, 20 min/day or 0.2% CHX, 1 min/day). Following 1 month staining, specimens were divided into two groups again. Half of the specimens was bleached with in office bleaching agent (Opalescence Boost 40% hydrogen peroxide concentration) 3 times in one visit for 15minutes and the others subjected to home bleaching agent(Opalescence 10% carbamide peroxide) 6h/day until 2 weeks both from Ultradent Products, Inc., South Jordan, UT, USA. Color of the specimens was measured with a spectrophotometer using CIELAB color space at baseline, after 1 month staining, and after ending the bleaching process., Statistical Analysis: Analysis of variance was used to analyze the data ( P < 0.05)., Results: Coffee and CHX provided significant color changes in all groups ( P < 0.05). Z550 was the material more prone to discoloration in coffee in comparison with Filtek Ultimate ( P = 0.003). After bleaching, materials showed significant reduction except stained Z550 by coffee in home bleaching groups. Both home and office bleaching provided significant color changes in all CHX groups ( P < 0.05)., Conclusion: Coffee produced more color changes than CHX. The hydrogen peroxide has the same whitening effect in comparison with carbamide peroxide., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Conservative Dentistry.)

Objectives: This study aimed to assess the microshear bond strength (MSBS) of Scotchbond Universal adhesive, used in self-etch and etch-and-rinse modes, to primary and permanent dentin at 24 hours and six months., Materials and Methods: A total of 88 composite micro-cylinders were divided into eight groups (n=11) as follows: (A) Etch-and-rinse, 24 hours, primary dentin; (B) Self-etch, 24 hours, primary dentin; (C) Etch-and-rinse, six months, primary dentin; (D) Self-etch, six months, primary dentin; (E) Etch-and-rinse, 24 hours, permanent dentin; (F) Self-etch, 24 hours, permanent dentin; (G) Etch-and-rinse, six months, permanent dentin; (H) Self-etch, six months, permanent dentin. The MSBS was measured by a testing machine at a crosshead speed of 0.5 mm/minute. Data were analyzed using three-way analysis of variance (ANOVA)., Results: The mean MSBS was 12.3±2.3 MPa in A, 18.8±4.1 MPa in B, 11.9±3.7 MPa in C, 16±2.9 MPa in D, 19.1±2.7 MPa in E, 22.8±4.1 MPa in F, 16.2±2.6 MPa in G, and 17.2±4.4 MPa in H. In the self-etch mode, the MSBS was significantly higher than that in the etch-and-rinse mode (P<0.001). The MSBS in permanent teeth was significantly higher than primary teeth (P<0.001). At six months, the MSBS significantly decreased in all groups (P<0.001)., Conclusion: The micro-shear bond strength of Scotchbond Universal adhesive decreases over time and depends on the type of tooth and the mode of application of the adhesive., Competing Interests: CONFLICT OF INTEREST STATEMENT None declared., (Copyright© Dental Research Center, Tehran University of Medical Sciences.)

Background: Stroke is the biggest cause of disability in adults. Spasticity is a primary impairment of stroke with a highly variable prevalence. In the present research, we aimed to determine the impact of functional stretching exercises on functional outcomes in stroke patients., Methods: Thirty stroke patients were randomized into two groups-Experimental group and control group for the purposes of the study. The subjects in the experimental group participated in a functional stretching training program at the rehabilitation center thrice a week for four weeks. The subjects in both groups were evaluated in 3 intervals, once at baseline, once at the end of the program, and once at 2 months following the program. Clinical assessments, such as measuring spasticity, were conducted using the Modified Modified Ashworth Scale (MMAS). Functional outcomes were also evaluated, using the Timed Up and Go (TUG) test, as well as the Timed 10-Meter Walk Test (WTT). Friedman test in SPSS version 22.0 was used to analysis the response variables with respect to each stage of evaluation. Spearman rank correlation was also used to measure correlation among clinical assessments and functional outcomes., Results: The comparison between two groups showed significant differences only in the Modified Modified Ashworth Scale and Visual Analogue Scale (VAS) post treatment. The experimental group showed significant differences in the MMAS (p = 0.002), WTT (p < 0.001), and TUG (p < 0.001) scores. Nevertheless, the scores of the control group were not significantly different in different stages of evaluation., Conclusion: The findings of the study suggest that using functional stretching exercises can improve functional outcomes in chronic spastic stroke patients., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: Due to the significant prevalence of knee disorders and patellofemoral pain syndrome, as well as the importance of quadriceps strengthening in knee rehabilitation programs, it is necessary to specify the best method to activate and strengthen the quadriceps muscles. The current study aimed at comparing the maximum generated isometric force during an active straight-leg-raising (SLR) maneuver in a sitting position by changing the hip rotational position with and without the simultaneous contraction of the ankle dorsiflexor muscles., Methodology: The current study was performed on 30 healthy males recruited with a non-random and available sampling method. The maximum generated force was measured during the SLR maneuver in six compound internal and external rotations and in a neutral position with and without ankle dorsiflexor contraction. The obtained generated force was analyzed using repeated measures ANOVA., Results: The generated forces in the SLR with and without contracting the ankle dorsiflexors were significantly different (p = 0.001), and taking different positions of hip rotation led to significant changes in the generated force (p = 0.005)., Conclusion: The adoption of external hip rotation with the contraction of ankle dorsiflexors during the SLR maneuver generated the most force. Based on the interaction of these conditions, the general recommendation is to perform the SLR exercise in an external hip rotation with the simultaneous contraction of the ankle dorsiflexors in subjects with quadriceps muscle weakness., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Pronated foot is one of the most important factors that may lead to musculoskeletal injuries of the lower extremities. It is known that in a pronated foot, excessive mechanical loads are applied to the lower limb structures, which result in the altered foot biomechanics, including vertical ground reaction forces (VGRFs) and rate of loading (ROL). Therefore, the aim of this study was to determine the changes in foot kinetic parameters in the pronated compared to the normal foot structures., Methods: In this cross-sectional study, 15 individuals (mean age of 23.27 ± 3.28 years) with asymptomatic pronated feet and 15 normal subjects (mean age of 23.40 ± 3.11 years) were recruited from both genders by using a simple non-random sampling method. VGRF, ROL, and the resultant vector of time to stabilization (RVTTS) were evaluated during the forward jump landing task by using a force plate., Results: The findings showed that the following parameters were significantly higher in the group of pronated feet than in the normal subjects: VGRF (3.30 ± 0.17 vs. 2.81 ± 0.15, p = .042), ROL (0.10 ± 0.01 vs. 0.07 ± 0.006, p = .020), and RVTTS (2592.80 ± 141.24 vs. 2114.00 ± 154.77, p = .030)., Conclusion: All the measured foot kinetic parameters were higher in the pronated foot subjects than in the normal participants. An impaired movement control and greater forces imposed on the foot region of the pronated foot, compared to the normal foot individuals, were discovered indicating the former group's possible increase of susceptibility to various musculoskeletal injuries., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Upper extremity motor impairment is one of the most prevalent problems following stroke. Considering the functional importance of the upper extremity in the daily life, the purpose of this study was to investigate the effect of kinesiotaping (KT) on hand function and spasticity in individuals following a stroke. Eight individuals who had experienced a stroke, with their age ranging from 47 to 66, participated in this pretest-posttest clinical study. An I- strip of tape was placed on the extensor muscles of the forearm. Primary outcome measures were the Modified Modified Ashwoth Scale, Box and Block test, and Nine Hole Peg test. At the immediate assessment, there were significant differences between two hand function tests scores. Secondary assessment was done after one week and the results showed significant differences between two hand function test scores. There was no significant change in flexor muscles spasticity after the intervention. This pilot study indicated that KT in the direction of the extensor muscles could result in better hand function in stroke patients., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Aim: This study aimed to compare the prevalence of pelvic musculoskeletal dysfunctions in women with and without Chronic Pelvic Pain (CPP)., Materials &methods: A total of 84 women with and without CPP (42 in each group), participated in this cross-sectional analytical study. After collecting demographic information, clinical examinations were carried out to compare pelvic musculoskeletal dysfunctions between two groups. Kolmogorov-Smirnov (K-S) goodness-of-fit, Independent t, X 2 and Pearson correlation tests were used for data analysis. Values of p < 0.05 were considered statistically significant., Findings: Significant differences were found in the asymmetric iliac crest and pubic symphysis height (45.2% vs 9.5%), positive sacroiliac provocation and positive Carnett's tests (50% vs 4.8%), (p < 0.05). CPP Patients exhibited more tenderness at Levator ani, Piriformis, and Obturator Internus muscles, also higher degrees of pelvic inclination (p < 0.05)., Conclusion: Higher frequency of pelvic musculoskeletal dysfunctions in women with CPP suggests the value of routine musculoskeletal examinations for earlier diagnosis of musculoskeletal originated CPP and effective management of these patients., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: The main objective of the present study was to analyze how supra spinal motor control mechanisms are altered in different directions during anticipatory postural phase of gait initiation in chronic ankle instability patients. It seems that supra spinal pathways modulate anticipatory postural adjustment phase of gait initiation. Yet, there is a dearth of research on the effect of chronic ankle instability on the anticipatory postural adjustment phase of gait initiation in different directions., Method: A total of 20 chronic ankle instability participants and 20 healthy individuals initiated gait on a force plate in forward, 30° lateral, and 30° medial directions., Results: According to the results of the present study, the peak lateral center of pressure shift decreased in forward direction compared to that in other directions in both groups. Also, it was found that the peak lateral center of pressure shift and the vertical center of mass velocity decreased significantly in chronic ankle instability patients, as compared with those of the healthy individuals., Conclusion: According to the results of the present study, it seems that chronic ankle instability patients modulate the anticipatory postural adjustment phase of gait initiation, compared with healthy control group, in order to maintain postural stability. These changes were observed in different directions, too., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: In order to gain a better perspective of the developmental status of children in different regions of Iran, this study was carried out to determine the prevalence and the factors impacting child development in Iranian studies., Materials & Methods: Articles published in Iranian and international journals indexed in the SID, PubMed, Scopus and Magiran databases from 2001-2015 were systematically reviewed using standard and sensitive keywords. After evaluating the quality of 155 articles in the initial search, 26 articles were analyzed according to the inclusion criteria. After investigations, meta-analysis was done for six studies and the results were combined using Random Effects model, and the heterogeneity of studies was evaluated using the I2 index. Data analysis was performed using STATA version 11.2., Results: Eagger & Beggs tests, respectively with 0/273 & 0/260 did not confirm the probability of publication bias in the data, but heterogeneity in studies was confirmed (p˂0/001). On such basis, the pooled prevalence of developmental disorder based on Random Effect model was calculated to be 0.146, CI (0/107-0/184). The prevalence of developmental disorders in children in the studies reviewed was reported between 7 to 22.4%. The most important risk factors were in SES )Socio Economic Status) and Prenatal, Perinatal, Neonatal &Child groups., Conclusion: More extensive studies and early intervention with respect to causes of developmental delay in children seems necessary., Competing Interests: The authors declare that there is no conflict of interests regarding the publication of this paper.

Aim: The purpose of this clinical trial experiment was to compare the effects of the combination of dry needling (DN) and the muscle energy technique (MET) on the upper trapezius latent myofascial trigger point., Method: Sixty female patients, aged 18-30 with latent myofascial trigger points in the upper trapezius muscle were randomly divided into three groups: group 1 (n = 20) received DN and MET, group 2 (n = 20) received only MET, and group 3 (n = 20) received only DN. The visual analogue scale (VAS), pressure pain threshold (PPT), and range of active contra lateral flexion (CLF) were measured before each treatment. The patients were treated for three sessions in a one-week period with at least a two-day break between each session, and in session four, an assessment of primary outcomes was conducted without any treatment., Results: All three treatment groups showed decreases in pain (p = 0.001) and increases in PPT levels (p = 0.001) as well as increases in CLF (p = 0.001). But the group receiving trigger point DN together with MET showed more significant improvement than the other two groups in VAS, PPT and ROM. No significant differences were found between the MET-only group and the DN-only group., Conclusion: Our results indicate that all three treatments used in this study were effective for treating MTP. According to this study, DN and MET is suggested as a new method for the treatment of MTP., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aim: The aim was to evaluate the effect of sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and xylitol on salivary Streptococcus mutans., Materials and Methods: A total of 60 dental students of 20-25 years old, who volunteered after checking their health condition and signing an informed consent, were randomly allocated to receive one of the following interventions: (A) Chewing gum containing CPP-ACP; (B) containing xylitol. Subjects within the experimental groups were taken the gums 3 times daily, after each meal for a period of 3 weeks. Pre- and post-intervention unstimulated saliva samples were quantified for S. mutans counts., Results: A statistically significant reduction of salivary S. mutans was displayed in both groups A and B after the intervention when compared with baseline (P < 0.001), and group A shows more statistically significant reduction of salivary S. mutans than group B (P = 0.011)., Conclusion: Daily consumption of chewing gum containing CPP-ACP and xylitol significantly reduces the level of salivary S. mutans, but chewing gum containing CPP-ACP can reduce the level of salivary S. mutans in more than xylitol chewing gum.

Objective: Recently, self-etching fissure sealants have been introduced to reduce technical sensitivity; however, their efficacy should be assessed. The aim of this study was to assess of the microshear bond strength of self-etching and conventional fissure sealants., Materials and Methods: Thirty non-carious third molars were randomly divided into three groups (N=10). Microcylinders of Concise fissure sealant were bonded to prepared buccal and lingual surfaces using the two following procedures. In the first group, phosphoric acid was used to prepare the substrate; whereas in group two, Concise was used in combination with Prompt L-Pop. In group 3, a self-etching fissure sealant (Enamel Loc) was utilized per se. After 24 hours, the samples were subjected to 500 rounds of thermocycling and shear bond testing using a microtensile tester machine with a crosshead speed of 0.5mm/min. Data were analyzed using one-way repeated measure ANOVA and Bonferroni Post HOC tests (SPSS version 16)., Results: THE MEAN AND STANDARD DEVIATION OF MICROSHEAR BOND STRENGTH OF THE GROUPS WERE AS FOLLOWS: Group 1: Concise+ etching (14.59 ± 1.19 MPa), Group 2: Concise+Prompt L-Pop (12.86 ± 1.98 MPa), and Group 3: Enamel Loc (5.59 ± 0.72 MPa). One-way ANOVA revealed that all the differences were significant and the conventional sealant exhibited the highest mean bond strength., Conclusion: Conventional sealant using phosphoric acid etch application prior to fissure sealant application demonstrated more bond strength in comparison with that of self-etch bonding and self-etch sealant.

Aim: The aim of this study was to compare alternatives methods for analysis of zero inflated count data and compare them with simple count models that are used by researchers frequently for such zero inflated data., Background: Analysis of viral load and risk factors could predict likelihood of achieving sustain virological response (SVR). This information is useful to protect a person from acquiring Hepatitis C virus (HCV) infection. The distribution of viral load contains a large proportion of excess zeros (HCV-RNA under 100), that can lead to over-dispersion., Patients and Methods: This data belonged to a longitudinal study conducted between 2005 and 2010. The response variable was the viral load of each HCV patient 6 months after the end of treatment. Poisson regression (PR), negative binomial regression (NB), zero inflated Poisson regression (ZIP) and zero inflated negative binomial regression (ZINB) models were carried out to the data respectively. Log likelihood, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare performance of the models., Results: According to all criterions, ZINB was the best model for analyzing this data. Age, having risk factors genotype 3 and protocol of treatment were being significant., Conclusion: Zero inflated negative binomial regression models fit the viral load data better than the Poisson, negative binomial and zero inflated Poisson models.

Aim: This study aims to employ random effect model to evaluate prognostic factors of hepatitis C., Background: In recent years, Hepatitis C virus (HCV) infection has been a major cause of liver diseases worldwide and represents a major public health problem. Evaluation of risk factors and a community intervention in order to decrease the problem is one of the solutions which help protect people from the infection., Patients and Methods: The data was collected from a longitudinal study during 2005-2010. The response variable in this study was the viral load of each HCV patient during the treatment, immediately after the treatment and 3 to 4 months after the end of the treatment. The outcome variable of interest is the viral load of HCV patients. For analyzing repeated measure viral load of HCV patients, random effect models were used., Results: The results obtained from random effect model showed that treatment protocol and time statistically significant. The variance component was statistically differing with zero., Conclusion: According to the results time had a positive effect on rate of viral load of patient. Combination therapy of Peg-interferon plus Ribavirin increased the rate of virological response.