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Abstract Objective To compare the effectiveness of different oral hygiene education strategies on periodontal health in fixed orthodontic patients in a one-month period: assistant-led instruction, social media-based education, and custom-made software. Methods Sixty orthodontic patients from Mashhad University of Medical Sciences’ Dentistry School were randomly assigned into three groups. Each group received oral health education differently: via assistant instruction, educational videos on social media, or a researcher-designed software for Android smartphones. After a month, participants’ oral health was evaluated using the plaque index (PI) and the gingival index (GI). Results Assistant-led education group demonstrated the highest PI (1.26 ± 0.70) and GI (0.92 ± 0.67), while the software group reported the lowest indices (PI = 0.68, GI = 0.46 ± 0.46). The social media group’s measurements fell between these extremes (PI = 0.89 ± 0.75, GI = 0.60 ± 0.52). Significant group differences were found for both PI and GI (P = 0.028 and P = 0.047, respectively). Pairwise comparison revealed significantly lower PI and GI in the software group compared to the assistant group. No significant differences were found between the social media and other groups. Conclusion Our results suggest that the use of specially designed software could be the most effective strategy for improving oral hygiene in orthodontic patients. Meanwhile, traditional assistant-led education showed the least effectiveness. The study supports the potential benefit of utilizing digital tools, such as bespoke software and social media, in oral health education for orthodontic patients. Trial registration The study was registered in the Iranian Registry of Clinical Trials (IRCT) database with the identification code IRCT20200609047705N2 in 13.07.2021.

In this experimental work, the 2-phase air-water non-boiling ascending fluid flow in a vertical tube with helical corrugations has been investigated. The results showed that the head loss values decreased with an increase of the volume fraction. Also, by comparing the head loss values for each corrugation pitch, it can be observed that as the corrugation pitch goes down, the head loss values significantly increase. As a result, the intensity of vapors increases perpendicular to the main flow of water, which leads to an increase in the intensity of disturbance in the flow, and then the head loss increases. The Nusselt number goes down when the volume fraction experiences an increment. Looking at the figures related to Nusselt number, it is easy to see that the curves are drawn for a constant air flow rate. Consequently, an increase in volume fraction (VF) is equal to a decrease in the water flow rate. By reducing the water flow rate, the intensity of the main flow is reduced the intensity of turbulence is also reduced and the heat transfer coefficient is reduced. As a result, the amount of heat transfer has increased due to air injection. It should be noted that pipes with the largest corrugation pitch had the best Cost-benefit ratio (C.B.R.) factor values (which means the lowest value). This means that air injection in larger corrugation pitch tubes was more beneficial than in smaller corrugation pitch tubes.

Prompt detection of renal involvement through evaluation of microalbuminuria can both reduce mortality in diabetic patients and significantly reduce the cost of managing these patients. To this end, Micral test strips have been used as a screeing tool in this group of patients though not yet in our country. The present study aimed to evaluate this test and to abtain a simpler and less expensive method of screening for microlbuminuria. In this study, 200 type 1 and type 2 diabetic patients referred to the Endocrine & Metabolims Research Center of the Tehran university of medical Sciences were evaluated for microabluminuria. Entry criteria consisted of a history of recognized diabetes longer than or equal to 5 years. Exclusion criteria included development of urinary tract infection, pyrexia, and a history of uncontrolled hypertension. Every patient first completed a data questionnaire and then provided a first-void urine sample, which was tested for microalbuminuria with a urinary protein test strip (an Iranian-made Uri-Yab and a German-made BM-test-GP strip) and the sulphasalicylic acid chemical method. Negative samples were tested further using Micral test strips (based on gold-lable immunochromatograpy) and the microalbumin measurement kit manufactured by Dako. Germany (based on turbidometry using a Hitachi autoanalyser). 126 women and 74 men were recruited into the study. The average age of the sample was 40.7 years (range=16 to 63 years); 17 patients had IDDM and 173, NIDDM. Average duration of recognized diabetes was 8.75 years. Based on results obtained using chemical analysis and foreign-made tests strips, 46 patients (23%) had macroalbuminuria, though the detection rate using Iranian-made test strips was 18 percent (36 patients). A further 16.2 percent of patients had microalbuminuria, with an average urinary albumin excertion of 28.7 mg per liter. Compared with colorimetric methos, the Micral test yieled a sensitivity of 93% and a specificity of 87 percenct. Furthermore, the negative predictive value of the Micral test was 0.92, compared with a figure of 0.94 for a combination of the sulphasalicylic acid method and the BM-Test-GP strips. The results we obtained for the Micral test as a screening tool concurs with the results of numerous other studies. Diurnal variations in albumin excretion dicatate the performance of screening tests on three different occasions at specified regular intervals. Given the relatively high cost of Micral strips, it seems that a simpler and less expensive method should be devised for our country. We observed a higher negative predictive value for the combined suluphasalicylic+BM-Test-GP method than for the Micral strips. The cost of the latter combination comes to 2,000 Rials (@0.25 USS) , which is easily affordable for most patients; the methodology falls comfortably within the experits of medical diagnostic laboratories in Iran. More detailed studies, using 24-

Throughout its history, Afghanistan has lacked a system of separation of powers with checks and balances. Even the 2004 constitution, which was drafted in a relatively open political environment, fell short of establishing such a system. It granted the president excessive executive, legislative, and judicial powers, effectively concentrating power in the executive branch. This centralism fostered autocratic tendencies. The President intervened in legislative matters, bypassing constitutional requirements and weakening legislative oversight. Similarly, the president’s excessive power undermined the independence of the judiciary system, turning it into a tool to pursue his interests. The combined executive, legislative, and judicial powers of the president, coupled with weak oversight institutions, led to unchecked centralism. This concentration of power weakened the rule of law, fueled corruption, exacerbated wealth and power imbalances, and eroded public trust in the government. More importantly, this centralism exacerbated ethnic tensions in the country. The present contribution, informed by the author’s experience with the Constitutional Oversight Commission in Afghanistan, follows a descriptive and analytical approach. It argues that there is a need for decentralizing power in any future constitution in order to establish a modern and stable governance system in Afghanistan.

Aim: This study aimed to collect evidence on the validity and reliability of measurements obtained from digital impression techniques. Materials and Methods: This comparative study was conducted on 31 patients. Intraoral scanner was applied to all patients. For each patient, an alginate impression of the upper maxilla was taken and later the 3D digital model was extracted by dental cone-beam computed tomography (CBCT). For preparation of plaster models, alginate impressions were taken and immediately poured with dental stone. In the next stage, a comparison was performed among the intraoral scanner, CBCT, and plaster models in terms of tooth size, dental width, and intra-arch dimensions. Results: Measuring tooth size and intra-arch dimensions in digital images obtained from intraoral scanner and CBCT were in most cases lower than the results obtained in the plaster models but the differences between digital techniques and plaster models are not clinically noticeable. Conclusions: Digital systems including intraoral scanner and CBCT are acceptable for clinical use in terms of accuracy.

Background and purpose: Healing burn wounds is considered to be a prominent medical issue, and the identification of a drug or substance that can effectively heal these wounds with minimal side effects is of great importance. The aim of the present study was to investigate the anti-inflammatory, antioxidant and restorative effects of the glandular sorrel plant on the experimental burn wound model in BALB/C mice. Materials and methods: In this experimental-laboratory study, a total of 60 BALB/C mice were randomly assigned to 5 groups, each consisting of 12 mice. These groups included the control group, the cold cream sham group, the cream group containing the extract of the glandular sorrel plant, the Laagex cream group, and the group of the glandular sorrel leaf group. After second degree burns on days 3, 7, 14 and 21, wound healing variables include comparison of wound closure speed, inflammation, vascularization, epithelial regeneration, number of hair follicles, and number of strands. Collagen levels, inflammatory cytokines, antioxidant enzymes and liver enzymes were also examined. Results: The results of the study indicated that the average inflammation, vascularization, epithelial regeneration, the number of hair follicles, the amount of collagen fibers and also the average of apparent wound closure in the groups treated with the cream containing the extract and leaves of the Rumex Tuberosus L. And Lajex cream has a significant difference (P

Pancreatic cancer (PC) is a dangerous digestive tract tumor that is becoming increasingly common and fatal. The most common form of PC is pancreatic ductal adenocarcinoma (PDAC). Bile acids (BAs) are closely linked to the growth and progression of PC. They can change the intestinal flora, increasing intestinal permeability and allowing gut microbes to enter the bloodstream, leading to chronic inflammation. High dietary lipids can increase BA secretion into the duodenum and fecal BA levels. BAs can cause genetic mutations, mitochondrial dysfunction, abnormal activation of intracellular trypsin, cytoskeletal damage, activation of NF-κB, acute pancreatitis, cell injury, and cell necrosis. They can act on different types of pancreatic cells and receptors, altering Ca2+ and iron levels, and related signals. Elevated levels of Ca2+ and iron are associated with cell necrosis and ferroptosis. Bile reflux into the pancreatic ducts can speed up the kinetics of epithelial cells, promoting the development of pancreatic intraductal papillary carcinoma. BAs can cause the enormous secretion of Glucagon-like peptide-1 (GLP-1), leading to the proliferation of pancreatic β-cells. Using Glucagon-like peptide-1 receptor agonist (GLP-1RA) increases the risk of pancreatitis and PC. Therefore, our objective was to explore various studies and thoroughly examine the role of BAs in PC.

Introduction: Few studies were conducted on the effectiveness of clear aligners. The present study aimed to compare the quality of life related to oral health, patient satisfaction, and the level of anxiety caused by treatment in patients treated with fixed orthodontics and clear aligners.Materials and Methods: This descriptive-analytical study was conducted on 100 patients undergoing fixed orthodontic treatment six months from the start of their treatment and 100 patients undergoing treatment with clear aligners six months from the start of their treatment. The Oral Health Impact Profile (OHIP-14) questionnaire was used to compare the effect of these two treatments on the quality of life related to the oral health of these patients. Additionally, Patient Satisfaction (PSQ-18) questionnaire was used to check patients’ satisfaction and State Trait Anxiety Inventory was used to assess patients’ anxiety status.Results: The patients included 78 (38. 8%) males and 122 (61.2%) females. The average quality of life related to oral health was 53.26 with a range of 19 to 69, the average patient satisfaction was 42. 46, with a range of 14 to 50, and the mean and standard deviation of anxiety caused by treatment was 72. 26 ± 13. 93 with a range of 37 to 99. The average anxiety caused by the treatment in the transparent aligners group was significantly higher than the fixed orthodontic group (P

Introduction: Assessing and improving infection prevention and control (IPC) knowledge and practicing skills among medical students who are the future medical practitioners is crucial for reducing the burden of healthcare-associated infections (HAIs). In this study, we assessed the IPC knowledge of undergraduate clinical-year medical students before and after interventional IPC modular training and evaluated the effectiveness and students’perception on structured modular IPC training presented to them.Methods: This cross-sectional interventional study was conducted on single medical cohort comprising of 145 final-yearundergraduate medical students of the academic year 2022-23 at COMHS. Pre-test, post-test, and feedback questionnaire were used as the assessing tools. The data were collected, entered into Excel sheet, and analyzed using SPSS software version 22. McNemar and Paired-T tests were carried out, and a P-value90%) perceived IPC training as an excellent tool to improve IPC knowledge and practicing skills.Conclusion: IPC training had a significant impact in gaining adequate IPC knowledge and practicing skills among ourparticipants. Therefore, it is recommended that IPC training should be implemented in the undergraduate medical curriculum with greater emphasis on practicing skills.

Abstract Background Elevated plasma total homocysteine is an independent risk factor for cardiovascular disease and a sensitive marker of the inadequate vitamin B12 and folate insufficiency. Folate and vitamin B12 have a protective effect on cardiovascular disease. This population based study was conducted to evaluate the plasma total homocysteine, folate, and vitamin B12 in healthy Iranian individuals. Methods This study was a part of the Cardiovascular Risk Factors Survey in the Population Lab Region of Tehran University has been designed and conducted based on the methodology of MONICA/WHO Project. A total of 1214 people aged 25–64 years, were recruited and assessed regarding demographic characteristics, homocysteine, folate, and vitamin B12 levels with interview, questionnaires, examination and blood sampling. Blood samples were gathered and analyzed according to standard methods. Results The variables were assessed in 1214 participants including 428 men (35.3%) and 786 women (64.7%). Age-adjusted prevalence of hyperhomocysteinemia (Hcy≥15 μmol/L) was 73.1% in men and 41.07% in women (P < 0.0001). Geometric mean of plasma homocysteine was 19.02 ± 1.46 μmol/l in men and 14.05 ± 1.45 μmol/l in women (P < 0.004) which increased by ageing. Age-adjusted prevalence of low serum folate level was 98.67% in men and 97.92% in women. Age-adjusted prevalence of low serum vitamin B12 level was 26.32% in men and 27.2% in women. Correlation coefficients (Pearson's r) between log tHcy and serum folate, and vitamin B12 indicated an inverse correlation (r = -0.27, r = -0.19, P < 0.0001, respectively). Conclusion These results revealed that the prevalence of hyperhomocysteinemia, low folate and vitamin B12 levels are considerably higher than other communities. Implementation of preventive interventions such as food fortification with folic acid is necessary.

Invasive fungal rhinosinusitis (IFRS) is a life-threatening infection that can occur in immunocompromised patients, including those with COVID-19. Although Mucorales and Aspergillus species are the most common causes of IFRS, infections caused by other fungi such as Fusarium are rare. In this report, we present three cases of proven rhinosinusitis fusariosis that occurred during or after COVID-19 infection. The diagnosis was confirmed through microscopy, pathology, and culture, and species identification of the isolates was performed by DNA sequencing the entire ITS1-5.8 rRNA-ITS2 region and translation elongation factor 1-alpha (TEF-1α). Antifungal susceptibility testing was conducted according to CLSI guidelines. The causative agents were identified as Fusarium proliferatum, F. oxysporum + Aspergillus flavus, and F. solani/falciforme. Treatment involved the administration of antifungal medication and endoscopic sinus surgery to remove the affected mucosa, leading to the successful resolution of the infections. However, one patient experienced a recurrence of IFRS caused by A. flavus 15 months later. Early diagnosis and timely medical and surgical treatment are crucial in reducing mortality rates associated with invasive fusariosis. Additionally, the cautious use of corticosteroids in COVID-19 patients is highly recommended.

Treatment of impacted canine teeth is a challenge for most clinicians, especially in adult patients with high risk of ankylosis. Conventionally, leveling and alignment of the teeth are first performed and after heavy arch wire placement in slot of brackets, de-impaction force is applied. However, this method has some disadvantages, such as inability to detect ankylosis of the impacted tooth until load application, risk of root resorption of incisors or necrosis of them, distortion of dental arch form, the need for early extraction of primary canines, which is esthetically unfavorable for patients, and long-term presence of fixed orthodontic appliances in the oral cavity. This study aims to introduce approach that can be easily used by busy clinicians to guide palatally impacted canines into the dental arch using a cantilever spring supported by two palatal miniscrews prior to the initiation of fixed orthodontic treatment, and report some cases treated with this technique. This technique does not have the shortcomings of the conventional technique. In addition, the total duration of treatment, and duration of presence of orthodontic appliances in the oral cavity are shorter than the conventional technique. In addition, is less technique sensitive and do not need time complex and time consuming wire bending.

Benyamin Netanyahu has been the main figure in the Israeli political scene for the past decade. Since he has played a major role in shaping the Israeli foreign policy in the international arena, this study seeks to examine his leadership style and personality traits as an influential and at the same time a neglected factor in the foreign policy behavior of the state of Israel. Hence, the main hypothesis is the fact that Israel’s foreign policy behavior has been more influenced by Netanyahu’s cognitive system and leadership style. The conceptual/methodological framework used in this paper is Leadership Traits Analysis (LTA) proposed by Margaret G. Hermann with a focus on the Conceptual Complexity variable in this regard. The results of this study, which itself are the quantitative content analysis of Netanyahu’s verbal material from 2009 to 2019; suggest that BIBI’s low conceptual complexity and his black and white thinking to foreign policy with high belief in ability to control events, a high desire for power, and a strong distrust to others have shaped Netanyahu’s aggressive and hawkish approach to Israeli foreign policy, which can be seen in exaggerating the Iranian threat and opposing to the idea of a Palestinian independent state.

This study aimed to evaluate the ability of the Fränkel manoeuvre to identify the contributing jaw to a class II malocclusion.

All governments especially those having a high risk of natural disasters must have a comprehensive and implementable plan. In Iran, the placement of relief centers for the injured is usually done experimentally by relief organizations without considering the necessary standards. In this research, according to the crisis management standard, the criteria are classified and determined as layers of information in the Geographic Information System (GIS). Then, the selected relief centers in the study area were evaluated according to the standard criteria and using the obtained matrix, the research criteria were weighed by entropy method. Finally, using net flows, performance scores and research constraints, the optimal options were identified by the PROMETHEE 5 method. The strengths and weaknesses of each of these options were also assessed. The results showed that half of the relief centers considered in the region were not optimal and had poor performance in most of the effective and important criteria for locating relief centers. Criteria of population density and distance from worn tissue were the most important criteria in this study.

Objective: This study aimed to compare the effect of ibuprofen and low-intensity pulsed ultrasound (LIPUS) on the reduction of pain after the placement of initial archwire in orthodontic patients. Material and Methods: This double-blind clinical trial study was carried out on 60 female candidates for fixed orthodontic treatment referring to the Orthodontic Department of School of Dentistry in Mashhad University of Medical Sciences, Mashhad, Iran, during 2015-2016. The subjects were divided into four groups of ibuprofen, LIPUS, placebo, and mock LIPUS. A questionnaire and a rectangular and flexible cubic silicone were given to each patient to record the severity of pain based on the visual analog scale at specified time points (i.e., 2 h, 6 h, at bedtime, 2nd, 3rd, and 7th days after archwire placement) when biting the silicone block with the anterior and posterior teeth and without biting at all. Repeated measures analysis of variance was used in order to compare the pain severity at different time points. Results: The comparison of pain severity at various time points showed that the highest and lowest mean scores of pain were reported at bedtime and seven days after the intervention (p0.05). Conclusion: In conclusion, LIPUS (with a frequency of 1 MHz and an intensity of 100 mW) and ibuprofen have no significant effects on reduction of the pain severity at different time points and various conditions in orthodontic patients.

There have been numerous studies demonstrating how cancer patients are at an increased risk of mortality. Within New York City, our community hospital emerged as an epicenter of the first wave of the pandemic in the spring of 2020 and serves a unique population that is predominately uninsured, of a lower income, and racially/ethnically diverse. In this single institution retrospective study, the authors seek to investigate COVID-19 diagnosis, severity and mortality in patients with an active cancer diagnosis. Demographic, clinical characteristics, treatment, SARS-CoV-2 laboratory results, and outcomes were evaluated. In our community hospital during the first wave of the COVID-19 pandemic in the United States, patients with active cancer diagnosis appear to be at increased risk for mortality (30%) and severe events (50%) due to the SARS-CoV-2 infection compared to the general population. A higher proportion of active cancer patients with Medicaid insurance, Hispanic ethnicity, other race, and male sex had complications and death from COVID-19 infection. The pandemic has highlighted the health inequities that exist in vulnerable patient populations and underserved communities such as ours.

Summary: Although systemic chemotherapy remains the standard of care for TNBC, even combination chemotherapy is often ineffective. The identification of biomarkers for differential chemotherapy response would allow for the selection of responsive patients, thus maximizing efficacy and minimizing toxicities. Here, we leverage TNBC PDXs to identify biomarkers of response. To demonstrate their ability to function as a preclinical cohort, PDXs were characterized using DNA sequencing, transcriptomics, and proteomics to show consistency with clinical samples. We then developed a network-based approach (CTD/WGCNA) to identify biomarkers of response to carboplatin (MSI1, TMSB15A, ARHGDIB, GGT1, SV2A, SEC14L2, SERPINI1, ADAMTS20, DGKQ) and docetaxel (c, MAGED4, CERS1, ST8SIA2, KIF24, PARPBP). CTD/WGCNA multigene biomarkers are predictive in PDX datasets (RNAseq and Affymetrix) for both taxane- (docetaxel or paclitaxel) and platinum-based (carboplatin or cisplatin) response, thereby demonstrating cross-expression platform and cross-drug class robustness. These biomarkers were also predictive in clinical datasets, thus demonstrating translational potential.

One of the distinguishing features of the current international situation is the growth of China as a great power. The growing power of China for protecting of security interests is directly tied to the US international position; As a result, China's strategic engagement with the US is one of the issues that is essential to understand the future state of international order. This article examines China's pattern of behavior toward the US under the unipolar order system. Hence, the question that the authors have tried to answer with a descriptive-analytical approach is that what pattern governs China's foreign policy to advance its interests, and strategic interactions with the US in the current international order? Findings show that due to the necessity of entangling polarity, economic factor and threat perception, China has adopted a dual pattern of behavior, like the domestic capabilities and external soft balance, in order to advance its strategic interests and interactions with the US. The first concept refers to the continuation of economic efforts along with increasing military capabilities to increase China's relative power. In the second concept, China's internationally balanced behavior toward the United States is considered. This is mostly done through multilateral institutions and economic diplomacy.

Abstract Diaphragm tanks are a common type of pressurized tanks in which the diaphragm is used to separate the fuel part from the high-pressure part, compress the fuel in the tank, and reduce free space to avoid liquid fuel sloshing. The main purpose of the application of the diaphragm tanks is to ensure the continuous flow of pure fuel without the gas bubble into the spacecraft engine. In space mission, diaphragm tanks will experience a wide range of acceleration at different levels of filling. These conditions change the state of equilibrium between the volume of the gas and the fluid and move the diaphragm toward the discharge portion of the tank. As a result of this movement, the diaphragm curvature is changed and the structure collapses at rest, which is called folding. When large nonlinear folding occurs, there is potential for diaphragm damage through wear, rubbing, and excessive stress. Predicting diaphragm behavior in order to calculate a diaphragm’s susceptibility to corrosion, rupture, and surface strain is one of the major design challenges. In this study, new method is provided to analyze deformation of diaphragm tanks by using numerical techniques. Also, the investigation method is verified by using experimental methods. In this process, first a 3D numerical model is developed to investigate the inverse behavior of a hyper-elastic diaphragm by using ANSYS software and the results of the simulations are compared with the results of experimental tests in the same situation. After validation, a second case study is performed to survey the effect of reducing diaphragm thickness according to the strain energy and natural frequency behavior of the diaphragm in different fill levels. The results of this study showed that numerical simulations are capable of reconstructing diaphragm inversion properties with good accuracy. In addition, the numerical model can detect the proper thickness for the diaphragm. In the last section, algorithm and software for optimal automatic modeling of diaphragm tanks are proposed.

Objective: To compare the high-cycle fatigue behavior of four commercially available NiTi orthodontic wires. Material and Methods: Twelve NiTi orthodontic wires, round, 0.016-in, three per brand, were selected and divided into four groups: G1 - Heat-activated NiTi, G2 - Superelastic NiTi, G3 - Therma-Ti, and G4 - CopperNiTi. The atomic absorption spectrometry method was used to determine the chemical composition of investigated NiTi wires. We also performed a fatigue test at three-point bending using a universal testing machine for 1000 cycles in a 35 °C water bath. For the first and thousandth cycle, the average plateau load and the plateau length were determined in the unloading area of the force versus displacement diagram. In addition, we calculated the difference between the average plateau load of the first and thousandth cycle (∆F), as well as the difference between the plateau length of both cases (∆L). Results: According to our results, there were no significant differences between the average plateau load of the first and thousandth cycles of each group (p>0.05) and in the plateau length of the first and thousandth cycles of the groups (p>0.05). Conclusion: There were no significant differences between the groups changing the superelasticity property after high-cycle fatigue.

Introduction: Improving the quality of clinical education requires a continuous review of the status quo, recognition of strengths and weaknesses, as well as correction of these weaknesses. Besides, the experiences of ICU students can be useful in removing such weaknesses. The objective of the present study was to investigate the personal experiences of nursing students about the characteristics of an effective clinical instructor and to explain the concept of “effective instructor” in clinical education. Methods: This qualitative study was conducted based on van Manen’s phenomenology. Using purposive sampling, 12 nursing students working in the intensive care unit of Qazvin University of Medical Sciences were selected and studied. The data were collected by conducting in-depth semi-structured interviews. All interviews were recorded and then the related codes and themes were extracted using van Manen’s analysis method. The validity and robustness of the study were obtained through attention to the four axes of validity, trustworthiness, reliability, and generalizability. Results: The transcripts of the interviews were analyzed and conceptual codes were extracted. After analyzing the data, 12 categories, 51 subcategories, and 5 themes were extracted. The extracted themes included scientific and practical competence, communicator and clinical coordinator, professional behavior guide, theoretical-clinical mediator, and fair evaluator. Conclusion: Based on the findings, the participants in this study emphasized the key role of the instructor in creating a suitable context for professionalization. They acknowledged that an instructor with good personality traits, speaking skills, management, appropriate clinical competencies, effective professional communication, and a realistic evaluation can train qualified students to work in the country’s healthcare system.

Background: Deep bite is known as one of the most common malocclusions, and its treatment and retention are often challenging. The use of mini-screws has been suggested as an ideal method for the intrusion of incisors in deep-bite patients. Still, there are conflicting reports regarding the superiority of this method compared to other common treatments. Aim: The aim of this systematic review and meta-analysis was to evaluate the effects of the intrusion of anterior teeth by skeletal anchorage in deep bite patients. Methods: From the beginning to 15 September 2022, articles on the topic of interest were searched in electronic databases including PubMed, Web of Science, Scopus, EMBASE, and Cochrane’s CENTRAL. Additionally, a hand search for pertinent studies and a search of the grey literature were carried out. After the selection of eligible studies, data extraction was performed using piloted forms. Inverse-variance random-effects meta-analyses were used to combine the outcome measures of dental indices, skeletal cephalometric indices, and dental cephalometric indices. Results: A total of 15 studies (6 RCT; 9 CCT) were included in the systematic review and 14 were used in the meta-analyses. The differences in overbite changes (MD = −0.45, p = 0.04), true incisor intrusion [u1-pp] (MD = −0.62, p = 0.003) and molar extrusion [u6-pp] (MD = −0.40, p = 0.01) were statistically significant and TADs showed better treatment results than other intrusion methods (segmented intrusion arch, utility arch, J hook headgear). No significant differences regarding overjet, molar and incisor tipping, and skeletal indices between mini-screw and other intrusion methods could be found. Conclusion: The use of mini-screws leads to lower overbite and higher true intrusion (about 0.45 and 0.62 mm, respectively) compared to the use of other methods for intruding upper incisors. Furthermore, the effect of TAD on extrusion of molar teeth is less (by 0.4 mm) than other methods.