فهرست مطالب پگاه مسنن مظفری

The purpose of this study is to comparison the effect of dental treatments under general anesthesia and outpatient on the level of fear and anxiety and quality of life related to oral health of children.

Methods & Materials: 

In this cross sectional study two groups of 3 to 6 years old children are selected, one group need dental treatment with general anesthesia and the other group need outpatient treatment in the office. Questionnaires for assessing the child's fear and anxiety level (DS-CFSS) and evaluating the quality of life related to the child's mouth (F-ECOHIS) are provided to the parents before the treatment and 1 month after the treatment. Data were analyzed in SPSS software (version17) using Mann whitney, T-Test , Kruskal-Wallis and Wilcoxon Signed Ranks.The level of significancy was 0.05.

Anxiety before the treatment and also after the end of the treatment was significantly higher in the general anesthesia group than in the outpatient treatment group (p<0.001 and p<0.001). Children's anxiety score has decreased significantly in the outpatient treatment method (p=0.007) and in the treatment method under general anesthesia decreased significantly (p<0.001). The quality of life of children in the outpatient treatment group was significantly higher than the general anesthesia group before the study (p=0.008). There is no significant difference in the quality of life after the treatment between children in the outpatient treatment group and general anesthesia. (p=0.614).

Both methods, outpatient treatment and treatment under general anesthesia are highly effective and have a positive effect on the quality of life related to children's oral health and are able to reduce their anxiety. The treatment under general anesthesia was more successful in reducing anxiety of children comparison to base line ,but in related to the quality of life there was no significant difference.

Peripheral ameloblastoma (PA) is a rare subtype of ameloblastoma that occurs in soft tissue. It most commonly affects the mandible and is more common in males. It most commonly occurs in the sixth decade of life. This case report represented a 19-year-old girl with a 10-mm lesion on the lingual gingiva of the mandible. The surface was papillary and no pain or bleeding was noted. Histopathologic examination revealed neoplastic proliferation of odontogenic epithelial cells nested in a connective tissue context. Unlike many other PA cases, these nests appeared to originate from the basal cell layer of the epithelium. Cone-beam computed tomography and orthopantomogram did not reveal severe bone involvement and aggression. The patient is planned to be followed-up for 10 years. The prognosis of patients with PA is generally good, but cases of lesion recurrence have been reported. Due to the rarity of PA, further studies are needed on its development and treatment outcome.

Amelogenesis Imperfecta is a hereditary complication that affects the quality and quantity of tooth enamel. This disease usually affects both deciduous and permanent dentition and causes various abnormalities such as unaesthetic appearance, dental sensitivity, and severe attrition. The incidence of this condition is estimated at 1 in 14,000 people. At the moment, there are no specific treatment recommendations for patients suffering from AI. when treating these patients, a comprehensive treatment with interdisciplinary approach should be considered.

The patient was a 14-year-old girl who had referred to Shahab Dental Clinic in Mashhad with a complaint about the improper shape and color of her teeth. The patient had no history of any specific disease and no family history of this disease was reported in his family. After clinical and radiographic examination the patient was diagnosed with AI (hypoplastic type).

Related to Patient’s functional and emotional impression of AI, treatment of these patients has specific importance.

Ameloblastoma is an odontogenic tumor with diverse clinical behavior and histomorphologic presentations. Basal cell ameloblastoma are extremely rare variants of ameloblastoma. Keratocystic odontogenic tumor (KCOT) is a distinct form of odontogenic cyst that is considered a benign cystic neoplasm and not a cyst. Co-occurrence of these odontogenic tumors has been rarely reported.This paper reports a 34-year old female patient with a unilocular radiolucency around the crown of a partially erupted third molar that was detected accidentally on a routine radiographic examination. She underwent excisional biopsy with a clinical diagnosis of dentigerous cyst. Histopathologic examination revealed a cystic lesion with criteria of OKC and islands and nests reminiscent of basal cell ameloblastoma and acanthomatous ameloblastoma in the stroma. Follow-up showed no recurrence of lesion to date. Due to the rarity of the lesion, the diagnosis was challenging but altogether we made a diagnosis of keratoameloblastoma with basaloid features.

Pain and sensitivity to thermal irritation after amalgam restoration is one of the most common problems, causes frequent recurrence of these patients to dental clinics. Since low-level laser has several benefits in reducing inflammation, pain and sensitivity, the aim of this study was to evaluate the effect of low-level Ga-Al-As laser on the treatment of dentinal sensitivity after amalgam restoration.

In this double-blind clinical trial study, 21 patients with short-term sensitivity to thermal irritation after amalgam restoration (from the time of repair to two months) were evaluated. The case group was treated with Ga-Al-As laser in 4 sessions with intervals of three days. For the control group, the similar condition was applied except that the device was off. The sensitivity was assessed based on VAS criteria prior to treatment, immediately after treatment, and 3 and 6 months after treatment.

Pre and post-treatment pain in case group was 7.3±1.16, 4.5±3.03 and in control group was 6.45±1.75, 4.27±3.04 respectively. The reduction in pain immediately after treatment was significant only in the case group (p= 0.004). In the follow-up period of 3 and 6 months, the mean VAS in the case group was significantly higher than that in the control group (p= 0.026 and p= 0.020, respectively).

Based on the results this study, the Ga-Al-As low-level laser has a decreasing effect on the sensitivity of post-amalgam restorations in a short term.

The aim of this study was to evaluate the frequency of different types of medical errors in patients having complaints with no physical explanation, referred to Mashhad Dental Faculty Orofacial Pain Clinic. In this cross-sectional/descriptive-analytical study, records of patients referred to the Orofacial Pain Clinic of Mashhad Dental School from 2013 to 2017 were evaluated. A checklist consisting of the following was completed: type of complaint at the visit, method of treatment, diagnostic methods and referral pattern. All the patients had been examined by oral medicine specialists. Their complaints that could not be physically explained based on the history, clinical examinations and paraclinical tests had been evaluated, and the type of sensory disorder had been determined. Furthermore, all the patients had been interviewed by a psychiatrist to determine any psychiatric disorder. The frequency of different types of medical errors, diagnostic methods, psychiatric disorder and sensory impairment were determined and the possible connection was statistically analyzed. Data were analyzed with SPSS (α = 0.05), using frequency tables, graphs and means and standard deviations. ANOVA, t-test and chi-squared test were used to compare the subgroups. In addition, if necessary, non-parametric tests of Mann-Whitney and Kruskal-Wallis were used. The highest frequency of complaints at the time of visit was facial, mandibular or neck pain (74.8%), and the lowest frequency was the complaint about a dull pain in the whole mouth. The most common treatment error was medication errors (49%), followed by tooth extraction. The most common error in diagnostic methods was radiography (65.2%), followed by CT scan (24.1%), and the lowest error occurred in sonography (2.3%). Based on the findings of this study, when a patient with a complaint without any physical explanation is referred to the dental clinic, there is a high probability of diagnostic and therapeutic medical errors. Therefore, it is recommended that specific training programs be organized for dentists to identify complaints with a mental origin and their proper diagnosis or to consider referral of these patients.

Due to the high prevalence of oral diseases and lack of knowledge, giving the proper education is needed to familiarize patients with oral diseases. This study aimed to determine the efficacy of using an educational booklet on patients` knowledge. This interventional study was conducted from spring to winter 2016 on fifty patients referred to Mashhad Dental School. An educational booklet of oral diseases describes various domains of oral diseases in six different groups. Also a questionnaire containing eighteen questions of oral diseases that was prepared and used in two stages, prior to the intervention and after the intervention. The patients were divided into control (n=25) and intervention (n=25) groups. Initially, a pre-test questionnaire was given to both groups. The intervention group received the educational booklet. After one month, the post-test questionnaire was taken from both groups. Chi-square, Mann-Whitney, Fisher and independent t-test were used for statistical analysis. Findings: The difference between mean score changes was significant in both groups respectively 1.6±0.12 and 5.4±1.5 (P<0.001). The intervention significantly increased the knowledge score for all domains in the intervention group compared to the control group (P<0.001). The booklet had the most significant effect on the awareness of cancer and the least influence on pain. It seems that the educational booklet significantly could enhance the level of patients’ knowledge about oral diseases.

Given the importance of randomized clinical trials (RCTs) in the evidence-based approach in dentistry, the study aimed to conduct critical appraisal of dentistry RCTs of Iran published in English from 1999 until 2012.
In total, databases of PubMED, ISI web of science and Scopus were searched using specific keywords (i.e., dental, dentistry, critical appraisal, clinical trial, evidence-based RCT, randomized clinical trial, Iran). After the elimination of duplicate articles, the 433 remaining articles were assessed, which led to the selection of 86 studies by employing the inclusion and exclusion criteria. Following that, the articles were evaluated using the revised version of Jadad scale.
In this research, mean jadad score was 5.33±1.73, and articles were at a moderate level (4 According to the results of the study, the methodological quality of the Iranian English dentistry articles was generally at a medium level, which requires improvement. Emphasis on standard instructions in designing the studies and using review checklists during the complication of a research, along with holding educational relevant workshops, can considerably improve the quality of Iranian articles.

Neurofibroma is a slow-growing benign tumor of neural origin. The lesion is rare in the oral cavity. Most reported cases are parts of a generalized syndrome called Neurofibromatosis (NF), but in rare cases, solitary lesion unrelated to the syndrome has been reported. The tongue is the most common site. Gingiva is a rare location for solitary neurofibroma. In this study, we report a rare case of solitary oral neurofibroma in buccal mandibular gingiva of a 33 year-old male.
A 33 year-old man with a history of 30 months gum swelling was referred to oral medicine department of Dental School. A well-defined, pale pink, soft, 1×1 cm nodule was observed on right mandibular gingiva on premolar region. No abnormal radiographic findings was observed. In histopathological features, benign proliferations of spindle mesenchymal cells with storiform pattern were seen. The s-100 immunohistochemistry staining of the lesion was positive. No recurrence was evident after one year.
A few isolated cases of Neurofibroma of the gingiva have been reported. Because of the risk of malignant transformation, long-term follow-up is recommended.

The subject of education has always been a matter of great importance. The most commonly available educational aid is Microsoft PowerPoint software. The aim of this study was to determin the most effectiv farsi fonts on training and to find preferences of the Mashhad Dental School students. This study was performed in two parts 1)Evaluation of farsi fonts and 2) Evaluation of student preferences. In the first part, a free topic powerpoint presentation was given and was assessed if the types of farsi fonts affected the students’ learning rate. In the second part, a powerpointpresentation was shown to the students and they were asked about their preferences in the structure of slides. The most correct answers were in slides prepared by “Traffic” font (84%). Results for other fonts were as follows: "Arial" (48.1%), "Titr" (57.4%) and “Homa" (46.3%). In the second part, 58% of the students preferred to use the original English words. To attract the attention of the audieuce, 39.1% of the students preferred to change the font color. For the style of aligning the sentences, 52% chose the Justify alignment. Simple color background, smart art text, indented bullet and pause between paragraphs were other preferences of students. Content prepared by "Traffic" font was best remembered by students. The students had some preferences in alignment,background, pause between paragraphs, etc

This study aimed to investigate the effectiveness of constructivist education on participants’ satisfaction and learning in web-based continuing medical education courses. The study followed an experimental pretest-posttest control-group design. The sampling frame of the study included general dentists (N=1750) who participated in web-based continuing medical education in Mashhad University of Medical Sciences (MUMS). They enrolled in one of the 30 Web-based continuing education courses in the summer of 2012. From among the participants، a sample of 40 was selected randomly and then using random numbers were assigned to two groups of 20 as the experimental and control group. A trainer-made test with approved face and content validity and Kuder-Richardson reliability of 0. 80 was used to evaluating the participants’ learning rate. In addition، in order to assess their satisfaction، a use was made of a validated researcher-made questionnaire with Cronbach’s alpha of 0. 93. Data was analyzed employing descriptive and inferential statistics (MANOVA and ANCOVA). The results revealed that there was a significant difference between the posttest scores of the control and experimental groups. Thus، it was concluded that applying the constructivist theory for medical education in a web-based continuing education could enhance the learning rate and satisfaction of participants. It was indicated that the constructivist education could make the course more effective because of its capability to create an attractive، interactive and cooperative learning environments and also by taking into account the learning needs of participants and their characteristics.

The aim of this case report was to show how acommon oral condition, such as recurrent aphthous stomatitis, could be the only clinical sign leading to early diagnosis of celiac disease. Case Report: A recurrent oral ulcer was detected by a physician during examination of a 23-year-old young woman complaining of severe weakness and inability to intake foods orally. The patient was visited in oral medicine department and a major aphtous ulcer was diagnosed by an oral medicine specialist. An interesting finding was presence of gastrointestinal manifestations which exacerbated with oral ulcers. The patient was evaluated by gastroenterologist and diagnosis of celiac disease was established by laboratory findings and small intestine biopsy which showed a strong atrophy of the intestinal villi which confirmed diagnosis of celiac disease. After six months on a gluten-free diet, no evidence of oral ulcers was found. At the time of submission of this paper, the patient was in a good health status. Oral medicine specialist has a fundamental role in diagnosing syndromes associated with apthous ulcers. Appropriate referral by other health care providers can help in early diagnosis and prevent long term complications of celiac disease. However, the importance of investigating systemic anomalies in cases with aphtous ulcers should be emphasized.

With advances in medicine, more systemic patients seek dental treatment. On the other hand, oral health care is an essential part of pregnancy and diabetes mellitus health care. The aim of this study was to assess dentist’s awareness about dental management of pregnant and diabetic patients. This study was conducted on 106 out of 204 dentists attending in oral medicine congresses and continuous education programs from June 2009 to June 2010. A self-established questionnaire with approved validity and reliability was used. Along with demographic data, some multiple choice questions about dental management of diabetic and pregnant patients were asked. Totally 20 points were assigned to questions and awareness was classified to excellent (18-20 points), good (14-<18 points), moderate (10-<14 points) and poor (<10 points). Statistical analysis was done by Mann-Whitney and Kruskal-Wallis tests. P-value less than 0.05 were considered significant. The mean awareness score (MAS) was moderate (10.5±2.5). The MAS for pregnancy was (3.5±1.78) of 10 and for diabetes mellitus were (7±1.32) of 10. MAS were higher in women especially about diabetes mellitus but it was not significantly different. The University of Graduation and years of career were not significantly related to awareness status. Education and treatment attitude for pregnant patients were not related to awareness but women had a higher attitude in treatment of pregnant patients (P<0.05). The lowest awareness was about indications of consultation in diabetic patients and the highest awareness was about administration of suitable antibiotic and analgesic during pregnancy. The awareness level of dentists studied here was moderate and low about dental management in pregnancy and diabetes mellitus which should be improved via continuous education programs.

Malignant lymphoma of the oral region is uncommon and accounts for approximately 3.5% of all oral malignancies. Non-Hodgkin’s lymphoma occurs primarily in adults, although children may also be affected, particularly by the more aggressive intermediate and high-grade forms. The condition most commonly develops in the lymph nodes, but so-called extra nodal lymphoma is also found. In children, extanodal lymphoma is more common. The presentation can be as a non tender mass mostly in cervical, auxiliary, or inguinal regions that has been enlarging for months. In the oral cavity, lymphoma appears usually as extra nodal disease. The malignancy may develop in the oral soft tissues or centrally within the jaws. Soft tissue lesions appear as non-tender, diffuse swelling; they most commonly affect the buccal vestibule, posterior hard palate, or gingiva. The patient may complain of paresthesia, particularly with a mandibular lesion (numb chin syndrome). Case report: An 8-year-old boy was visited in the Oral Medicine Department of Mashhad Dental School with the chief complaint of permanent tooth mobility in the oral cavity for 15 days. The patient also had a history of bone pain mainly in lower lip for the last month and Bell’s palsy (left side) was observed which had been occurred since 7 days before. Simultaneously, the patient had malaise, anorexia, bone pain, illness, lymphadenopathy (head and neck), and flu like signs and symptoms, fatigue and leukocytosis. Under clinical diagnosis of lymphoma, the patient was referred to pediatric hematologist-oncologist. Our diagnosis, none Hodgkin’s lymphoma (NHL), was confirmed by the report of lymph node biopsy.

Dentists can play an important role in the early detection of the malignant lymphoma of the oral cavity. NHL primarily appears in the head and neck. It is typically characterized by a swollen, non-painful lymph node although other presentations may pose significant diagnostic problems and frequently lead to misdiagnosis and mistreatment.

Dentists and oral healthcare providers have a unique opportunity to motivate and help their patients to stop using different types of tobacco.There are many evidences that they can have a principle rule in prevention and treatment of many tobacco related oral and systemic diseases and repeated nature of dental services and relatively prolonged chair time provide multiple chances for informing, advancing and assisting patients in tobacco Cessation. On the other hand, it seams that they lack enough education in this area, leading to not adhering to this professional practice. This review provides a comprehensive discussion about the new published approaches for dentist's intervention in tobacco cessation programs.