Journal of Dental Advances in Clinical Sciences

Abstract The present study was conducted to evaluate the clinical diagnostic ability of final-year dental students. In a cross-sectional survey, final-year dental students of Ilam Dental School clinically examined patients who visited for treatment and had bitewing radiographs available. Three faculty members evaluated the radiographs, and the results agreed upon by all were used as the benchmark to assess students’ responses. Each student’s diagnostic accuracy was determined by comparing their diagnosis with the faculty’s consensus on the presence or absence of caries and its depth. If the student’s diagnosis matched the instructor’s opinion, a score of 1 was given; otherwise, a score of 0 was given. Results showed that 34.51% of students correctly diagnosed caries in premolar teeth and 44.67% in molar teeth (P=0.220). False negatives were observed in 23.47% of mesial surfaces of premolars and 52.68% of molars, while false positives were reported in 43.04% and 49.75%, respectively. The students’ ability to detect healthy interproximal surfaces was 69.44% for premolars and 55.12% for molars (P=0.001). Their ability to identify enamel interproximal caries was below 20%. Specifically, 13.15% of students had mesial enamel caries in the first third, and 13.15% had lesions reaching the Dentino-Enamel Junction (DEJ). In the distal surfaces, 18.42% and 15.78% of students were able to detect enamel caries, respectively. Moreover, for dentin caries surfaces, students demonstrated even lower diagnostic capability—5.26% of students detected dentin caries in the first third and 15.78% beyond the first third on mesial surfaces. In comparison, these rates on distal surfaces were 15.78% and 18.42%, respectively. The overall results indicate that final-year dental students have achieved an adequate ability to identify healthy surfaces. However, their competence in recognizing interproximal caries was moderate, emphasizing the need for additional experience and training in this area.

Abstract This study aimed to evaluate the effect of twin-block appliance treatment on oral health-related quality of life (OHRQoL) among children with Class II malocclusion, as perceived by children and their parents. In this prospective study, thirty-four (Male=18, Female=16) children (age range: 11-14 years) who required functional appliance treatment for the interception of their mandibular retrusions and one of their parents (n=34; Father=17, Mother=17) were included. The impact of twin block appliance on the OHRQoL among children and their parents towards treatment was evaluated before the delivery of twin block appliance (T₀) and 1-week (T₁), 1-month (T₂), 3-months (T₃) and 6-months (T⁴) afterthe delivery of appliance using Child Perception Questionnaire _11-14 (CPQ _11–14) and Parental-Caregiver Perception Questionnaire (P-CPQ) respectively. The total CPQ_11-14 score decreased significantly from 21.57 (SD=12.93) at T₀ to 13.33 (SD=12.46) at T₄ (P<0.001). The total P-CPQ score increased at T₁ and then gradually decreased from T₁ to T₄ (P<0.010). There was moderate to excellent agreement between children's and parents' perceptions of children's OHRQoL. The OHRQoL improved following the twin block appliance treatment among Class II malocclusion children, and parents estimated a poorer overall OHRQoL of their children than did the children themselves.

Abstract The rubber dam is a fundamental isolation device in restorative and endodontic dentistry, enhancing treatment quality and reducing contamination risks. Despite strong scientific support, its routine use in clinical practice remains below recommended standards. This study aimed to assess dentists’ attitudes and practices regarding rubber dam use in Zahedan, Iran, and to identify associated factors. A cross-sectional study was conducted in 2023 involving 93 dentists (general practitioners and specialists) selected through stratified random sampling proportional to practice type. Data were collected using a structured questionnaire that included demographic and professional variables, eight attitude items, five practice items, and a multiple-choice question on barriers to routine rubber dam use. An expert panel confirmed content validity, and internal consistency was acceptable (Cronbach’s alpha = 0.70). Of the 93 participants, 59.1% were female and 40.9% male; 65.5% were general dentists and 34.5% specialists. Attitudes toward the rubber dam were categorized as moderate in 8.6% and good in 91.4% of respondents. Practice levels, however, were poor in 78.5%, moderate in 21.5%, and good in 0% of participants. Attitude was significantly associated with practice setting (P=0.024), whereas no significant associations were observed with sex, work experience, education level, or previous training (P>0.05). Practice level was likewise significantly associated with practice setting (P<0.001), but not with other individual or educational variables. The most commonly reported barrier was patients’ unwillingness to accept rubber dam placement. Despite generally upbeat attitudes, routine clinical use of rubber dam among dentists in Zahedan was markedly low, revealing a substantial attitude–practice gap. Strengthening both theoretical and hands-on training, addressing logistical barriers (e.g., cost, time, and patient acceptance), and reinforcing infection-control requirements in professional guidelines may enhance routine implementation.

Abstract This study aimed to assess the diagnostic and therapeutic approaches dentists use in Zahedan, Iran, and examine associated factors. In this cross-sectional study conducted in 2023, 67 dentists—including general practitioners and specialists—working in public centers and private offices/clinics in Zahedan were recruited via convenience sampling. Data were collected using a researcher-designed checklist capturing demographic and professional characteristics, level of training in dentin hypersensitivity (DHS), perceived predisposing factors, preferred diagnostic methods, and in-office and home-care management strategies. Of the 67 participants, 58.2% were male, 64.2% were general practitioners, and 74.6% practiced exclusively in private settings. The majority (89.6%) reported prior DHS training, either complete or partial. Gingival recession was the most frequently identified predisposing factor (approximately two-thirds of respondents), followed by non-carious cervical lesions, acidic diet, and toothbrushing technique. The most commonly employed diagnostic methods were direct questioning regarding pain characteristics, thermal testing, and air-blast stimulation. In-office management primarily involved topical desensitizing agents, instruction on proper toothbrushing, and the use of bonding agents. At the same time, home-care recommendations were dominated by desensitizing toothpastes, dietary and habit modifications, and fluoridated mouth rinses. The first-choice predisposing factor and diagnostic method were not significantly associated with work experience, practice setting, or prior training (P>0.05). In contrast, first-line home-care treatment was significantly associated with practice setting (P=0.025). Dentists in Zahedan employ a combination of educational, pharmacologic, and restorative strategies to manage DHS. However, management patterns remain heterogeneous and lack complete standardization, highlighting the need for guideline development, continuing professional education, and evidence-based training to optimize patient care.

Abstract This narrative review explores the bidirectional relationship between oral health and systemic diseases, highlighting that oral health extends far beyond local conditions and plays a significant role in overall well-being. Dental caries and periodontal disease, as the most prevalent oral diseases, increase the risk of cardiovascular disease, diabetes, rheumatoid arthritis, Alzheimer’s disease, and respiratory disorders through mechanisms such as chronic inflammation, bacterial translocation, and cytokine secretion. Poor oral health during pregnancy has also been associated with adverse outcomes, including preterm birth and low birth weight. Routine screening for oral diseases—particularly in patients with chronic conditions such as cardiovascular disease or diabetes—should become standard practice in medical settings. Periodontal therapy can reduce systemic inflammation, improve chronic disease control, and lower healthcare costs. Additionally, unhealthy dietary patterns, tobacco use, and socioeconomic disparities can further exacerbate oral-systemic health burdens. By summarizing existing scientific evidence, this review underscores the need for an integrated medical–dental approach and emphasizes that a deeper understanding of the oral–systemic connection is essential for improving patient outcomes.

Abstract Lifestyle and dietary habits play a fundamental role in maintaining oral health and preventing disease. Diets high in sugar and refined carbohydrates contribute significantly to dental caries, while deficiencies in key nutrients—such as calcium, vitamin D, and antioxidants—compromise periodontal integrity and impair tissue repair. Lifestyle behaviors, including smoking, alcohol consumption, and physical inactivity, further exacerbate oral inflammation and disease risk. Conversely, balanced nutrition, adequate hydration, and healthy lifestyle practices support oral microbiome stability, enhance tissue regeneration, and promote systemic well-being, collectively strengthening oral resilience. Understanding these complex interactions is essential for designing preventive strategies and patient-centered interventions to improve both oral and general health.

Abstract The coronavirus disease 2019 (COVID-19) pandemic had a profound impact on global healthcare, increasing reliance on medical imaging and raising concerns about increased patient exposure to ionizing radiation, particularly in high-burden, resource-limited settings. This narrative review examines the global effects of the pandemic on medical radiation exposure, with a focus on compliance with the American Dental Association (ADA) radiation safety guidelines. The COVID-19 pandemic led to a significant increase in radiation exposure due to heightened use of chest computed tomography (CT) scans and X-rays for diagnostic and monitoring purposes, with inconsistent adherence to ADA safety guidelines, particularly in areas with limited resources. Recommendations include adopting low-dose CT protocols, increasing the use of non-ionizing imaging, and enforcing region-specific safety guidelines to mitigate risks and enhance patient safety in future crises.

Abstract Early orthodontic treatment with vertical control may decrease malocclusal severity and improve esthetics by harnessing growth potential in Class II division 1 patients. This case report presents orthodontic treatment and 12-year follow-up records of a severe Class II malocclusion in a nine-year-and-five-month-old growing female with a narrowed maxilla, hyperdivergent skeletal pattern, excessive vertical facial height, and gummy smile. Treatment included rapid maxillary expansion and modification of the maxillary growth pattern using occipital headgear and fixed orthodontic therapy. Twelve-year follow-up results showed no relapse. Stable and prosperous treatment outcomes can be achieved with early orthodontic treatment in severe skeletal and dental Class II patients with a hyperdivergent growth pattern, provided excellent compliance is maintained.

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