Nonsurgical Management of an Immature Maxillary Central Incisor with Type III Dens Invaginatus Using MTA Plug: A Case Report

Dens invaginatus is a developmental anomaly, caused by deepening of the enamel organ into the dental papilla before calcification of the dental tissues. Teeth with dens invagination are susceptible to early caries and pulp necrosis within a few years of eruption or even before root end closure. This article reports two immature maxillary central incisors with type I and III dens invaginatus which had necrotic pulp and a large periradicular lesion, that were treated successfully by nonsurgical root canal treatment. After apical plug placement, the remaining space was backfilled using warm vertical gutta-percha technique and the crowns were restored by composite restoration. At 6 months of follow up the patient was asymptomatic and probing depths were less than 3 mm. In addition, the reduction in the size of apical radiolucencies was observed by radiographic examinations. This case report revealed that even type III des invaginatus with an open apex and large periapical lesion, can be treated non-surgically using MTA as an apical plug. Although this case report presents a favorable result, further studies with long term follow-up periods are encouraged to support the use of nonsurgical endodontic treatment for type III dens invaginatus.Keywords: Dens Invaginatus; Maxillary Central Incisors; MTA Plug; Non-Surgical Endodontic Treatmen

Root Canal Morphology of Maxillary Second Molars according to Age and Gender in a Selected Iranian Population: A Cone-Beam Computed Tomography Evaluation

Introduction: This study sought to assess root canal morphology of maxillary second molars regarding age and gender in an Iranian population using cone-beam computed tomography (CBCT). Methods and Materials: Totally, 157 maxillary second molars of patients presenting to a radiology clinic were evaluated on CBCT scans. Tooth length, number of roots, root fusion, coronal and sagittal root deviation, number of canals per root, prevalence of second mesiobuccal canal, root canal morphology according to the Vertucci’s classification and the correlation of these variables with age and gender were evaluated. Data were analyzed using the Mann Whitney U, Kruskal Wallis and Fisher’s exact tests. Results: Of 157 teeth, 98 belonged to females and 59 to males. The mean tooth length was significantly greater in males than in females (P=0.002) and it was shorter in 50-60 years old group. The rate of root fusion was 18.6%. Distobuccal and palatal roots were mainly straight in both sagittal and coronal planes while mesiobuccal roots mostly had a distal-buccal deviation; 67.5% of the teeth had four canals. Number of canals was significantly correlated with gender and was higher in males (P<0.05). The most prevalent canal type was type VI in second mesiobuccal, and type V in palatal and distobuccal canals. The most common types in mesiobuccal canal were types I, VI and II, respectively. In the remaining two roots, type I was the most common. Conclusion: Root and canal morphology of the maxillary second molars in Iranian population showed features different from those in other populations.Keywords: Age; Cone-Beam Computed Tomography; Gender; Maxillary Second Molar; Root Canal Anatomy; Root Canal Morpholog

Prevalence of Corneal Arcus in Patients Younger Than 50 Years with Non-Alcoholic Fatty Liver Disease in Gorgan, Northeast of Iran

Introduction: Corneal arcus caused by lipid deposition around the cornea has been proposed as an early marker for several metabolic disorders and even cardiovascular events. Non-alcoholic fatty liver (NAFLD) is a common health problem diagnosed by elevated liver enzymes and abdominal ultrasound findings. This study was conducted to assess the prevalence of corneal arcus in patients with NAFLD in Gorgan, northeast of Iran.Materials and Methods: This cross-sectional study was performed on 200 NAFLD patients younger than 50 years of age who were referred to hospitals of Gorgan between March 2014 and February 2015. Diagnosis of NAFLD was based on liver function test and abdominal ultrasound examination. Presence of corneal arcus was evaluated by slit-lamp examination. Results: Overall, corneal arcus was found in 91 patients (45.5%). Presence of corneal arcus was significantly correlated with smoking, opium consumption and family history of NAFLD. After controlling the confounding variables )diabetes, hypertension, smoking, hyperlipidemia, age, gender, ethnicity and body mass index(, we found that corneal arcus is significantly associated with history of ischemic heart disease and family history of fatty liver disease.Conclusions: Presence of corneal arcus in patients younger than 50 years with NAFLD is significantly associated with having a history of ischemic heart disease and family history of fatty liver disease.&nbsp

Investigating Root Canal Number and Morphology of Mandibular Anterior Teeth Using Cone Beam Computed Tomography

Background and purpose: Root therapy will be successful if it is done based on a correct diagnosis and appropriate treatment plan with the knowledge of morphology and tooth anatomy, debridement, disinfection, and obturation of the entire root canal system. This study aimed to investigate the number and morphology of canals in root canals mandibular anterior using cone beam computed tomography (CBCT). Materials and methods: A cross-sectional descriptive study was performed in a private office in Tehran, Iran 2018, and 902 anterior teeth were evaluated. Teeth were selected according to the following criteria: complete evolved roots, absence of periapical lesion, and no history of root healing. CBCT images were evaluated from three dimensions of sagittal (root number, canal type, and apical foramen deviation from radiographic apex), coronal (apical foramen deviation from radiographic apex), and axial (canal type and apical foramen diameter). Data analysis was done in SPSS V16. Results: The mean apical foramen diameter was 0.21 ± 0.55 and the mean apical foramen deviation from the radiographic apex was 0.66 ± 0.48 mm. Class 1 and 3 morphologies were the most frequent classes observed in anterior teeth and other classes accounted for about 5% of the samples. Conclusion: In this study, there was no relationship between gender and the number of roots and in males the number of canals were higher than that in females

Challenges of Female Nurses in Disasters: A Qualitative Study

Background: Awareness of nurses’ experiences is helpful to identify current problems in providing services during disasters. In this regard, better planning and preparation may reduce the problems of this large group of health care providers. This study aimed to investigate the experiences of female nurses in providing services during disasters. Materials and Methods: This is a qualitative study with content analysis approach. The participants comprised 15 nurses with experience in providing healthcare services during disasters. Samples were recruited by purposive sampling method and sampling was continued until data saturation. Data were collected through semi-structured interviews, then analyzed by manifest content analysis. Results: Based on experiences and perceptions of nurses, three main categories found out of analyses of the obtained data were as follows: “the importance of paying attention to the specific needs of female nurses,” “places for female nurses during disastrous period,” and “the importance of the presence of female nurses in providing services.” Conclusion: Many factors affect the services delivered by female nurses. The results of this study showed that the specific needs of female nurses, who are the main body of Iranian nurses, could maximize their performance and minimize their psychological and emotional damages

Epidemiology and clinical study of phenylketonuria (PKU) patients in Khorasan Province; Norteast Iran

Epidemiology and clinical study of phenylketonuria (PKU) patients in Khorasan Province; Norteast Iran Background: Phenylketonuria is an autosomal recessive disease. Early diagnosis is a important public health intervention to prevent neurological impairment .This study was designed to describe characteristics of phenylketonouria patients in Khorasan ,Northeast of Iran. Methods: We included all patients suffering from PKU in khorasan until September 2013. We gathered the variables like diagnosis age , sib of parents, cause of asking physician and screening based diagnosis or clinical based diagnosis. We use descriptive statistics for analysis. Results: The mean age of diagnosis was 19 months .80% pku patients had a positive history of consanguineous marriage in their parents. Incidence of new cases that identified by screening in 2012-2013 was 57 per 1000000 live birth. 10% patients identified with screening in first week of birth. Conclusion: Nearly all of our patients (90%) had been diagnosed without screening in the first days of their life only due to clinical manifestations in the first year of their life . According to efficacy of early diagnosis and dietary treatment, enforcement of public health policy for screening is a critical public health preventive intervention

Nurse in limbo: A qualitative study of nursing in disasters in Iranian context

<div><p>Background</p><p>An understanding of nurses’ experiences in disasters can help to identify their problems in this area. These can be overcome with better planning and preparation. The aim of this study was to explore the experiences and perceptions of disaster nurses regarding their provision of disaster health care services.</p><p>Methods</p><p>This was a qualitative study using an inductive qualitative content analysis. Participants included 15 Iranian nurses who had experiences of health care delivery in disasters. A purposeful sampling was applied until data saturation was reached. Data were collected using semi-structured interviews and then analyzed based on the principle of inductive content analysis.</p><p>Results</p><p>Five main categories emerged from the experiences and perceptions of nurses who were involved in providing health care services in disasters: afraid of probability of recurrence, necessity of providing healthcare services for an unknown period of time, challenge of what to prioritize, nurses’ own conflicting emotions, and their concern for their own families.</p><p>Discussion</p><p>There are several factors affecting the delivery of healthcare in disasters. Nurses, who feel better prepared and have some understanding of the ethical implications of working under different standards of care, may be more comfortable with care giving in disasters. Appropriately, training and preparing nurses for disasters is important for optimizing the safe functioning and minimizing emotional and psychological damage.</p></div

Participant characteristics.

<p>Participant characteristics.</p