articles by Morteza Banakar
BMC Oral Health, 2024
Background Military personnel often face unique challenges in maintaining optimal oral health. Th... more Background Military personnel often face unique challenges in maintaining optimal oral health. This study investigated the oral health status, caries experience, and associated factors among a sample of Iranian soldiers, employing a structural equation modeling (SEM) approach to explore the complex interplay of socioeconomic and behavioral determinants. Methods A cross-sectional study was conducted among 658 male soldiers aged 18-30 years from three military barracks in Fars province, Iran. Data were collected through a structured instrument and clinical oral examinations. The study employs the DMFT index, which measures caries experience based on decayed, missing, and filled teeth, along with the Simplified Oral Hygiene Index (OHI-S) to assess overall oral health status. Structural equation modeling was employed to analyze the complex relationships between socioeconomic factors, oral health behaviors, and oral health outcomes. Results The mean DMFT score was 3.57 ± 5.91, and the mean OHIS score was 0.56 ± 1.42. SEM analysis revealed that socioeconomic status (SES) indirectly influenced DMFT and oral hygiene scores, mediated by drug use, oral hygiene practices, dietary sugar consumption, and dental visit frequency. Lower toothbrushing frequency was significantly associated with higher DMFT (Estimate =-0.064, p < 0.001) and OHIS scores (Estimate =-0.637, p < 0.001). Drug use (smoking, qalyan, alcohol) was linked to poorer oral health outcomes, while more frequent dental visits were associated with lower DMFT and OHIS scores. Conclusion This study reveals the complex interplay between socioeconomic conditions, oral health behaviors, and oral health outcomes among Iranian soldiers. The findings highlight the need for targeted interventions to address modifiable risk factors and improve access to preventive dental care within military settings. Future longitudinal studies are warranted to elucidate further the causal pathways between these factors and oral health outcomes in military populations.
The Lancet Neurology, 2024
Background Up-to-date estimates of stroke burden and attributable risks and their trends at globa... more Background Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990-2021. Methods We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and agestandardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2•5th and 97•5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings In 2021, stroke was the third most common GBD level 3 cause of death (7•3 million [95% UI 6•6-7•8] deaths; 10•7% [9•8-11•3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160•5 million [147•8-171•6] DALYs; 5•6% [5•0-6•1] of all DALYs). In 2021, there were 93•8 million (89•0-99•3) prevalent and 11•9 million (10•7-13•2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65•3% (62•4-67•7), intracerebral haemorrhage constituted 28•8% (28•3-28•8), and subarachnoid haemorrhage constituted 5•8% (5•7-6•0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88•2% [53•4-117•7]), high ambient temperature (72•4% [51•1 to 179•5]), high fasting plasma glucose (32•1% [26•7-38•1]), diet high in sugar-sweetened beverages (23•4% [12•7-35•7]), low physical activity (11•3% [1•8-34•9]), high systolic blood pressure (6•7% [2•5-11•6]), lead exposure (6•5% [4•5-11•2]), and diet low in omega-6 polyunsaturated fatty acids (5•3% [0•5-10•5]). Interpretation Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. Funding Bill & Melinda Gates Foundation.
Food Science & Nutrition, 2024
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Dental Research Journal, 2024
Background: The acidic component of liquid medicinal syrups used by pediatric patients may cause ... more Background: The acidic component of liquid medicinal syrups used by pediatric patients may cause erosion and partial demineralization. This study aimed to evaluate the effect of cheese and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups. Materials and Methods: In this in vitro study, 60 noncarious deciduous molars were used. After measuring the surface microhardness of the samples, they were randomly separated into two groups and immersed in either amoxicillin or ibuprofen for 1 min three times per day. CPP-ACP, cheese, and artificial saliva were then applied to each of the three subgroups (n = 10). After each immersion time, 10 min of therapy was given. Between treatment intervals, the samples were kept in artificial saliva. The microhardness was remeasured after 1 week. Data were analyzed using SPSS software through repeated-measures ANOVA (α = 0.05). Results: All samples' microhardness reduced considerably after immersion in liquid pharmaceuticals (amoxicillin [84.9 kgf/mm 2 ] and ibuprofen [75.1 kgf/mm 2 ]), but increased significantly following exposure to therapeutic solutions. There was no difference between the amoxicillin-cheese and amoxicillin-CPP-ACP subgroups (P = 0.975). A statistically insignificant difference was found between the ibuprofen group and the ibuprofen-CPP-ACP subgroup (P = 0.499). Conclusion: As a result, cheese and CPP-ACP can be utilized to remineralize erosive lesions caused by amoxicillin or ibuprofen exposure.
The Lancet Rheumatology, 2024
Background Neck pain is a highly prevalent condition that leads to considerable pain, disability,... more Background Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050. Methods Systematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2•5th and 97•5th percentiles of 100 draws of the posterior distribution. Findings Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age-standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age-standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age-standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0•2% [-1•3 to 1•7]). Globally, females had a higher agestandardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32•5% (23•9-42•3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing. Interpretation Although age-standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain. Funding Bill & Melinda Gates Foundation and Global Alliance for Musculoskeletal Health.
Med, 2024
As adolescence and young adulthood have been largely overlooked in MSK health, the GBD 2019 MSK i... more As adolescence and young adulthood have been largely overlooked in MSK health, the GBD 2019 MSK in Adolescents Collaborators estimate the burden, trends, forecasts, and disparities of early MSK disorders. They found an increasing burden of and crosscountry inequalities in early MSK disorders, which might continue to increase by 2050. Highlights More adolescents and young adults (AYAs) are expected to develop MSK by 2050 There are increasing contributions of high BMI to gout, LBP, and OA and of KD to gout The slope index of inequality increased for six musculoskeletal disorders More attention to AYAs is needed to bring targeted risk factors under control
PeerJ, 2024
Bacteriophages are bacterial viruses that are distributed throughout the environment. Lytic phage... more Bacteriophages are bacterial viruses that are distributed throughout the environment. Lytic phages and prophages in saliva, oral mucosa, and dental plaque interact with the oral microbiota and can change biofilm formation. The interactions between phages and bacteria can be considered a portion of oral metagenomics. The metagenomic profile of the oral microbiome indicates various bacteria. Indeed, there are various phages against these bacteria in the oral cavity. However, some other phages, like phages against Absconditabacteria, Chlamydiae, or Chloroflexi, have not been identified in the oral cavity. This review gives an overview of oral bacteriophage and used for metagenomics. Metagenomics of these phages deals with multi-drug-resistant bacterial plaques (biofilms) in oral cavities and oral infection. Hence, dentists and pharmacologists should know this metagenomic profile to cope with predental and dental infectious diseases.
Molecular Diagnosis & Therapy, 2023
Undifferentiated, highly proliferative, clonogenic, and self-renewing dental stem cells have pave... more Undifferentiated, highly proliferative, clonogenic, and self-renewing dental stem cells have paved the way for novel approaches to mending cleft palates, rebuilding lost jawbone and periodontal tissue, and, most significantly, recreating lost teeth. New treatment techniques may be guided by a better understanding of these cells and their potential in terms of the specificity of the regenerative response. MicroRNAs have been recognized as an essential component in stem cell biology due to their role as epigenetic regulators of the processes that determine stem cell destiny. MicroRNAs have been proven to be crucial in a wide variety of molecular and biological processes, including apoptosis, cell proliferation, migration, and necrocytosis. MicroRNAs have been recognized to control protein translation, messenger RNA stability, and transcription and have been reported to play essential roles in dental stem cell biology, including the differentiation of dental stem cells, the immunological response, apoptosis, and the inflammation of the dental pulp. Because microRNAs increase dental stem cell differentiation, they may be used in regenerative medicine to either preserve the stem cell phenotype or to aid in the development of tooth tissue. The development of novel biomarkers and therapies for dental illnesses relies heavily on progress made in our knowledge of the roles played by microRNAs in regulating dental stem cells. In this article, we discuss how dental stem cells and their associated microRNAs may be used to cure dental illness.
Radiology Research and Practice, 2023
Background. Internal derangement (ID) is the most common cause of temporomandibular disorders (TM... more Background. Internal derangement (ID) is the most common cause of temporomandibular disorders (TMDs) and extensively afects the articular disc function. Te anterior disc displacement is among the most important fndings in ID. Knowledge about the etiology of this condition is imperative, and the role of structural parameters in the development of TMDs has not been well evaluated. Objectives. Tis study aimed to assess the relationship between condylar angulation and intercondylar angle with anterior disc displacement in patients with TMD using magnetic resonance imaging (MRI). Materials and Methods. Tis casecontrol study evaluated 31 temporomandibular joints with internal derangement and 57 normal joints. Te data retrieved from MRI included disc position in the open mouth (normal, anterior disc displacement with a reduction (DDWR) and without reduction (DDWOR), and posterior displacement (PD)), horizontal condylar angle categorized as normal (10 to 30°angle) and abnormal (<10°and >30°), and intercondylar angle. Chi-square test, T-test, and Fisher's exact were done to assess the relationship between horizontal condylar angle and intercondylar angle in patients with TMDs with DDWR and DDWOR compared with the control group. Results. Patients with DDWR and DDWOR had higher odds of abnormal horizontal condylar angle, particularly >30°angle, which was a signifcant correlation (odds ratio of 0.19 and 8.3, respectively). Te intercondylar angle in the patients with disc displacement was signifcantly smaller compared to the control group. Conclusion. Disc displacement was correlated with abnormal horizontal angle (particularly < 30) and smaller intercondylar angle compared with the control group.
Evidence-Based Dentistry, 2023
Data sources
A systematic search of PubMed, LIVIVO, and Ovid was conducted up to March 2021. Thes... more Data sources
A systematic search of PubMed, LIVIVO, and Ovid was conducted up to March 2021. These databases were searched for relevant clinical studies on periodontal treatment success in individuals with Papillon-Lefèvre syndrome (PLS).
Study selection
Clinical studies reporting successful treatment outcomes defined as the loss of four or fewer permanent teeth due to periodontitis and the arrest of periodontitis or probing depths of 5 mm or less in individuals with PLS followed up for ≥24 months were included, and data extracted.
Data extraction and synthesis
Twelve studies reporting on nine PLS patients met the inclusion criteria. The extracted main outcomes in the studies reporting successful periodontal treatment in PLS were as follows: (1) clinical and genetic diagnosis of PLS; (2) age at baseline; (3) initial dental, periodontal parameters, and microbiological assessment, if available; (4) description of disease progression and applied therapies; and (5) outcome and follow-up.
Results
Twelve studies reporting nine individuals were included. The timely extraction of affected or all primary teeth, compliance with oral hygiene instructions, supra- and subgingival debridement within frequent supportive periodontal care intervals, and adjunctive systemic antibiotic therapy in most patients affected a halt in disease progression. Suppression of Aggregatibacter actinomycetemcomitans below detection limits was associated with periodontal stabilization.
Conclusions
An intensive, multidisciplinary approach with strict compliance may enable the decelerated progression of PLS-associated periodontitis. The early diagnosis of PLS and the suppression of A. actinomycetemcomitans below the detection level might be critical factors for treatment success. It required significant effort and patient compliance. The study emphasized the importance of timely interventions, oral hygiene maintenance, regular professional dental care, and, in some cases, systemic antibiotics.
Clinical and Experimental Dental Research, 2023
Objectives: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causes coronav... more Objectives: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causes coronavirus disease 2019 (COVID-19), a respiratory infection that has spread worldwide and is responsible for a high death toll. Although respiratory symptoms are the most common, there is growing evidence that oral signs of COVID-19 can also be seen in children. The purpose of this systematic review is to provide a comprehensive analysis of the available data on the oral manifestations of COVID-19 in children and to recommend appropriate methods of diagnosis and treatment. Methods: A systematic search of the MEDLINE, EMBASE, Scopus, and Web of Science databases was done to discover relevant papers published between their establishment and January 2023. Articles detailing oral symptoms in pediatric patients with confirmed COVID-19 infection were included, and data on clinical characteristics, diagnosis, treatment, and outcomes were extracted and evaluated. Results: A total of 24 studies involving 2112 pediatric patients with COVID-19 were included in the review. The most common presentations are oral lesions, taste and smell disorders, oral candidiasis, hemorrhagic crust, tongue discoloration, lip and tongue fissuring, gingivitis, and salivary gland inflammation. These manifestations were sometimes associated with multi-system inflammatory syndrome in children (MIS-C) or Kawasaki disease (KD). Management strategies varied depending on the severity of the oral manifestation and ranged from symptomatic relief with topical analgesics to systemic medications. Conclusion: Oral symptoms of COVID-19 are relatively prevalent in juvenile patients and can be accompanied by severe systemic diseases, such as MIS-C or Kawasaki illness. Early detection and adequate care of these oral symptoms are critical for the best patient results. Understanding the underlying pathophysiology and developing targeted treatments requires more investigation.
Galen medical Journal, 2023
Background: Leukemia remains a global health challenge, requiring the exploration of alternative ... more Background: Leukemia remains a global health challenge, requiring the exploration of alternative therapies with reduced side effects. Probiotics, particularly Lactobacillus species, have gained attention because of their potential anticancer properties. This study investigated the anticancer and cytotoxic effects of postbiotic mediators (PMs) derived from Lactobacillus rhamnosus GG (LGG) and Lactobacillus reuteri (LR) on acute lymphoblastic leukemia (ALL) cells and peripheral blood mononuclear cells (PBMCs). Materials and Methods: The PMs were prepared by culturing LGG and LR strains and isolating the supernatant. The MTT assay assessed cell viability on ALL Jurkat cells and PBMCs, and apoptosis analysis was conducted using flow cytometry. Quantitative real-time PCR was also performed to analyze BAX, BCL-2, BCLX, FAS, and p27 gene expression levels. Results: The results showed that PMs derived from LGG and LR significantly reduced cell viability in Jurkat cells (P<0.05) but not PBMCs (P>0.05). Apoptosis analysis revealed an increase in apoptotic cells after PMs treatment. Nevertheless, gene expression analysis revealed no statistically significant difference between the treated and untreated groups in BAX, BCL-2, BCLX, FAS, and p27 gene expression levels (P>0.05). Conclusion: Findings suggest that specific PMs derived from LGG and LR possess anticancer properties against ALL cells. This research highlighted the promise of PMs as a cutting-edge and less toxic adjuvant therapeutic strategy in cancer treatment.
Evidence-Based Dentistry, 2023
DATA SOURCES: The authors searched Medline via PubMed, Scopus, CINAHL, Web of Science, and PsycIN... more DATA SOURCES: The authors searched Medline via PubMed, Scopus, CINAHL, Web of Science, and PsycINFO for relevant studies
published until April 2022.
STUDY SELECTION: Longitudinal studies that assessed periodontal health as the exposure and cognitive decline and/or dementia
as the outcome were included. Case reports, reviews, cross-sectional studies, and animal studies were excluded.
DATA EXTRACTION AND SYNTHESIS: Two authors independently reviewed studies for inclusion, extracted data, and assessed
study quality. Meta-analysis was conducted to generate pooled odds ratios (ORs) for cognitive decline and hazard ratios (HRs) for
dementia. Sources of heterogeneity were explored through subgroup analyses.
RESULTS: A total of 24 studies were included for cognitive decline and 23 for dementia. Poor periodontal health was associated
with increased odds of cognitive decline (OR = 1.23; 95% CI: 1.05–1.44) and dementia (HR = 1.21; 95% CI: 1.07–1.38). Tooth loss also
appeared to increase the risk independently. However, significant heterogeneity existed between studies.
CONCLUSIONS: Poor periodontal health may increase the risk of cognitive decline and dementia, but the quality of evidence was
low. Further high-quality, longitudinal studies with standardized assessments are needed to establish causality.
International Journal of Dental Hygiene, 2023
Objectives
Knowledge and awareness gained from mass media can prepare people for lifestyle change... more Objectives
Knowledge and awareness gained from mass media can prepare people for lifestyle changes and impact their health and well-being. Considering the differences in the results of primary studies, we decided to conduct this study to evaluate the effect of mass media campaigns on oral health knowledge as a systematic meta-analysis and review.
Method
The databases such as the Web of Sciences (ISI), Scopus, PubMed/Medline, and the Cochrane Library were searched systematically until February 2022. Data pooling was performed using a random effects model. The effect sizes were estimated as odds ratios (ORs) with their 95% confidence intervals (CIs). Additional analyses, including sensitivity, subgroup, and publication bias analyses, were also conducted.
Results
Our meta-analysis comprised a total number of seven articles. The pooled results indicated significant increases in oral health knowledge among included studies (OR = 1.64, 95% CI: 1.20–2.24, p < 0.001). In subgroup analyses, the effects of mass media campaigns on oral health knowledge remained significant for the studies with follow-up of less than 150 weeks (OR = 1.69, 95% CI: 1.49–1.91) and working-age populations (OR = 1.80, 95% CI: 1.40–2.32) compared to other categories.
Conclusion
In general, this study showed that mass media campaigns may have positive effects on oral health knowledge, especially in the working-age population; it seems that for improving health knowledge among children, more initiatives are needed. Besides, the effects of these campaigns seem to be time-dependent and higher in shorter follow-up periods.
Background Previous global analyses, with known underdiagnosis and single cause per death attribu... more Background Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021. Methods We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures-borrowing strength from predictive covariates and across age, time, and geography-and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs). Findings Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13•7% (95% uncertainty interval 11•1-16•5), to 515 000 (425 000-614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41•4% (38•3-44•9), from 5•46 million (4•62-6•45) in 2000 to 7•74 million (6•51-9•2) in 2021. We estimated 34 400 (25 000-45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000-467 000). In children younger than 5 years, there were 81 100 (58 800-108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021. Interpretation Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease. Funding Bill & Melinda Gates Foundation.
Health Science Reports, 2023
Background/Purpose: The COVID-19 pandemic affects social and psychological resources. Healthcare ... more Background/Purpose: The COVID-19 pandemic affects social and psychological resources. Healthcare workers, especially dental personnel, are more at risk for mental issues due to anxiety, pressure, and frustration. This study assessed mental health outcomes during the COVID-19 epidemic among Iranian dental care providers, focusing on insomnia, anxiety, depression, and posttraumatic stress disorder (PTSD). Methods: In this multicenter cross-sectional survey, the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, and the Global Psychotrauma Screening were masured. Six hundred thirty-eight dental care providers (dental specialists, general dentists, dental hygienists, dental assistants, and dental students) from different parts of Iran (Tehran, Shiraz, Tabriz, and Mashhad) were investigated by the stratified sampling method. The univariate analysis was incorporated as independent in binary logistic regression models to analyze the data. In this study, the significance level was set at 0.05. Results: Among all the participants, 42.8% were dental students or residents, 21.9% were general or specialist dentists, 18.7% were dental assistants, and 16.6% were nonclinicians. The prevalence of insomnia, anxiety, and depression was 31.3%, 40.8%, and 54.9%, respectively. The frequency of participants in the low, moderate, and high levels of PTSD resulting from LCA 56.6%, 33.7%, and 9.7%, respectively. Conclusions: This study found a significant frequency of mental health issues among Iranian dentists. Females, participants whose relatives have COVID-19, and those with a higher workload were more likely to develop mental health symptoms. As mental problems among dental professionals might affect the quality of patient care, diagnostic, supportive, and therapeutic interventions should be taken.
IMR Press, 2023
Background: Streptococcus mutans is a major component of dental plaque, contributing to cariogeni... more Background: Streptococcus mutans is a major component of dental plaque, contributing to cariogenic biofilm formation and inducing dental caries. Attempts have recently been made to use postbiotic mediators (PMs) to prevent dental caries. This research evaluated the antimicrobial/antibiofilm activity of PMs derived from Lactobacillus rhamnosus GG (LGG) and Lactobacillus reuteri (LR) against S. mutans in vitro. Methods: PMs were obtained from the Lactobacilli supernatants. The minimum inhibitory concentration, minimum bactericidal concentration, antibiofilm potential, and metabolic activity of PMs against S. mutans were evaluated using CFU/mL, scanning electron microscopy, and XTT (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) reduction assay. The expression of gtfB gene as one of the most important genes involved in S. mutans biofilm formation was also measured using qRT-PCR. Results: CFU score was reduced by both PMs, but the reduction was only significant in LGG (p = 0.02). Both PMs caused a significant decrease in the metabolic activity of S. mutans compared with the controls (p ≤ 0.002). S. mutans treated with LGG PMs exhibited more destructive effects than LR PMs (p > 0.05). S. mutans gtfB gene expression was significantly downregulated when treated with the PMs obtained from both LGG and LR (p = 0.01 for both). Conclusions: We showed that PMs isolated from two Lactobacillus strains inhibited S. mutans biofilm, metabolic activity, and gtfB gene expression. Therefore, these derivatives may be a suitable biofilm-destruction agent against S. mutants. However, the oral environment is a complex ecosystem that needs further investigation.
Salvia, 2023
Background: Healthcare workers (HCWs) directly or indirectly involved in the coronavirus disease ... more Background: Healthcare workers (HCWs) directly or indirectly involved in the coronavirus disease 2019 (COVID-19) treatment process may experience severe mental consequences of the pandemic. Hence, this study aimed to evaluate the mental health status of HCWs in hospitals affiliated with Shiraz University of Medical Sciences, Iran. Materials and Methods: This cross-sectional study was performed on 503 HCWs from five hospitals in Shiraz, including one COVID-19 front-line hospital, two COVID-19 second-line hospitals, and two without COVID-19 wards. Then, to assess the levels of anxiety, depression, insomnia, and posttraumatic stress disorder (PTSD) among HCWs, the Persian versions of the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), and Global Psychotrauma Screen (GPS) questionnaires were placed, respectively. Results: The mean age of participants was 33.94±8.26 years, and 252 (50.1%) were females. Anxiety, depression, insomnia, and moderate to high levels of PTSD were observed in 40.4%, 37.8%, 24.5%, and 71% of participants, respectively. A history of mental disorders was associated with all four outcomes (P<0.05). Females gender and living with elderly and/or children were correlated with anxiety and PTSD (P<0.05). Working at COVID-19 front-and second-line hospitals were similarly linked to higher insomnia and PTSD levels (P<0.05). Also, working in COVID-19 wards or non-clinical settings was associated with anxiety and depression (P<0.05). Conclusion: Most of the HCWs in this study may experience mental difficulties. Some factors may increase their risk of experiencing these difficulties. Hence, in the crisis era, mental health monitoring and identification of groups with predisposing factors are required to provide appropriate care as quickly as feasible.[GMJ.2023;12:e2512]
Elsevier, 2023
Periodontitis, as a complex inflammatory disorder, is characterized by continuous destruction of ... more Periodontitis, as a complex inflammatory disorder, is characterized by continuous destruction of the teethsupporting components, like alveolar bone and periodontal ligament, and affects a great percentage of individuals over the world. Also, this oral disease is linked with multiple serious illnesses, e.g., cardiovascular disorders, diabetes, and oral cancer; thus, exerting efficient therapy for periodontitis is necessary. Unfortunately, the current therapies for the disease (e.g., surgical and nonsurgical methods) have not reflected enough effectiveness against periodontitis. At present, mesenchymal stem cell (MSC)-based remedy has created new hope for curating different diseases; however, MSCs have no capability to engraft into the chosen tissue, and the tumorigenic influences of MSCs are still the main concern. Interestingly, documents have revealed that MSCderived mediators, like exosomes, which their exploitation is more feasible than intact MSCs, can be an effective therapeutic candidate for periodontitis. Therefore, in this study, we will review evidence in conjunction with their possible curative impacts on periodontitis cases.
Brieflands, 2023
Background: Quality of life (QOL) in the elderly has not been investigated as much as their life ... more Background: Quality of life (QOL) in the elderly has not been investigated as much as their life expectancy. Objectives: The present study aimed to evaluate the elders' QOL. Methods: In this study, 386 elders were selected using the multistage cluster random sampling method. The Leiden-Padua (LIEPAD) questionnaire, consisting of the core components (CCQOL) and moderators (MQOL) of QOL, was used and analyzed with SPSS software. Results: The interviewees' mean age was 68.12 ± 6.24 years. The QOL score was 83.67 ± 13.75 (out of 127), consisting of 27 (6.9%) elders with low, 316 (81.8%) elders with moderate, and 43 (11%) elders with high levels of QOL. The CCQOL and MQOL scores were 70.68 ± 9.42 (out of 93), and 20.94 ± 2.30 (out of 34), respectively. According to the multivariate analysis, sleep disorders (B =-0.15), osteoporosis (B =-0.14), female gender (B =-0.13), and not being the source of family income (B =-0.13) were inversely correlated with QOL. In contrast, sleep disorders, facing violence, female gender, migraine, psychological diseases, and not being the source of family income were inversely correlated with CCQOL. Sexual problems, facing violence, no supplementary insurance coverage, inability to walk, and migraine had inverse correlations with MQOL. Conclusions: Seven out of ten elders had a moderate level of QOL, while elderly females and elders with chronic diseases or those who were not the source of family income had lower levels of QOL. Accordingly, the elders' QOL can be improved by integrating the elders' care programs in the health centers.
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articles by Morteza Banakar
A systematic search of PubMed, LIVIVO, and Ovid was conducted up to March 2021. These databases were searched for relevant clinical studies on periodontal treatment success in individuals with Papillon-Lefèvre syndrome (PLS).
Study selection
Clinical studies reporting successful treatment outcomes defined as the loss of four or fewer permanent teeth due to periodontitis and the arrest of periodontitis or probing depths of 5 mm or less in individuals with PLS followed up for ≥24 months were included, and data extracted.
Data extraction and synthesis
Twelve studies reporting on nine PLS patients met the inclusion criteria. The extracted main outcomes in the studies reporting successful periodontal treatment in PLS were as follows: (1) clinical and genetic diagnosis of PLS; (2) age at baseline; (3) initial dental, periodontal parameters, and microbiological assessment, if available; (4) description of disease progression and applied therapies; and (5) outcome and follow-up.
Results
Twelve studies reporting nine individuals were included. The timely extraction of affected or all primary teeth, compliance with oral hygiene instructions, supra- and subgingival debridement within frequent supportive periodontal care intervals, and adjunctive systemic antibiotic therapy in most patients affected a halt in disease progression. Suppression of Aggregatibacter actinomycetemcomitans below detection limits was associated with periodontal stabilization.
Conclusions
An intensive, multidisciplinary approach with strict compliance may enable the decelerated progression of PLS-associated periodontitis. The early diagnosis of PLS and the suppression of A. actinomycetemcomitans below the detection level might be critical factors for treatment success. It required significant effort and patient compliance. The study emphasized the importance of timely interventions, oral hygiene maintenance, regular professional dental care, and, in some cases, systemic antibiotics.
published until April 2022.
STUDY SELECTION: Longitudinal studies that assessed periodontal health as the exposure and cognitive decline and/or dementia
as the outcome were included. Case reports, reviews, cross-sectional studies, and animal studies were excluded.
DATA EXTRACTION AND SYNTHESIS: Two authors independently reviewed studies for inclusion, extracted data, and assessed
study quality. Meta-analysis was conducted to generate pooled odds ratios (ORs) for cognitive decline and hazard ratios (HRs) for
dementia. Sources of heterogeneity were explored through subgroup analyses.
RESULTS: A total of 24 studies were included for cognitive decline and 23 for dementia. Poor periodontal health was associated
with increased odds of cognitive decline (OR = 1.23; 95% CI: 1.05–1.44) and dementia (HR = 1.21; 95% CI: 1.07–1.38). Tooth loss also
appeared to increase the risk independently. However, significant heterogeneity existed between studies.
CONCLUSIONS: Poor periodontal health may increase the risk of cognitive decline and dementia, but the quality of evidence was
low. Further high-quality, longitudinal studies with standardized assessments are needed to establish causality.
Knowledge and awareness gained from mass media can prepare people for lifestyle changes and impact their health and well-being. Considering the differences in the results of primary studies, we decided to conduct this study to evaluate the effect of mass media campaigns on oral health knowledge as a systematic meta-analysis and review.
Method
The databases such as the Web of Sciences (ISI), Scopus, PubMed/Medline, and the Cochrane Library were searched systematically until February 2022. Data pooling was performed using a random effects model. The effect sizes were estimated as odds ratios (ORs) with their 95% confidence intervals (CIs). Additional analyses, including sensitivity, subgroup, and publication bias analyses, were also conducted.
Results
Our meta-analysis comprised a total number of seven articles. The pooled results indicated significant increases in oral health knowledge among included studies (OR = 1.64, 95% CI: 1.20–2.24, p < 0.001). In subgroup analyses, the effects of mass media campaigns on oral health knowledge remained significant for the studies with follow-up of less than 150 weeks (OR = 1.69, 95% CI: 1.49–1.91) and working-age populations (OR = 1.80, 95% CI: 1.40–2.32) compared to other categories.
Conclusion
In general, this study showed that mass media campaigns may have positive effects on oral health knowledge, especially in the working-age population; it seems that for improving health knowledge among children, more initiatives are needed. Besides, the effects of these campaigns seem to be time-dependent and higher in shorter follow-up periods.
A systematic search of PubMed, LIVIVO, and Ovid was conducted up to March 2021. These databases were searched for relevant clinical studies on periodontal treatment success in individuals with Papillon-Lefèvre syndrome (PLS).
Study selection
Clinical studies reporting successful treatment outcomes defined as the loss of four or fewer permanent teeth due to periodontitis and the arrest of periodontitis or probing depths of 5 mm or less in individuals with PLS followed up for ≥24 months were included, and data extracted.
Data extraction and synthesis
Twelve studies reporting on nine PLS patients met the inclusion criteria. The extracted main outcomes in the studies reporting successful periodontal treatment in PLS were as follows: (1) clinical and genetic diagnosis of PLS; (2) age at baseline; (3) initial dental, periodontal parameters, and microbiological assessment, if available; (4) description of disease progression and applied therapies; and (5) outcome and follow-up.
Results
Twelve studies reporting nine individuals were included. The timely extraction of affected or all primary teeth, compliance with oral hygiene instructions, supra- and subgingival debridement within frequent supportive periodontal care intervals, and adjunctive systemic antibiotic therapy in most patients affected a halt in disease progression. Suppression of Aggregatibacter actinomycetemcomitans below detection limits was associated with periodontal stabilization.
Conclusions
An intensive, multidisciplinary approach with strict compliance may enable the decelerated progression of PLS-associated periodontitis. The early diagnosis of PLS and the suppression of A. actinomycetemcomitans below the detection level might be critical factors for treatment success. It required significant effort and patient compliance. The study emphasized the importance of timely interventions, oral hygiene maintenance, regular professional dental care, and, in some cases, systemic antibiotics.
published until April 2022.
STUDY SELECTION: Longitudinal studies that assessed periodontal health as the exposure and cognitive decline and/or dementia
as the outcome were included. Case reports, reviews, cross-sectional studies, and animal studies were excluded.
DATA EXTRACTION AND SYNTHESIS: Two authors independently reviewed studies for inclusion, extracted data, and assessed
study quality. Meta-analysis was conducted to generate pooled odds ratios (ORs) for cognitive decline and hazard ratios (HRs) for
dementia. Sources of heterogeneity were explored through subgroup analyses.
RESULTS: A total of 24 studies were included for cognitive decline and 23 for dementia. Poor periodontal health was associated
with increased odds of cognitive decline (OR = 1.23; 95% CI: 1.05–1.44) and dementia (HR = 1.21; 95% CI: 1.07–1.38). Tooth loss also
appeared to increase the risk independently. However, significant heterogeneity existed between studies.
CONCLUSIONS: Poor periodontal health may increase the risk of cognitive decline and dementia, but the quality of evidence was
low. Further high-quality, longitudinal studies with standardized assessments are needed to establish causality.
Knowledge and awareness gained from mass media can prepare people for lifestyle changes and impact their health and well-being. Considering the differences in the results of primary studies, we decided to conduct this study to evaluate the effect of mass media campaigns on oral health knowledge as a systematic meta-analysis and review.
Method
The databases such as the Web of Sciences (ISI), Scopus, PubMed/Medline, and the Cochrane Library were searched systematically until February 2022. Data pooling was performed using a random effects model. The effect sizes were estimated as odds ratios (ORs) with their 95% confidence intervals (CIs). Additional analyses, including sensitivity, subgroup, and publication bias analyses, were also conducted.
Results
Our meta-analysis comprised a total number of seven articles. The pooled results indicated significant increases in oral health knowledge among included studies (OR = 1.64, 95% CI: 1.20–2.24, p < 0.001). In subgroup analyses, the effects of mass media campaigns on oral health knowledge remained significant for the studies with follow-up of less than 150 weeks (OR = 1.69, 95% CI: 1.49–1.91) and working-age populations (OR = 1.80, 95% CI: 1.40–2.32) compared to other categories.
Conclusion
In general, this study showed that mass media campaigns may have positive effects on oral health knowledge, especially in the working-age population; it seems that for improving health knowledge among children, more initiatives are needed. Besides, the effects of these campaigns seem to be time-dependent and higher in shorter follow-up periods.