Background In patients with fixed orthodontics, the presence of orthodontic appliances causes dental plaque accumulation and hygiene problems. The purpose of this study was to evaluate the effect of Propolis and chlorhexidine mouthwashes on plaque and gingival indices in patients who are undergoing orthodontic treatment. Material and Methods In this triple blind study, in total, 37 patients aged from 15 to 35 years those who have been undergoing fixed orthodontic treatment were studied. After that, one of the mouthwashes that containing either Propolis or Chlorhexidine was randomly prescribed to patients. The patients were asked to use mouthwashes twice a day after brushing their teeth for three weeks consecutively. Indicators of plaque, gingival and periodontal status (PI, GI, CPI) were determined on Ramford teeth at the beginning and at the end of three weeks for each patient. Then the results were analyzed statistically. Results The difference between the values of plaque index ( P <0.001), gingival index ( P =0.006) and periodontal index ( P = 0.005) before and after administration of Propolis were statistically significant. The difference was also statistically significant for all three indexes of plaque ( P <0.001), gingival ( P =0.001) and periodontal ( P =0.003) before and after chlorhexidine mouthwash usage. The indices after using mouthwashes were not statistically significant different between two mouthwash groups. Conclusions It seems that Propolis mouthwash can be used as a suitable alternative in patients with fixed orthodontic treatment without the side effects of chlorhexidine mouthwash. Key words: Mouthwash, antimicrobial, Oral hygiene, Propolis, Dental plaque.

The current study aimed to investigate the coping strategies and level of psychological distress in mothers of patients with cleft lip and palate (CLP) and the family impact of this disorder. Participants were mothers of 55 children or adolescents with nonsyndromic CLP recruited from families attending a CLP clinic and 2 university hospitals in Mashhad, northeast of Iran. Family impact, psychological distress, and coping strategies were assessed using validated psychological questionnaires including Family Impact Scale, General Health Questionnaire, and Coping Response Inventory. Findings revealed that mothers relied more on the use of approach-oriented rather than avoidance-oriented coping strategies. According to General Health Questionnaire scores, 38.2% of mothers showed some evidence of psychological distress, and 23.6% were suspected of having severe psychological problems. Regarding the family impact of CLP, mothers reported the greatest impact to be on the family's financial status and parental emotions. Those mothers who used avoidant coping strategies reported a greater family impact of CLP (P = 0.002). Emotional discharge and acceptance coping were significant predictors of family impact (P = 0.037 and P = 0.035, respectively). Mothers of 13- to 18-year-old patients with CLP reported greater use of problem-solving coping strategy when compared with mothers of younger patients (P = 0.006). Child's age and coping strategies were not significant predictors of the level of mother's psychological distress. Increased knowledge about how parents cope with their child's craniofacial condition may help caregivers develop a more family-oriented care approach, which is sensitive to the psychosocial needs of parents, children, and their families.

The purpose of this study was to cephalometrically evaluate the facial soft-tissue characteristics of adolescent patients with bilateral cleft lip and palate (BCLP) and to compare them with a noncleft control group. Lateral cephalometric radiographs obtained from 56 adolescents with nonsyndromic BCLP (29 boys and 27 girls) were analyzed and compared with 67 control subjects (29 boys and 38 girls) who were matched for sex, age, and ethnicity. All patients had been operated on before the age of 2 years for the surgical repair of cleft lip and palate. None had received any orthopedic or orthodontic treatment. Independent-samples t test revealed that patients with BCLP significantly differed from the control group by having a flatter facial profile, thinner and more retruded nasal base, flatter nasal tip (in males), and reduced upper-lip length. Furthermore, thicker lower-lip pit, shallower mentolabial sulcus, and increased inclination angles of the upper and lower lips relative to the horizontal plane were observed in female patients compared with the normal group. The findings of the current study suggested that adolescent patients with BCLP showed several facial soft-tissue deformities when compared with normal individuals with the same age, sex, and ethnic origin. This study provides objective measures that could lead to better treatment planning and prediction of the need for corrective surgeries in patients with BCLP.

Considering the essential need for oral health-related quality-of-life measures for patients with craniofacial malformations, the current study aimed to investigate the oral health-related quality of life of Iranian patients with cleft lip and palate. Fifty children referred to Cleft lip/Palate Research Center of Mashhad Dental School (Iran) were recruited. Participants were asked to complete the Child Oral Health Impact Profile questionnaire. The questionnaire comprised 38 items and was divided over 5 subscales. The scores on all subscales were compared with regard to patients' age, sex, and type of cleft. A significant difference between boys and girls was found on the subscale "emotional well-being" (P = 0.027). There was no significant difference between 8- to 12-year-old patients and those older than 12 years. Also, no significant difference was found between bilateral and unilateral cleft lip and palate patients regarding mean score of Child Oral Health Impact Profile questionnaire and its subscales. Oral health-related quality of life of cleft lip and palate patients did not change with patients' age. Also, the impact of unilateral and bilateral clefts on OHRQoL was similar. Quality of life of girls was more affected by oral health.

The aim of the present study was to investigate the prevalence of dental anomalies in a group of patients with cleft lip and palate (CL/P) in the northeast of Iran. Ninety-one patients referring to the Cleft Lip and Palate Clinic of Mashhad Dental School were enrolled and classified into right CL/P, left CL/P, and bilateral CL/P groups. Photographs, dental casts, and panoramic and periapical radiographs were retrieved, and dental anomalies were recorded. χ test was used to analyze the frequency of dental anomalies according to type of cleft and sex. Missing maxillary lateral incisors was the most frequent dental anomaly, which was slightly higher in the bilateral group (61.1%). There were significantly more cases of missing lateral incisors outside the cleft area in right CL/P (P = 0.015). Peg lateral incisors were observed in 33.3% of bilateral CL/P compared with 28% of right and 23.3% of left unilateral cases. The sample presented rotations of central incisors in the cleft area in 33.3% of bilateral clefts. In unilateral clefts, it occurred more frequently in the right side (48%). Sexual dimorphism appeared only for maxillary central incisor rotation in the cleft area, which showed significantly greater frequency in females (P = 0.025). Transposition of maxillary canine and first premolars was found in 5.5% of bilateral, 8% of right, and 3.3% of left unilateral clefts. The prevalence of dental anomalies in the studied sample seems to be higher than that reported in the normal population. More anomalies were observed at the cleft side. The frequency of most anomalies was not significantly different between the 2 sexes.