Impact of dental insurance on adults’ oral health care in Tehran, Iran.

The aim of the present study was to determine relationships between insurance status and utilization of oral health care and its characteristics and to identify factors related to insured patients’ selection of dental clinic or dentist. The study was based on cross-sectional data obtained through phone interviews. The target population included adults in the city of Tehran. Using a two-stage stratified random technique, 3,200 seven-digit numbers resembling real phone numbers were drawn; when calling, 1,669 numbers were unavailable (busy, no answer, fax, line blocked). Of the 1,531 subjects who answered the phone call, 224 were outside the target age (under 18), and 221 refused to respond, leaving 1,086 subjects in the final sample. The interviews were carried out using a structured questionnaire and covered characteristics of dental visits, the respondent’s reason for selecting a particular dentist or clinic and demographic and socio-economic background (gender, age, level of education, income, and insurance status). Data analysis included the Chi-square test, ANOVA, and logistic regression and the corresponding odds ratios (OR). Of all the 1,086 respondents, 57% were women, 62% were under age 35, 46% had a medium and 34% a high level of education, 13% were under the poverty line, and 70% had insurance coverage; 64% with the public, and 6% with a commercial insurance. Having insurance coverage was more likely for women (OR=1.5), for those in the oldest age group (OR=2.0), and for those with a high level of education (OR=2.5). Of those with dental insurance, 54% reported having had a dental visit within the past 12 months ; more often by those with commercial insurance in comparison with public (65% vs. 53% p<0.001). Check-up as the reason for the most recent visit occurred most frequently among those with commercial insurance (28%) compared with those having public insurance (16%) or being non-insured (13%) (p<0.001). Having had two or more dental visits within the past 12 months was most common among insured respondents, when compared with the non-insured (31% vs. 22% p=0.01). The non-insured respondents reported tooth extractions almost twice as frequently as did the insured ones (p<0.001). Of the 726 insured subjects, 60% selected fully out-of-pocket-paid services (FOP), and 53% were unaware of their insurance benefits. Of those who selected FOP, good interpersonal aspects (OR=4.6), being unaware of dental insurance benefits (OR=4.6), and good technical aspects (OR=2.3) as a reason had greater odds of selecting FOP. The present study revealed that dental insurance was positively related to demand for oral health care as well as to utilization of services, but to the latter with a minor extent. Among insured respondents, despite their opportunity to use fully or highly subsidized oral health care services, good interpersonal relationship and high quality of services were the most important factors when an insured patient selected a dentist or a clinic. The present findings indicate a clear need to modify dental insurance systems in Iran to facilitate optimal use of oral health care services to maximize the oral health of the population. A special emphasis in the insurance schemes should be focused on preventive care.

Dental health and school-based health education among 15-year-olds in Tehran, Iran

The aim of the present study was to assess dental health and its determinants among 15-year-olds in Tehran, Iran and to evaluate the impact of a school-based educational intervention on their oral cleanliness and gingival health. The total sample comprised 506 students. Data collection was performed through a clinical dental examination and a self-administered structured questionnaire. This questionnaire covered the student s background information, socio-economic status, self-perceived dental health, tooth-brushing, and smoking. The clinical dental examination covered caries experience, gingival status, dental plaque status, and orthodontic treatment needs. Participation was voluntary, and all students responded to the questionnaire. Only three students refused the clinical dental examination. The intervention was based on exposing students to dental health education through a leaflet and a videotape designed for the present study. The outcome examinations took place 12 weeks after the baseline among the three groups of the intervention trial (leaflet, videotape, and control). High participation rates at the baseline and scanty drop-outs (7%) in the intervention speak for reliability of the results. Mean value of the DMFT (D=decayed, M=missing, and F=filled teeth) index of the 15-year-olds was 2.1, which comprised DT=0.9, MT=0.2, and FT=1.0 with no gender differences. Dental plaque existed on at least one index tooth of all students, and healthy periodontium (Community Periodontal Index=0) was found in less than 10% of students. Need for caries treatment existed in 40% of students, for scaling in 24%, for oral hygiene instructions in all, and for orthodontic treatment in 26%. Students with the highest level of parents education had fewer dental caries (36% vs. 48%) and less dental plaque (77% vs. 88%). Of all students, 78% assessed their dental health as good or better. Even more of those with their DMFT=0 (73% vs. 27%) and DT=0 (68% vs. 32%) assessed their dental health as good or better. Smokers comprised 5% of the boys and 2% of the girls. Smoking was common among students of less-educated parents (6% vs. 3%). Of all students, 26% reported twice-daily tooth-brushing; girls (38% vs. 15%) and those of higher socio-economic background (33% vs. 17%) did so more frequently. The best predictors for a good level of oral cleanliness were female gender or twice-daily tooth-brushing. The present study demonstrated that a school-based educational intervention can be effective in the short term in improving the oral cleanliness and gingival health of adolescents. At least 50% reduction in numbers of teeth with dental plaque compared to baseline was achieved by 58% of the students in the leaflet group, by 37% in the videotape group, and by 10% of the controls. Corresponding figures for gingival bleeding were 72%, 64%, and 30%. For improving the oral cleanliness and gingival health of adolescents in countries such as Iran with a developing oral health system, school-based educational intervention should be established with focus on oral self-care and oral health education messages. Emphasizing the immediate gains from good oral hygiene, such as fresh breath, clean teeth, and attractive appearance should be key aspects for motivating these adolescents to learn and maintain good dental health, whilst in planning school-based dental health intervention, special attention should be given to boys and those with lower socio-economic status. Author s address: Reza Yazdani, Department of Oral Public Health, Institute of Dentistry, University of Helsinki, P.O. Box 41, FI-00014 Helsinki, Finland. E-mail: reza.yazdani@helsinki.fi

An electron microscopic study of quasicrystals in a quaternary alloy : Mg32(Al, Zn, Cu)49

The discovery of a solid exhibiting m 3 5 point group symmetry by Shechtman et. al. (l) in a rapidly solidified Al-14at%Mn alloy has activated intensive studies of a new class of solids, termed as quasicrystals (2). While the original discovery reported the existence of quasicrystals in AI-Mn. AI-Fe and AI-Cr alloys, subsequent work has revealed their existence in Mg-Zn-Al(3,4), Mg-A]-Cu(5), AI-Mn-Si(6) and Ti-Ni-V(7) alloys (Table l).

Microstructural evolution and grain boundary sliding in a superplastic magnesium AZ31 alloy

Tensile experiments on a fine-grained single-phase Mg–Zn–Al alloy (AZ31) at 673 K revealed superplastic behavior with an elongation to failure of 475% at 1 × 10−4 s−1 and non-superplastic behavior with an elongation to failure of 160% at 1 × 10−2 s−1; the corresponding strain rate sensitivities under these conditions were 0.5 and 0.2, respectively. Measurements indicated that the grain boundary sliding (GBS) contribution to strain ξ was 30% under non-superplastic conditions; there was also a significant sharpening in texture during such deformation. Under superplastic conditions, ξ was 50% at both low and high elongations of 20% and 120%; the initial texture became more random under such conditions. In non-superplastic conditions, deformation occurred under steady-state conditions without grain growth before significant flow localization whereas, under superplastic conditions, there was grain growth during the early stages of deformation, leading to strain hardening. The grains retained equiaxed shapes under all experimental conditions. Superplastic deformation is attributed to GBS, while non-superplastic deformation is attributed to intragranular dislocation creep with some contribution from GBS. The retention of equiaxed grain shapes during dislocation creep is consistent with a model based on local recovery related to the disturbance of triple junctions.

Preparation of cast aluminium alloy-mica particle composites

The optimum conditions for producing cast aluminium alloy-mica particle composites, by stirring mica particles (40 to 120 mgrm) in molten aluminium alloys (above their liquidus temperatures), followed by casting in permanent moulds, are described. Addition of magnesium either as pieces along with mica particles on the surface of the melts or as a previously added alloying element was found to be necessary to disperse appreciable quantities (1.5 to 2 wt.%) of mica particles in the melts and retain them as uniform dispersions in castings under the conditions of present investigation. These castings can be remelted and degassed with nitrogen at least once with the retention of about 80% mica particles in the castings. Electron probe micro-analysis of these cast composites showed that magnesium added to the surface of the melt along with mica has a tendency to segregate around the mica particles, apparently improving the dispersability for mica particles in liquid aluminium alloys. The mechanical properties of the aluminium alloy-mica particle composite decrease with an increase in mica content, however, even at 2.2% the composite has a tensile strength of 14.22 kg mm–2 with 1.1% elongation, a compression strength of 42.61 kg mm–2, and an impact strength of 0.30 kgm cm–2. The properties are adequate for certain bearing applications, and the aluminium-mica composite bearings were found to run under boundary lubrication, semi-dry and dry friction conditions whereas the matrix alloy (without mica) bearings seized or showed stick slip under the same conditions.

Micromechanisms of damage in a hypereutectic Ti-6Al-4V-B alloy

The tensile stress–strain response and fracture in a hypereutectic Ti–6Al–4V–1.7B (weight percent) alloy were investigated by employing interrupted tensile tests combined with acoustic emission measurements, with the aim to identify the cause for the observed low ductility in this alloy. These tests were complemented with microscopy. The alloy contains TiB whiskers of different length scales, the majority of which include micro-whiskers ( 5–10 μm length) and a few primary-whiskers ( 200–300 μm length). Although the fracture of both types of whiskers occur during deformation, the former leads to a gradual decrease in the secant modulus whereas initiation of the latter leads to a drastic drop in the modulus along with failure of the specimen, limiting the ductility.

Texture strengthening in warm-rolled cadmium-1% silver alloy

The variation in the tensile properties at 77 K and 300 K in warm-rolled (300 K) Cd-1% Ag alloy with deformation has been studied in longitudinal as well as transverse specimens. The low-temperature yield strength increases with warm rolling without much loss in ductility. The strength at 300 K, however, decreases with heavy warm deformation. From microstructural studies and X-ray investigations, it was observed that changes in grain size and texture occur during warm rolling. Both these changes are found to be important in deciding the tensile properties. The longitudinal and transverse strengths at 77 K vary linearly with l-frac12, where l is the average grain diameter, and thus they obey the Hall-Petch relation. The Hall-Petch slope, k, is lower in specimens with favourable lcub1013rcub texture while the intercept σo is higher when the lcub0002rcub texture is less favourable.

Mechanism of improvement in oil spreadability of aluminium alloy-graphite particle composites

The spreadability of SAE-30 oil on Al-12 Si base (LM-13) alloy containing dispersed graphite particles about 50 μm average size in its matrix is found to be greater than on either LM-13 with no graphite or brass. It is also found that the spreadability on LM-13 base alloys increase with increasing volume of graphite dispersion in the matrix of these alloys. Further increases in the spreadability of oil on machined LM-13-graphite particle composite test surfaces occur if these are rubbed initially against control discs of either LM-13 or grey cast iron. The formation of a triboinduced graphite-rich layer, confirmed by esca, appears to be responsible for the improved oil spreadability on the rubbed test surfaces of LM-13 base alloys as compared to the as-machined test surfaces prior to rubbing. The triboinduced layer of graphite is apparently responsible for the observed reduction in the friction, wear and seizing tendency of triboelements made from aluminium alloy-graphite particle composites.

Dental Clinic - Dr. Yaski

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Dental Clinic - Dr. Yaski

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Jerusalem - Dental Clinic - Dr. Yaski

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Deformation characterization of superplastic AA7475 alloy

AA7475 alloy was deformed up to 25% elongation in INSTRON at 788K. The grain boundary sliding due to this superplastic deformation was measured by Scanning Electron Microscope. The microstructure and texture development due to this deformation at elevated temperature was analyzed from the Orientation Image Microstructures i.e. the Electron Back Scattered Diffraction Image. The Orientation Image Microstructures revealed that superplastic deformation was associated with recovery and recrystallization in-situ process.