Background and Aims: Metal-free and fiber-reinforced composite (FRC) restorations have drawn considerable attention and interest in recent years for restoring in the posterior area due to their improved esthetics. Fracture resistance is one of the most important mechanical properties of materials because of 500-600 N load of occlusion. The restorations should tolerate this load. The purpose of this in vitro study was to compare the fracture resistance of FRC with that of zirconia all-ceramic for posterior partial dentures.Materials and Methods: Forty extracted human intact teeth (20 first premolars and 20 first molars) selected for fabricating 10 pairs of fiber-reinforced composite and 10 pairs of zirconia all-ceramic bridges. After receiving standard tooth preparation, the teeth were mounted with 7.5 mm distance between each other. The bridges were made and cemented on the teeth. Then the restorations were stored in 37oC water for 30 days. The fracture resistance was measured using mechanical testing machine with cross-head speed of 1mm/min. Data were evaluated by Independent sample t test.Results: The mean fracture resistance in the ceramic group was 1329.41 N and for the F.R.C group was 1118.528 N with significant differences between them (P=0.034). The failure modes were mainly cohesive at pontic area for ceramic samples, but adhesive for FRC samples at pontic area.Conclusion: Both systems showed sufficient fracture resistance for using in posterior area.

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Background and Aim: The present study aimed at determination of the fatigue resistance and failure mode of cuspreplacing onlays in endodontically treated premolars using indirect composite resin restorations. Materials and Method: In this experimental study, 84 human premolars were randomly divided into 7 groups of 12. These groups were prepared as follows: Intact teeth used in groupl as control, the second group covers the endodontically treated teeth, restored with indirect onlays using Z-250 composite resin, the next two groups (i.e. 3,4) were similar to the second group, but subjected to 1 and 2 million fatigue load cycles, respectively. Groups 5, 6, 7 were similar to groups 2, 3, 4, respectively, however, in these groups Tetric Ceram used as the restorative material. All specimens were loaded using a Universal Testing Machine until fracture occurred and the mode of failure observed with naked eye. Kruskal-Wallis and Chi-Square tests were used to analyze the data (a=.05). Results: All specimens withstood the masticating simulation. The mean fracture strength for groups 1 to 7 were: 1276.92, 1269.05, 1217.80, 1188.13, 1228.97, 1127.86, 1105.58, respectively. No statistically significant differences were found between the groups in fracture strength and failure mode. There was no statistically significant difference between two types of resin composite (P=0.203) and load cycles (P=0.298) after zero, 4 and 8 years aging. Conclusion: Within the limitation of this study, restored premolars with indirect composite onlays show fatigue resistance equal to natural tooth up to 8 years after restoration. Furthermore, no statistically significant differences were found between 4 and 8 years of load cycles. Tetric Ceram Z-250 restoration agent showed no effect on the tooth fracture resistance with the most observed fractures to be occur under CEJ with no capability to be restored.

Background: This study aimed to provide tailored transferrable lessons for expanding population coverage through a descriptive lens by reviewing the population coverage policies, reforms and strategies in selected na-tions. Methods: In this comparative short communication, 14 countries with different status of population coverage and political economy that had successful experiences with coverage expansion were selected and categorized in four groups to study their approaches to reach Universal Health Coverage (UHC). Results: Although each country needs to tailor its policies and reforms based on its own contextual factors, the legal right of citizens to social security and health protection are enshrined in most countries' Constitution. Some countries adapted political and economic reforms to evolve their Social Health Insurance schemes. Na-tional laws to push governments to adapt UHC as a national strategy for ensuring that every resident is enrolled in health insurance schemes are key policies to reach UHC. Conclusion: A series of reforms are required to provide total population coverage through various approaches. To create an effective insurance coverage, physical merger of all insurance funds is not necessarily required. Further, the share of GDP for health is not a definite indicator to reach UHC. Finally, strong political commit-ment and citizens’ participation are the key issues in reaching UHC, while considering the poorest, remote and neglected population really matters.

Introduction &,Objective: Soft tissue coverspecially in lower extremity and leg is a challenag for all reconstructive surgeons. Many methods and flaps have been introduced and used in this area. In this study we discussed about some unusual flaps that we used in our cases in 15 khordad hospital. Materials &,Methods: In this study according to ourresults in our cases, the leg divides into three subarea. We used Distal &,lateral thigh flap in proximal third, free gracilis flap for the middle third and Medial plantar flap andmedial pedis flap for lower third defect. Results: Our results suggest that these less common flaps have comparable results VS common flaps, and can be used as first step for leg reconstruction. Conclusions: In some cases, this study showed that the desired flops have received less attention,their results are comparable to the more common flops in terms of performance and appearance. This study emphasizes that the common methods should not necessarily be recognized as the best method and the best decision should be made for each disease based on the existing conditions.

Dear Editor, Fingertip amputation is one of the most common industrial injuries and preservation of finger function, as much as possible, is very important for the affected patients. A thorough review of the most common treatment options for this type of lesion was more than necessary. All treatment modalities must restore the sensory function of fingertip, stable and durable skin and maximum support for nail bed (1).