فهرست مطالب عباس حقیقت

Trigeminal neuralgia is the most common brain neuralgia. It occurs in the form of shock-like pain. The chance of contracting the mandibular branch is higher. Acupuncture relieves pain by inserting thin, disposable sterile needles into specific areas of the body. Most methods are effective in the short term. This study aimed to determine the therapeutic effect of acupuncture in patients with trigeminal neuralgia undergoing drug treatment.

The study was an interventional study conducted on patients referred to Azhara Hospital in Isfahan. The sample size is 16 people who are divided into two groups of 8 people. The patients in the study were treated with carbamazepine. At the end of this period, patients' pain was taken and compared. In the control group, drug therapy continued, while in the intervention group, in addition to drug therapy, they received acupuncture. Finally, the data were analyzed by one-way analysis of variance and Paired t-test with a significance level of 0.05.

There was a significant difference in pain index between the intervention and control groups at different times. The independent t-test revealed that there was no significant difference between the two groups during the first and second weeks. However, there was a significant difference between the two groups during the other weeks.

Acupuncture is often used in conjunction with medication to effectively reduce the severity and duration of pain in patients with trigeminal neuralgia.

Close proximity between third molars and inferior alveolar canal is common. It is important to prevent damage to the inferior alveolar nerve during surgery. This research was undertaken to show the efficacy of panoramic radiography technique in demonstrating the relationship between impacted third molars and inferior alveolar canal by using a surgical technique. Sixty patients, referring to Isfahan Faculty of Dentistry and the relevant clinic during 2011-2012 educational year, were selected for this descriptive/analytical study by a radiologist; the subjects had at least one sign about the close proximity between the inferior alveolar canal and the tooth on their panoramic radiographs. The third molars were surgically extracted by a maxillofacial surgeon and the existence or non-existence of close proximity between the tooth and the canal was recorded as a gold standard. McNemar’s test was used to evaluate the diagnostic power of the radiographic technique (α = 0.05). The positive predictive value for superimposition of tooth image on the upper rim of the canal (p value = 0.1), superimposition of the tooth image on the entire canal (p value < 0.001) and superimposition of the tooth image on the entire canal along with narrowing of the alveolar canal (p value = 0.013) had higher diagnostic values compared to other signs, with positive predictive values 59.3%, 86.3% and 54.5%, respectively. Under the limitations of this study, it can be concluded that superimposition of tooth images on the entire alveolar nerve canal with narrowing and deviation of the canal can indicate a real relationship between the tooth and the canal.

Benign tumors and cysts of jaws comprise a complicated group of lesions characterized by various histologic and clinical manifestations, with odontogenic or non-odontogenic origins. These cysts are more common than other bone cysts and can give rise to pathologic jaw fractures. The aim of this study was to assess prevalence and frequency of benign non-odontogenic and odontogenic cysts and tumors in Isfahan Faculty of Dentistry and Al-Zahra Hospital during the past fifteen years.

A total of 246 files in relation to odontogenic and non-odontogenic tumors and cysts in the Departments of Surgery and Pathology in the Faculty of Dentistry and those in the Maxillofacial Surgery Department, Al-Zahra Hospital, Isfahan, Iran, were evaluated. Data was analyzed and compared using SPSS software (α=0.05).

There were 187 cases of odontogenic and 9 cases of non-odontogenic cysts, and also 47 odontogenic and 3 non-odontogenic tumors. While odontogenic cysts were more prevalent in 16-30 year-old males, non-odontogenic cysts were equally distributed between males and females in all age groups. Non-odontogenic tumors were more prevalent in middle-aged women.

Odontogenic cysts were significantly more prevalent compared to odontogenic tumors, with the highest prevalence rate (p value = 0.048). Odontogenic tumors, non-odontogenic cysts, and non-odontogenic tumors were less common in descending order. There was a significant increase in the number of patient referrals during the third 5-year period evaluated.

Based on data available request for dental implants is ever-increasing in Iran parallel with that in other countries. Therefore, dentists are required to increase their awareness about this treatment modality. The aim of the present study was to evaluate Isfahan dentists’ awareness to be able to program implant educational courses. In this descriptive, cross-sectional study 300 dentists were evaluated in Isfahan. Questionnaires were distributed among dentists and collected in person, which were later coded. Average marks of questionnaires were determined between 0 and 60. ANOVA and t-test were used for statistical analysis (α = 0.05). A total of 67.7% of the subjects had not participated in any sort of implant courses. Total average mark of the questionnaires was 28.33 ± 16.9 (based on marks from 0 to 60). Average marks of general practitioners and specialists were 27.87 ± 16 and 41 ± 17.9, respectively, demonstrating a statistically significant difference (p value = 0.03). Average marks of dentists participating in implant courses and those not participating in the courses were 38.72 ± 13.74 and 23.4 ± 16.12, respectively, with statistically significant differences (p value < 0.001). Average marks of general practitioners and even specialists were much lower than the ideal. Regarding the need for knowledge in dental implants it is recommended that dental students’ curricula and dentists’ in-service training courses be tailored to accommodate this need.

Chondrosarcomas are malignant mesenchymal tumors with cartilaginous differentiation. Chondrosarcomas of the maxillofacial region are extremely rare lesions, accounting for approximately 1% of chondrosarcomas of the entire body. In most cases, the tumor presents as a painless mass or swelling with loosening of the associated teeth. The final diagnosis of the lesion is based on histopathological findings.Case Report: A 30-year-old man with a swelling over the lingual side of his mandible was admitted. The patient had no complaints of pain or tenderness in the region.The mass lesion was biopsied. Histopathological examination on the biopsied sample confirmed the diagnosis of chondrosarcoma.The patient was advised to undergo surgery and the tumor was resected completely.So far there has been no evidence of recurrence in the 6 month post operation follow up.

Chondrosarcomas vary from a well-differentiated tumor resembling a benign mass of cartilage to a high grade malignancy with aggressive behavior and the potential to form metastasis. Tumor grade and resectability are the most important prognostic factors for head and neck chondrosarcomas. The treatment of choice for such lesions is wide surgical excision.

In addition to conventional radiography, several other techniques such as stereoradiography have so far been proposed to determine the position of impacted maxillary canines. The purpose of this study was to evaluate the diagnostic value of panoramic radiography and stereoradiography for determining the position of impacted maxillary canines.Method and materials: This was a prognostic, cross sectional study. A total of 30 impacted maxillary canines in 23 patients candidated for surgery were included. Four well coordinated observers separately determined the position of impacted maxillary canines using both panoramic radiography and stereoradiography. In the next phase, the exact position of impacted canines were determined through surgical exploration. Mc-Nemar and kappa index were applied for statistical data analysis. (α = 0.05). The rate of correct diagnosis in stereoradiography and conventional radiography was 93.35% and 60.82% respectively which demonstrated a statistically significant difference. With each method, there were no significant differences among observers. Sensitivity and specificity with stereoradiography were calculated 91.98% and 94.78% respectively. With conventional radiography however these values dropped to 49.90% and 74.11% respectively. Stereoradiography seems quite reliable for determining the position of impacted maxillary canines. On the contrary, conventional radiography per se does not look precise enogh to determin the position of impacted maxillary canines.

Multiple myeloma is a malignancy of plasma cells which affect the jaws in 15-30% of the cases. This paper explains a case of the multiple myeloma and its diagnosis.Case Report: The patient was 70 years old; he complained from painful nodule in the mandible interfered in chewing. In clinical examination some nodules were seen in the skull and jaws. In radiographic examination multiple destructive lesions were seen in the skull and jaws. The differential blood count (CBC diff), the urine analyzes, and biopsy was done. The diagnosis was multiple myeloma. More examinations and treatment process were done by oncologist. Although this is rare that the first signs of multiple myeloma are in the mouth and a patient comes to the dentist for diagnosis, but knowledge of the signs of this malignancy leads to fast diagnosis and treatment and improving the life time and the quality of life.

The epinephrine in local anesthetic solution induces elevation of blood glucose. Alsoanxiety can produces this effect. In this research, blood glucose changes during surgical removal ofimpacted third molar with use of lidocaine + epinephrine -as a local anesthetic- were evaluated.Methods and Materials: In this prospective analytic-descriptive study, 21 healthy patients, among thepatients who came to the faculty of dentistry of Isfahan for mandibular impacted third molar surgery,was chosen. Preoperative orders including, eating breakfast 3 hours prior to surgery, and nomedication consumption prior to operation, were served to every patient. Then, their blood glucosewere tested in 4 stages (15 minutes before surgery, immediately before use of local anesthesia, 7 & 15minutes after that) with Accu Check glucometer; and result were analyzed with SPSS software. Blood glucose changes through the 4 stages were significant (p<0.001). Mean blood glucoselevel which was 97.19 9.93 mg/dl in stage 1, was raised to 107.48 15.57 mg/dl in stage 4. Meanblood glucose level slightly decreased in stage 2, and then increased significantly in stage 3 and 4. After infiltration of local anesthesia and start of surgical process, the level of bloodglucose was increased; which is similar to Nakamura and Meechan studies. This result showed thatblood glucose doesn’t increase the normal range during dental surgery using two carpools of lidocaine2% pulse epinephrine 1/80.000.

Recent anti-inflammatory group of medications include the introduction of cyclooxygenase-II inhibitors such as coxibs. These agents offer potentially significant advantages because of their realive lack of gastrointestinal irritation. The aim of this study was to evaluate the effect third molar surgery.Methods and materials: This study was a double, randomized, cross over, clinical trial. Fourteen patients in age range of 17-30 years that acted as their own controls underwent bilateral third molar surgery with an interval of 2 weeks between each operation, when the tooth was removed in attention to right or left side of surgery, patients were randomly entered in study every twelve houres, ibuprofen 400mg was taken if pain persisted. Patients in control group took ibuprofen 400mg upon pain. The number of additional analgesic and the time of intake were recorded by patients. There was no significant difference between mean pain intensity in study and control group. The number of ibuprofen used in the study group was less significant. But the number of total analgesic in this group was more than control group. Incidence of first group adverse events was less in study group but there was no significant difference between first group adcerse events in two groups. Use of celecoxib clinically had valuable efficacy in control of postoperative pain after third molar surgery and reduced intake of ibuprofen in patients. Although there was no significant difference between pain intensity in two groups. It appears that because of reducing intake of ibuprofen and fewer first group advers events use of celecoxibe 200mg per 12 hours and ibuprofen PRN is suggested in the patients with first group problems. However in individuals without first group problems, intake of ibuprofen alone is suggested.

Dry socket is undoubtedly on tne most distressing post operative sequel of teeth extraction. It occurs in spite of the most careful aseptic procedures and regardless of the ability and skills of the surgeon. The purpose of this study was to determin the relative frequency of dry socket after mandibular wisdom teeth extraction and defining the risk factors corresponding to this complication. This descriptive-analytic study was performed on 386 patients who were candidate for wisdom teeth extraction. A medical history was taken. Some of these patients were found to have a history of smoking and were taking birth control pill. Operation time and trauma during extraction, and the oral hygiene status of patients were recorded. Three days after extraction the patients were recalled and examined for dry socket.The findings revealed the relative frequency of the dry socket was 7.5% (29 patient). Its occurrence was more in females than males, and maximum incidence was in the age between 20-40. The incidence were related to trauma and duration of extraction, history of smoking and oral contraceptive pills and pericoronitis, and had no specific relation with periapical lesions and oral hygiene.In this study, Similar to other studies, specific relation was found between dry socket and other factors like, smoking and age. But something which was obvious was the close relation of dry socket with the intensity of trauma during extraction.

Introduction. Temporo-mandibular disorders (TMDs) are a group of chronic and common disease that a lot of skeletal, Dental and psychologic factors can have an effect on it. Proposed treatment to control this disorder consists of wide variety of drugs and non-drugs methods beside dental treatment. Some investigations have reffered to relation between TMDs and some psychologic factors such as depression. The aim of this study was to investigate affects of relaxation therapy on TMDs.Methods. This was a clinical trial study. The case group consisted of 25 patients with TMDs and an average mark of depression Beck index of 4/4. After Beck test, patients were taught relaxation therapy methods. These methods were done until-two weeks. After completion of methods, Beck test was done again and TMD patients were re-enaluated.Results. The average incidence of pain in TMJ (in function and Rest) the maximum opening, maximum protrusive and Lateral movement, deviation of mandible in maximum mouth opening, and Beck test mark before and after relaxation therapy were meaningful and changes showed decrease in TMDs signs.Discussion. Findings show the effect of psychologic factors as an independent etiologic factor or dependent precursor of TMDs. These effects shouldn’t be ignored, therefore the relaxation therapy without any side effects can be a combined method with other methods to increase patients cooperation because of foovering the pain.