فهرست مطالب majid eshghpour

The purpose of the present study was to evaluate the changes in maxillofacial fracture epidemiology and etiology regarding Covid-19-related social distancing restrictions in an Iranian population.

A retrospective cross-sectional study was undertaken in six major trauma center hospitals in Iran in a period of two years (March 2018 until March 2020). The primary outcome variable was the maxillofacial fractures incidence. Patients’ demographic data, date of injury as well as fracture characteristics, fracture etiology, type, and site were all recorded, compared, and analyzed in the control and experimental groups.

 The patients consisted of 520 (83.6%) males and 102 (16.4%) females. Patients sustaining maxillofacial fractures over this two-year period displayed a mean age of 31.24±14.44, with an age range of 2 to 88 years. The incidence of maxillofacial fractures significantly decreased in all age groups (p<0.001). After social distancing restrictions were placed; there was a significant drop in the number of subjects attending due to motorcycle collisions and road traffic accidents, whereas the number of fractures caused by assaults and domestic violence significantly increased (p<0.001 for each).

The investigators realized that social distancing restrictions were able to change the trends and patterns in maxillofacial fracture incidence and etiology.

The purpose of this article was to systematically review maxillary sinus changes after LeFort. We examined and analyzed the anatomical abnormalities that occurred following LeFort I osteotomy, as well as the abnormalities of maxillary sinus volume (MSV) before and after the operation.

A systematic search was conducted on various databases, such as Google Scholar, PubMed, and Scopus. The articles used were in English and original. This study was conducted until September 2023, and after reviewing the articles, several keywords, such as "Maxillary sinus" and "LeFort I osteotomy", were employed. The obtained data were evaluated based on the PICO framework.

Findings from 15 studies showed that the amount of MSV decreased before and after the operation (considering the three dimensions of the sinus, the measurement was performed linearly). These reduction values differed between men and women, with men having a greater reduction. As is the case with other operations, there were some side effects associated with this type of operation that some patients experienced postoperatively.

In both male and female patients, the MSV was reduced after one-piece and multi-segment osteotomies. Nonetheless, one-piece LeFort I osteotomy showed a higher reduction in MSV than the multi-segment osteotomy method, according to this systematic review and meta-analysis.

We aimed to investigate the pharmacological and non-pharmacological interventions used for mitigating pain.

We integrated randomized controlled trials (RCTs) chosen from PubMed, Google scholar, and Scopus and aimed at assessing the effectiveness of one or multiple variants of Non-steroidal anti-inflammatory drugs (NSAIDs), as well as Narcotic analgesics, compared to corticosteroids, curcumin, hyaluronic acid, and antibiotics. In addition, trials utilizing NSAIDs, including Rofecoxib, which have been withdrawn from market circulation, were deemed ineligible for inclusion.

A total of 9 RCTs were evaluated in this study, and the patients' postoperative pain was assessed using the visual analog scale (VAS) and the time measurement. Moreover, there were various approaches to alleviating pain and discomfort.

The administration of ibuprofen prior to surgery leads to a marked reduction in pain. Pharmacological interventions, such as the administration of dexamethasone and oxycodone, alongside non-pharmacological interventions, such as laser therapy, have been shown to effectively alleviate the discomfort resulting from surgical procedures on the jaw and face.

The aim of this study was to systematically review the literature on the treatment options of maxillofacial fractures in Iran, complementing a previous article regarding causes and the overall prevalence.

A systematic search of PubMed, Cochrane Library, Web of Science (WS) and Google Scholar (GS) electronic databases was conducted to identify the relevant articles published up to January 2023. Studies reporting the treatment option of maxillofacial fractures in Iran were included in the analysis. MOOSE guidelines were adopted for the current systematic review. No data or language restriction were applied. Risk of bias across the articles was assessed.

This systematic review included 13 articles with a total of 19,147 treated patients for maxillofacial fractures. ORIF was the most common type of treatment, but complications occurred in approximately 5% of cases. Mandible fractures were not statistically more treated by ORIF than closed reduction or conservative treatment, and no type of treatment was considered statistically preferable depending on the anatomical region affected by Iranian maxillofacial surgeons. The included studies were considered to have a low risk of bias, but many were not clear in reporting cross-referenced data regarding the type of treatment, which could be considered a major flaw.

Overall, this study provides valuable insights into the types of treatment used for maxillofacial fractures by Iranian surgeons and highlights the importance of clear reporting of data in research articles.

The provision of sufficient stability after maxillofacial surgery is essential for the reduction of complications and disease recurrence. The stabilization of osteotomized pieces results in rapid restoration of normal masticatory function, reduction of skeletal relapse, and uneventful healing at the osteotomy site. We aimed to compare qualitatively stress distribution patterns over a virtual mandible model after bilateral sagittal split osteotomy (BSSO) bridged with three different intraoral fixation techniques.

This study was conducted in the Oral and Maxillofacial Surgery Department of Mashhad School of Dentistry, Mashhad, Iran, from March 2021-March 2022.  The mandible computed tomography scan of a healthy adult was used to generate a 3D model; thereafter, BSSO with a 3mm setback was simulated. The three following fixation techniques were applied to the model: 1) two bicortical screws, 2) three bicortical screws, and 3) a miniplate. The bilateral second premolars and first molars were placed under mechanical loads of 75, 135, and 600N in order to simulate symmetric occlusal forces. Finite element analysis (FEA) was carried out in Ansys software, and the mechanical strain, stress, and displacement calculations were recorded.

The FEA contours revealed that stress was mainly concentrated in the fixation units. Although bicortical screws presented better rigidity than miniplates, they were associated with higher stress and displacement readings.

Miniplate fixation demonstrated the most favorable biomechanical performance, followed by fixation with two and three bicortical screws, respectively. Intraoral fixation with miniplates in combination with monocortical screws can serve as an appropriate fixation arrangement and treatment option for skeletal stabilization after BSSO setback surgery.

Maxillofacial fractures are a common type of injury that can result in significant morbidity and mortality. We aimed to systematically review the literature on the prevalence and causes of maxillofacial fractures in Iran to estimate the overall prevalence of maxillofacial fractures and the most common causes.

A systematic search of PubMed, Cochrane Library, Web of Science (WS) and Google Scholar (GS) electronic databases was conducted to identify relevant articles published up to January 2023. Studies reporting the prevalence and causes of maxillofacial fractures in Iran were included in the analysis. MOOSE guidelines were adopted for the current systematic review. No data or language restriction were applied. Risk of bias across the articles was assessed.

A total of 32 studies comprising 35,720 patients were included in the analysis. The most common cause of maxillofacial fractures was road traffic accidents (RTAs), accounting for 68.97% of all cases, followed by falls (12.62%) and interpersonal violence (9.03%). The prevalence of maxillofacial fractures was higher in males (81.04%) and in the age group of 21-30 years (43.23%). Risk of bias across studies was considered low.

Maxillofacial fractures are a significant public health problem in Iran, with a high prevalence and RTAs being the leading cause. These results highlight the need for increased efforts to prevent maxillofacial fractures in Iran, especially through measures to reduce the incidence of RTAs.

The aim of this study was to compare the dento-skeletal stability between one and three-screw fixation of mandible following bilateral sagittal split osteotomy (BSSO) in skeletal class 3 patients.

Healthy patients with skeletal class 3 malocclusion in Mashhad, Iran, from August 2020 to May 2021 were undergone mandibular setback through bilateral sagittal split osteotomy. Rigid fixation was performed in one group with one-screw technique, and three-screw fixation was done in another group. Cephalogram x-rays were prepared and analyzed in three stages: before surgery (T0), one week after the surgery (T1), and six months postoperatively (T2). The linear and angular alterations of chosen multivariate skeletal and dental variables were evaluated and statistically compared in all three periods.

This study included a total of 20 patients, 12 of them were female (60%). Patients in the one-screw fixation group had a mean age of 20.6 ± 2.2 years old, whereas those in the three-screw fixation group were 21.5 ± 2.8 years old, with no statistically significant difference. Both groups had excellent mandibular stability six months following surgery. No statistically significant differences were observed in the postoperative skeletal and dental changes between the two techniques.

Fixation of the mandible following the setback surgery by the BSSO technique with the one-screw fixation method may be accomplished effectively, and the therapeutic outcomes are comparable to those obtained with the traditional 3-screw fixation approach.

We aimed to investigate the effect of preoperative administration of oral tizanidine on postoperative pain intensity after bimaxillary orthognathic surgery.

All healthy skeletal class III patients who were candidates for bimaxillary orthognathic surgery were enrolled in this triple-blind randomized clinical trial. The study was carried out in the Maxillofacial Surgery Department of Qaem Hospital, Mashhad, Iran; from January 2021 to November 2021. The consecutive patients were randomly divided into tizanidine and placebo groups. One hour prior to anesthesia induction, the tizanidine group received 4 mg Tizanidine dissolved in 10 ml apple juice, whereas the placebo group received an identical glass of plain apple juice. All operations were performed by the same surgical team, under the same general anesthesia protocol. Postoperative pain was measured using the Visual Analogue Scale (VAS) at 3, 6, 12, 18, and 24 hours. For statistical analysis; the significance level was set at 0.05 using SPSS 23.

A total of 60 consecutive patients, consisting of 36 females (60%) and 24 males (40%) with an average age of 25.4 ± 6.0 were recruited. An increasing trend was noticed in the amount of perceived postoperative pain from the 3rd till 12th hour, and then decreased afterward. Nevertheless, the average amount of pain was significantly lower in the tizanidine compared to the placebo group, in all the evaluated time intervals (P<0.001). Moreover, there was a significantly higher requirement for postoperative opioid analgesics in the placebo compared to the tizanidine group (P=0.011).

The addition of oral tizanidine was effective in reducing postoperative pain following bimaxillary orthognathic surgery. Further studies are necessary for more relevancy.

We aimed to compare the emergence from anesthesia between the isolated mandibular setback and bimaxillary orthognathic surgeries in Skeletal Class III Patients.

All healthy patients with skeletal class III deformity admitted to Mashhad Dental School, Mashhad, Iran from the years 2017 to 2018 were included in this study. They were candidates for either bimaxillary orthognathic surgery (Bimax surgery) through a combination of mandibular setback surgery plus maxillary advancement or isolated mandibular setback (Monomax surgery). The predictor variable was the type of jaw displacement and anesthesia duration, while the outcome variable was the duration of emergence from general anesthesia. The duration of emergence from anesthesia was calculated from the time the patient was transported to the recovery room until the time of safely discharging from the recovery room. For statistical analysis, the significance level was set at 0.05 using SPSS 21.

A total of 81 consecutive patients, comprising 45 (55.6%) males and 36 (44.4%) females, with an average age of 23.15±4.58 years were recruited. Among the participating patients, 56 (69.1%) underwent bimaxillary surgery while the other 25 (30.9%) were treated with Monomax surgery. Regardless of the type of performed surgery, the duration of general anesthesia was the only factor to be significantly correlated to the length of emergence from anesthesia (P= 0.001). 

Increased exposure time to general anesthesia might result in a longer emergence from anesthesia, despite the type of performed orthognathic surgery. Further clinical trials are needed to support the relevancy.

Removal of teeth and residual roots is one of the most common dental surgeries which is sometimes accompanied by complications such as root displacement to adjacent anatomical spaces. The present study aimed to report a rare case of tooth root displacement to the pyriform area.

The patient was a 56-year-old woman who was referred to Mashhad School of Dentistry following extraction of the maxillary premolar root by closed method and improper pressure by the dentist which transferred the root to the soft tissue of the pyriform sinus.

Observing the principles of prevention, selecting a qualified patient, and appropriate techniques and devices for tooth extraction are important The possibility of errors and complications increases during work if the correct surgical method is not used and the surgeon has insufficient experience.

We aimed to evaluate the possibility of temporomandibular joint (TMJ) dysfunction following mandibular advancement surgery in skeletal class 2 patients.

All healthy non-syndromic patients with Class 2 deformity, who were eligible for mandibular advancement surgery, were included in this before-after quasi-experimental study. The main intervention was mandibular advancement through bilateral sagittal split osteotomy (BSSO). Maxillary impaction or setback surgery using LeFort 1 osteotomy was simultaneously performed in some cases. Variables such as TMJ pain, clicking, crepitus, or any other type of sounds or complaint as well as the amount of maximum mouth opening (MMO) were evaluated before surgery and two months postoperatively.

Thirty patients including 15 men and 15 women with a mean age of 23.3 ±2.7 yr were studied. The mean amount of mandibular advancement displacement was 3.30 ± 0.87 mm. The rate of TMJ dysfunctions and complaints was relatively low two months postoperatively when compared to the preoperative state. Postoperative evaluation demonstrated that there was no significant correlation between the presence of TMJ symptoms and dysfunctions and the type of surgery. After treatment was completed, the mean MMO reduced significantly from 39.03±5.86 to 38.12±6.05 (P<0.001).

Mandibular advancement with BSSO surgery in skeletal class 2 patients did not clinically lead to TMJ dysfunctions. Among all the investigated factors, only preoperative pain, noises, or complaints were proven to have predictive value for postoperative TMJ dysfunction.

We aimed to assess the incidence of bad split fractures during Bilateral Sagittal Split Osteotomy (BSSO) mandibular setback surgery using Dal Pont and Hunsuck techniques.

All healthy adults with skeletal class III discrepancy, who were candidates for mandibular setback surgery were enrolled in this randomized clinical trial in the Maxillofacial Surgery Department of Qaem Hospital, Mashhad, Iran; from 2018-2020. These patients were randomly divided into two equal groups; one group underwent BSSO using Dal Pont osteotomy while the Hunsuck osteotomy was employed for the other group. A bad split fracture which identified through intra-operative clinical and postoperative radiographic examination was the outcome variable. The significance level was set at 0.05 using SPSS 16.

Overall, 104 consecutive patients, comprising of 52 (50%) males with an average age of 23.09±3.08 were recruited. The average duration of osteotomy and splitting was reported to be 22.74±3.06 min. 10 bad split fractures (9.62%) were observed; 7 of which occurred in the Dal Pont group and 3 in the Hunsuck group. However, this difference was not significant. In 80% of the cases, bad split osteotomy occurred in the proximal segment, while this finding was identified in the distal segment in 20% of cases. The average duration of osteotomy and splitting was significantly longer in the Dal Pont group (P<0.001).

The duration of osteotomy and splitting is much shorter when the Hunsuck technique is employed, and the incidence of unfavorable fractures is also less compared to the Dal Pont osteotomy technique.

The present study aimed to investigate the etiology and epidemiology of maxillofacial spaces infection in patients referred to Kamyab Hospital, Mashhad, during 2016-2019.

The medical records of patients who had been referred to Kamyab Hospital in Mashhad due to maxillofacial abscess were reviewed in this cross-sectional study. The research variables included gender, age, offending tooth, type of abscess, symptoms, systemic problems, smoking and alcohol use, type of antibiotics prescribed, type of anesthesia and surgical procedure, length of hospitalization, postsurgical complications. Data were analyzed in SPSS software (version 19).

The present study was con conducted on 209 cases (including 86 (41.1%) females and 123(58.9%) males) with a mean age of 35.45±14.19 years. A number of 58 (27.8%) patients used cigarettes and tobacco and 26 (12.4%) subjects consumed alcohol. Moreover, 34 (16.3%) cases had a systemic disease. The highest frequency of offending tooth was related to lower third molar in 56 (26.8%) cases. The most infected site was submandibular in 108 (51.7%) cases, and the most abscess-related symptom was swelling in 179 (85.6%) subjects. The most common complication was Ludwig's angina, and the most prescribed antibiotic was clindamycin in 151 cases.

As evidenced by the results of the present study, maxillofacial abscesses can cause irreversible complications for patients. Patients with infected pterygomandibular and submasseteric spaces were more likely to be hospitalized longer than others.

The possibility of mandibular bad spilt might happen during bilateral sagittal split osteotomy (BSSO). This study investigated the effect of impacted mandibular third molars on bad spilt incidence during BSSO.

Totally, 140 patients under 40 years old who were candidates for BSSO surgery due to class 3 skeletal discrepancy were divided randomly into two equal groups. The impacted mandibular third molars were presented in one group during BSSO (Exposed), and the third molars were removed at least six months before surgery for the other group (Unexposed). All cases underwent BSSO using the same technique by a single surgeon. A bad split was diagnosed by inter-operative clinical examination and postoperative panoramic radiography. 

Four bad split occurrences were observed including three patients in the group which impacted mandibular third molars were presented and one patient in the group without impacted mandibular third molars. The incidence of bad fracture in the exposed group was 3.7 times more than the unexposed group. The incidence of the bad fracture in exposed group was 3.7 times more than unexposed group. The chance of fractures in females was 1.7 times higher than males. With one year addition to the patient’s age, chance of fracture increased 0.985 times more. 

Overall incidence of bad split fracture in presence of mandibular third molars in females and at older ages increased during BSSO. The extraction of impacted mandibular third molars, six months before the BSSO is recommended to prevent the bad split incidence during the operation.

The present study aimed to evaluate the incidence of obstructive sleep apnea (OSA) after monomax mandibular setback surgery using a combination of Berlin, STOP-BANG, and Epworth SleepScale questionnaires. This double-blind quasi-experimental before-after study was carried out on a total of healthy patients with class III deformity and eligible for orthognathic mandibular setback surgery. Age, gender, body mass index, neck circumference, and amount of mandibular setback were recorded in the study checklist. The incidence of OSA was assessed for allthe patients 1 week before the operation and 1 and 6 months following the surgery using the aforementioned questionnaires under the supervision of a pulmonary specialist. Descriptive and analytical statistics were analyzed by SPSS software (version 17). A p-value of less than 0.05 was considered statistically significant. A total of 30 patients, including 15 males and 15 females, with a mean age of 25.77±4.76 years participated in this study. The mean scores of OSA questionnaires increased a month after mandibular setback surgeryusing bilateral sagittal split osteotomy, compared to those reported before the operation; however, 6 months following the surgery, the results numerically reduced closer to the patient’s normal condition. The amount of mandibular setback was directly correlated with the incidence of OSA in patients 1 and 6 months after the surgery based on all the three questionnaires; nevertheless, it was significantly and directly correlated with STOP-BANG questionnaire (p < /em><0.05). The obtained results of the present study indicated that there was no evidence of severe OSA 6 months following mandibular setback surgery. Additionally, obese patients and those submitted to a large amount of mandibular setback presented a higher chance of developing OSA. The findings of the present study showed that the results of the numerical changes of the sleep questionnaires and incidence of OSA 1 and 6 months after the surgery and before the operation were significantly lower in patients with mandibular setback up to 5 mm, compared to those with equal or greater than 5 mm.

This study aimed to determine the effect of low-level laser therapy (LLLT) on reducing complications following tooth extraction.

This randomized clinical trial consisted of 40 subjects who underwent lower molar extraction. The patients were randomly assigned to 4 groups. Group 1 was irradiated with a 660 nm laser (200 mW, 30 seconds radiation to lingual, buccal and occlusal surfaces of the socket, 6 J/area). In group 2, an 810 nm laser was applied similar to group 1. In group 3, a combination of 660 and 810 nm lasers was used. The patients in group 4 served as a placebo group. LLLT was performed after 0.5-1 hour of extraction and 2 days later. The participants were asked to record pain degree using a visual analogue scale (VAS) over 7 days. The amount of wound healing was evaluated on the third and seventh days.

There was no significant difference in pain scores among the groups at any of the assessment intervals (P > 0.05). The between-group differences in wound healing scores were small and insignificant (P > 0.05).

LLLT with 660 nm or 810 nm lasers or their combination had no greater effect than the placebo laser for reducing the complications of tooth extraction.

Obstructive sleep apnea is a disorder of repetitive complete or partial airway obstruction during sleep. The aim of this study was to assess the impact of alveolar cleft reconstruction on the obstructive sleep apnea (OSA) condition and apnea/hypopnea index (AHI).

In a double-blinded prospective quasi-experimental study, all healthy systemic children (n=30 female cleft patients) with unilateral alveolar cleft defects within the age range of 8-14 years and BMI less than 30 kg/m2 who admitted for alveolar cleft repair were enrolled. OSA monitoring was performed one week before surgery, and 3 months postoperatively by Apnea Link device. Sleep apnea indices such as AHI, respiratory disturbance index (RDI), oxygen desaturation index (ODI) and oxyhemoglobin saturation (SpO2) as well as pulse rate (PR) and respiratory rate (RR) were the variables.

The patients’ mean age was 11.0±1.4 years, and BMI average was 21.48±4.4 kg/m2. Mean AHI was 21.6±5.0 events/hour, preoperatively; which decreased significantly and reached 4.4±2.5 events/hour after alveolar cleft reconstruction surgery (p=0.005). Moreover, the other OSA variables (SpO2, RDI, and ODI), as well as vital signs (PR, and RR) improved postoperatively (p=0.005). In other words, the preoperative moderate OSA status relieved after alveolar cleft repair and reconstruction.

Our study showed that the OSA and AHI ameliorated after bone graft surgery in alveolar cleft repair. More clinical trials including larger sample sizes may be required for relevancy.

Dry socket is one of the most common postoperative complications following the surgical extraction of the impacted third molar. In clinical observations, the tooth cavity is devoid of the blood clot and bone is completely exposed. The duration of surgery is one of the factors affecting the incidence of this lesion. Nonetheless, the assessment of the studies on the effect of increased length of surgical extraction of impacted third molars on the incidence of dry socket has not yielded accurate results. With this background in mind, the present study aimed to evaluate the correlation between the duration of surgical extraction of impacted third molars and the incidence of dry socket.

The current study was conducted on 227 patients within the age range of 17-30 years old referring to the oral and maxillofacial surgery department of Mashhad Dental School. The impacted difficulty score was considered 4-8 based on the Peterson reference. The amount of pain and incidence of the dry socket was evaluated in 2, 4, and 7 days after surgery.

The mean pain scores in the second, fourth, and seventh days after the surgery were measured at 4.72±1.08, 1.57±1.26, and 0.29±1.11, respectively, which indicated a significant difference in the severity of pain in different times (P<0.001).There was no incidence of dry socket on the second day after surgery; nonetheless, five cases of dry socket were observed on the fourth day and the same five cases on the seventh day after the operation (P=0.007). Moreover, the pain significantly increased on the second and seventh days after surgery with increasing the duration of surgery. Furthermore, with increasing the duration of surgery, the amount of pain increased significantly on the second and seventh days after surgery. However, it increased only to a very small amount on the fourth day and its correlation was not significant

As evidenced by the obtained results, the duration of the impacted mandibular third molar operation is associated with an increased risk of alveolar osteitis.

Ridge atrophy accompanied by the pneumatization of maxillary sinus in the maxillary posterior region may lead to inadequate bone height, thereby precluding implant placement. Therefore, it may be mandatory to perform a sinus membrane elevation procedure and augmentation in the bone. The present study aimed to introduce a novel modification method for sinus floor elevation using a gelatin sponge (Gelatamp, COLTÈNE ROEKO, India) in order for better visualization, hemostasis, and conservative maxillary sinus membrane dissection with the low risk of complications. Implant placement was performed in a case series of 28 patients with hyperpneumatized sinus or a moderately resorbed posterior maxillary alveolus.
According to the findings, implant placement caused no complications in the patients. Furthermore, none of the patients experienced infections, sinusitis or graft and implant failure clinically and radiographically at the three- and six-month follow-up. Therefore, it could be concluded that gelatamp-assisted sinus lift is a simple, safe, noninvasive, and innovative technique for sinus membrane elevation. In addition, it is predictable and efficient, especially in the cases where piezoelectric surgery armamentarium is not available.

Impacted teeth are a common incident with significant frequency and distribution variation in various populations. Several complications may arise if immediate diagnosis and proper treatment are not performed in the case of impacted lower wisdom teeth. The present study aimed to evaluate the frequency and difficulty score of lower third molar impaction in the patients referring to the oral and maxillofacial surgery department of Mashhad Dental School, Iran. This descriptive, cross-sectional study was conducted on 743 patients referring to the oral and maxillofacial surgery department of Mashhad Dental School during September 2017-March 2018. The position, impaction angle, and difficulty score were determined by panoramic views. Out of 1,118 impacted lower third molars, 456 cases (41%) had a mesioangular position, 293 cases (26%) were horizontal, 276 cases (25%) were vertical, and 94 cases (8%) had a distoangular position. In addition, impaction was more prevalent in women (58%) compared to men. The most frequent impaction was the moderate type (53%). However, no significant correlation was observed between gender and the difficulty score of the impacted teeth. On the other hand, a significant correlation was denoted between gender and the angle of wisdom teeth impaction based on the Schiller and Winter classification, as well as the impaction depth and ramus relation based on the Pell and Gregory classification (P<0.001). According to the results, the frequency of moderate-to-severe impacted lower third molars was high in the patients referring to Mashhad Dental School. Therefore, it is critical to perform accurate screening, timely diagnosis, and proper treatment in these cases

With the advancement of the instruments for oral surgeries, use of alternative methods instead of traditional scalpels has been evaluated, The present study aimed to compare the complications associated with electrosurgery techniques and use of scalpel during and after orthognathic surgery.
In this split-mouth designed study, 20 patient who were candidate for orthognathic surgery were enrolled. Symmetrical incisions were made using electrosurgical methods on one side of the jaw and routine techniques with a scalpel number 15 on the other side. Evaluation of the techniques was performed during the surgery and six weeks postoperatively based on specific parameters, including the cutting time, and rate of scar tissue formation. Finally, the collected data from the implications of the two methods were compared using Man-Whitney U- test.
Mean cutting time was 6.63±1.22 and 10.19±1.95 minutes in the electrical cautery and scalpel groups, respectively, which denoted a significant difference between the groups (P According to the results, cautery could lead to a more significant reduction in the cutting time compared to use of scalpel. Furthermore, the scar tissue produced in the electrocautery technique was significantly higher compared to scalpel, which could be due to the induced heat damage to the adjacent tissues.

Adenoid ameloblastoma with dentinoid is a rare odontogenic tumor. Granular cell ameloblastoma also is a less common histological subtype of ameloblastoma. In this report, the patient was a 31‑year‑old male. The lesion was located in the right mandible and was unicystic with well‑defined borders. The tumor tissue was showing a combination of follicular, plexiform, and desmoplastic patterns of ameloblastoma with wide areas of granular cells, fibrous stroma, glandular pattern, and dentinoid calcified. Very few cases of distinct forms of ameloblastoma that show the formation of dentinoid has been reported. However, there are no cases of adenoid granular cell ameloblastoma with dentinoid reported.

Accurate estimation of the amount of blood loss for predicting the need for transfusion during bimaxillary orthognathic surgery is important for maxillofacial surgeons and anesthesiologists. The aim of this study was to determine the amount of blood loss during various types of orthognathic surgery.
A total of 92 patients were selected and were separated into two groups of monomaxillary & bimaxillary. All the surgeries were performed in Ghaem Hospital of Mashhad University of Medical Sciences under anesthesia with deliberate hypotension.Blood pressure during surgery was maintained under 100 mm/hg. Surgical blood losses was measured by the amount of blood in the surgical suction unit and counting the number of gauze pads saturated with blood by the anesthesiologiste and at the end of surgery was recorded. In the end, the amount of blood loss was determined separately according to the type of surgery & was statistically analyzed.
The study sample consisted of 92 subjects with a mean age of 23.6±3.64 years and all of the subjects completed the study. The average surgical blood loss was 351.63 ml. Mann-Whitney Test showed that the amount of blood loss in class II was significientlya higher than class III (monomaxillary P=0.040 and bimaxillary P=0.008). Blood loss in monoaxillary surgery was significiently less than bimaxillary surgery (P According to the present study, the amount of bleeding among different types of orthognathic surgeries is different depending on type & number of surgery and these factors are important in estimating the amount of blood loss and peredicting the necessary actions in order to replace the lost blood volume.

surgeons have always sought to use techniques to decrease pain and swelling. One of the solutions that can minimize these complications is closing the wound with the minimum number of sutures or sutureless technique. The goal of this study was to evaluate the role of sutureless technique in decreasing pain and swelling after impacted mandibular third molar surgery.
nineteen patients with bilaterally mandibular impacted third molars (one side as control and the other as the case) entered the study. A single surgeon performed the surgery using a single protocol. After removing each tooth, the flap on the control side was sutured, while on the study side, it was handled sutureless. Post-operative pain evaluated with visual analogue scale (VAS) at first, third and seventh days after surgery. Inflammation evaluated with measuring the distance between tragus and oral commissure in the same distance.
In our study, in all patients, the average mean pain score increased from the first to the third day and decreased from third to seventh day and the difference in the average of pain scores in the aforementioned three days was significantly different(p Results of this study showed that secondary wound closure (sutureless technique) was effective in decreasing pain and swelling after mandibular third molar surgery

One of the best methods for reconstruction of bone defects in the area of dental patients is using autogenously bone grafts that is considered the gold standard for bone defect augmentation. Different intraoral donor sites to harvest the bone graft are available and the maxillary tuberosity due to its convenient surgical access and fewer complications is a perfect place for taking a limited amount of bone. The aim of this study was to evaluate maxillary second molar periodontal problems after tuberosity bone graft harvesting. 15 patients admitted to the Department of Oral and Maxillofacial surgery at Mashhad Dental School with ages ranging from 20 to 40 years, were studied. For each patient, pocket depth index, gingival attachment loss index, plaque index, gingival index and bleeding on probing at four areas including middistal, disto buccal, disto lingual of each tooth, both before and 6 months after surgery were measured and recorded. Paired t test and Wilcoxon and Mc Nemar tests were used for data analysis (α=0.05). The data showed that the mean pocket depth of distal of maxillary second molar, both before and 6 months after surgery, showed a rate of 15.4% reduction which was significant (P=0.002). Plaque index, gingival attachment loss index and gingival index were ordinal evaluated as and all three had declined significantly over time (P-value=0.002, 0.025 and 0.077 respectively. Bleeding rate observed at 6 months after surgery showed a 21.4% decrease which was not significant (P=0.250). The removal of bone from the maxillary tuberosity, will not cause any periodontal problems for second molar maxillary and if the supporting bone distal to it is damaged during surgery, would be restored so that there will be a normal biologic width and pocket depth.