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Craniomaxillofacial Research - Volume:6 Issue: 1, Winter 2019

Journal of Craniomaxillofacial Research
Volume:6 Issue: 1, Winter 2019

  • تاریخ انتشار: 1398/06/02
  • تعداد عناوین: 7
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  • Farzaneh Farid, Sepideh Arastouei, Jamal Saker * Pages 1-10
    Statement of Problem

    Prosthetic treatments account for more than half of the all provided dental services, as well as the highest number of lawsuits in some countries. The quality of  Prosthodontics postgraduate programs has profound effect on the improvement of provided patient  health care and reduction of patient complaints.

    Goal

    The goal of this study was to survey different universities around the globe for the duration and subjects of Prosthodontics specialty programs, the title of degree awarded and the programs hat are offered in conjunction with other disciplines.

    Materials and Methods

    This study surveyed Prosthodontics specialty programs offered by different universities available on their websites, and reviewed published research on this subject using search engines such as Google, Pubmed and Medline. The published Accreditation Standards for the program and minimum requirements for achieving competency after completion of the program was reviewed.

    Result

    The results of survey showed that prosthodontics specialty is not recognized by all countries. In 42 universities surveyed, the duration of program ranged from two to four years. The title of awarded degree varied in different universities. In some universities, prosthodontics and other disciplines were integrated in one program. Few universities offered additional subjects like photography, geriatrics and pain in their educational curriculum.

    Conclusion

    The core subjects of the programs seemed identical. However, programs differ in duration, title and extra subjects.

    Keywords: Prosthodontics, Prosthetic dentistry, Post graduate, Residency, Specialty, Education, Curriculum
  • Hamid Mahmood Hashemi, Reza Sharifi, Mahboube Hasheminasab, Mostafa Mortazavi * Pages 11-19
    Purpose

    Maxillofacial infections (MIs) commonly occur in patients of all ages, representing a life-threatening challenge when reaching deep facial spaces. The epidemiologic studies of MIs and  their characteristics are very important and beneficial for both patients and clinicians. Therefore, the aim of this prospective study was to determine the annual incidence, etiology, risk factors an surgery of the Shariati hospital during a 1-year period.

    Material and Methods

    The demographic data, levels of some serum markers on day of admission, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), bandemia, serum albumin, predisposing factors for each patient referred for treatment of MI were recorded by one researcher in November 2013 to November 2014. The linear regression test was used to evaluate whether there was a relationship between the amount of changes in ESR, CRP and albumin levels and age of the patients, pregnancy, gender and severity of infection. Panoramic radiography as well as axial and coronal CT scans with soft tissue window were performed for all cases, except pregnant participants. The origin of MIs, including odontogenic, pathologic and foreign body, was identified for each patient.

    Results

    During the study period, a total of 157 patients (87 female, 70 male), with an age range of 3 to 74 years (mean, 23.5±13.2 years), were admitted to the department of maxillofacial surgery. Regardless of the gender, the most frequent cause of MIs was odontogenic sources (128 cases, 81.5%). The most common affected area was the buccal space with 106 positive cases (67.5%). The most common teeth responsible for maxillofacial fascial space infection were mandibular third molars. A positive association was found between CRP and ESR levels and the severity of infections. Serum albumin and ESR levels were significantly reduced and increased in the patients with severe infection and pregnant patients, respectively.

    Conclusion

    The results of this study indicated that odontogenic origins were the main cause of MIs and the most common involved space was the buccal space. Diabetes mellitus was the most commonly found systemic disease among the participants of this study. The findings of this study suggest that dentists should consider that the most appropriate treatment of odontogenic infections involves surgical intervention and selection of a suitable antibiotic as an adjunct.

    Keywords: Maxillofacial infection, Risk factors, Complications
  • Reza Sharifi, Mohammad Atai, Mahsa Mohajeri, Naghmeh Bahrami * Pages 20-25
    Background

    In oral and maxillofacial fractures, plates and screws routinely fix fragments until the completion of healing process, which has its own complications in some critical fractures. To overcome this drawbacks bone adhesives are developed for the immobilization of fractured bones.

    Objective

    In this in-vitro study we compared the bond strength obtained by immobilization of the bone fragments using plates and screw and new adhesive containing BTDMA monomer.

    Materials and Methods

    In this experimental in-vitro trial, bone fractures were simulated in bovine’s mandibular bone using an electrical saw. The bone fragments were randomly allocated in different groups and were immobilized with either plate and screws and adhesive containing 0, 10, 15% BTDMA. After 24 hours tensile bond strength was calculated using universal testing machine. One-way ANOVA and Tukey post hoe test were used for statistical analysis.

    Results

    Mean (±standard deviation) of tensile bond strength of bone fixation using adhesive containing 15% (W/W) BTDMA monomer were 176.0 (±18.89) N. These values were 149.1 (±23.88) N for adhesive containing 10% BTDMA; 102 (±17.99) N for the base adhesive and 278.9 (±24.12) N for the screw and plate technique. Significant differences were found regarding bond
    strength of bone fixation in 4 groups using bone adhesives or plate technique (P<0.001). The highest bond strength was recorded for the plate group and the least was related to the base adhesive. Significant differences existed between all bone adhesives as declared by paired comparison (p<0.05).

    Conclusion

    Despite the lower bond strength in adhesive groups in comparison with screw and plate, with regards to possible complications of screw and plate technique, it seems bone adhesives containing BTDMA monomer can be used for bone fragment fixation. However, bond strength is just one of the numerous properties that an adhesive should have and more studies must be done on these kinds of adhesives.

    Keywords: Tensile bond strength, Bone adhesives, Maxillofacial fractures, Plates-screws
  • Shirin Shahnaseri, Navid Mohammadi, Alireza Tamizifar, Seyed Amir Mousavi * Pages 26-33
    Background

    This study aims to compare the anesthetic efficacy, postoperative pain, hemorrhage & dry sock incidence of articaine 4% versus lidocaine 2% in inferior alveolar nerve block during impacted lower third molar surgery.

    Materials and Methods

    A prospective randomized study was conducted on 20 subjects planned for elective surgical removal of bilateral impacted mandibular with similar difficulty indices. A single operator performed all surgeries on basis using 4% articaine or 2% lidocaine as an anesthetic agent and with the same concentration of vasoconstrictor (epinephrine 1:100,1000). Latency, duration of anesthetic effect, intra and post surgical pain experiences, hemorrhage & dry socket occurrences were evaluated with respect to the type of anesthetia. A visual analog scale was used to score pain. Data were analyzed by descriptive statistics, repeated measures ANOVA, Wilcoxon and McNemar’s test (α=0.05).

    Results

    Latency, Intra & Postoperative pain and hemorrhage showed clinical differences in favor of articaine, though statistical significance was not reached. In turn, the mean duration of anesthetic for articain was much extended and showed statistically significant difference. Dry socket incidence consisted of two occurrences (5%) and those two only occurred in Lidocain group.

    Conclusion

    Although 4% articaine offers better pharmacological performance than 2% lidocaine, both articaine and lidocaine have demonstrated adequate, negligible differences and acceptable clinical profiles. For this reason, their use in oral surgery should remain of the professional preference who will evaluate their use base on the necessary surgical time.

    Keywords: Articaine, Bleeding, Dry socket, IAN bock, Impacted lower third molar, Lidocaine, Post operative pain
  • Maryam Masoum Khani, Abdolreza Mohamadnia, Farzaneh Hosseini, Parisa Bayat, Naghmeh Bahrami * Pages 34-38
    Introduction

    Oral squamous cell carcinoma accounts for 2% of all cancers and also is one of  the top 10 causes of death in humans. The goal of this article is to assess changes of VEGF mRNA and miR-494 expression.

    Materials and Methods

    We chose 30 patients with OSCC and 30 healthy people (as a controlled group) and assess the rate of VEGF mRNA and miR-494 expression in peripheral blood with real-time PCR technique.

    Findings

    VEGF mRNA marker was positive in 24 out of 30 patients. Also, miR-494 was positive in 20 out of 30 patients.

    Results

    Overall based on this article’s findings, results could count as a diagnostic screening test for OSCC  detection in early steps of cancer.

    Keywords: Oral squamous cell carcinoma, Early diagnosis, VEGF mRNA, miR-494
  • Ramin Foroughi, Oveis Khakbaz, Mehrdad Maneshi * Pages 39-50
    Introduction

    Maxillary advancement is applied extensively for malocclusion class III correction. This procedure is done using one of the two methods, Conventional or High. Maxilla moves in both vertical and horizontal and only in the horizontal directions in Conventional and High method respectively, so expecting a difference in facial soft tissue changes. In present study is a case series that describes this issue.

    Materials and Methods

    The cases included 30 patients with class III malocclusion due to maxillary deficiency, whom underwent Le Fort I osteotomy for maxillary advancement in Shahid Beheshti Hospital in Babol, Iran during 1995 to 1995. According to surgical technique, the cases were placed in group 1 (Conventional) or group 2 (High). Maxillary advancement and changes in hard and soft tissue of the middle and lower facial regions where measured through tracing on the lateral cephalometry. Intra-group and inter-group statistical comparisons were done using SPSS20 software at significance level as 0.05.

    Result

    The pre-surgical mean size of SNA, SNB, nasolabial and mentolabial angles was similar in two groups. In all patients, after surgery, SNA angle size was increased and SNB، nasolabial and Mentolabial angles size were decreased. The mean value of these change was similar in two groups. In group 2, the displacement of point A ‘(mean difference: 1.30 mm) and Labrale Superius (mean difference: 1.40 mm) were significantly more than group 1. The amount of displacement of SN (mean difference: 1.30 mm), Labrale Inferius (mean difference: 0.88 mm) and Pogonion (mean difference: 0.23 mm) points in group 2 was higher than that of group 1, but this difference was not statistically significant.

    Conclusion

    It is needed strong evidence for decision about selecting High or Conventional approach maxillary advancement in terms of facial aesthetic aspects. So, further studies with larger sample sizes and cohort or quasi-experimental design is suggested.

    Keywords: Esthetics_Conventional Le Fort I osteotomy_Face_High level Le Fort I osteotomy_Maxillary advancement
  • Farnoosh Razmara, Farzane Mosavat, Forooz Keshani * Pages 51-54

    The lipoma is 5% of benign tumors and 25 to 50% of soft tissue tumors. It most occurs in the upper trunk area, neck and the extremities. But it is rare in the oral and maxillofacial area. It is a benign lesion composed of fat mature adipose tissue that Separated with fibrous septa and surrounded with a thin fibrous capsule. Jaw Intraosseous lipoma is very rare, and its prevalence has been mentioned in articles 1.0%. The case of this manuscript was a 33-year-old woman who referred to an orthodontic specialist with a complaint about the tooth crowding and requesting orthodontic treatment. Based on clinical, radiography and histopathology finding, a diagnosis of intraosseous lipoma of the mandible was made.

    Keywords: Benign tumor, Lipoma, Intraosseous