Accuracy of Cone Beam CT Measurements for Assessment of Posterior Mandible: A Cadaver Study

Objectives: This study is aimed at analysing the accuracy and reliability of the cone beam CT (CBCT) measurements and direct physical measurements of the posterior mandible. Materials and methods: Eighteen cadaveric hemi-mandibles were dissected from the soft tissues and the CBCT images of the mandibles were taken. Direct physical and cone beam CT measurements of six landmarks which includes height of ramus (R), distance of lingula to sigmoid notch (LS), distance of lingula to inferior border (LI), position of lingula in relation to occlusal plane (L-OP), ramus thickness at crestal level (RT-C), and ramus thickness at midway between sigmoid notch and lingula (RT-M) were determined. Accuracy and reliability of the measurements were tested. Results: Four landmarks showed high accuracy when measuring the posterior mandible, while two landmarks, LI and RT-M, showed statistically significant weaker accuracy (p<0.05). Inter-reliability were good for all landmarks when measured directly physically on mandibles (ICC>0.7 and p>0.05), but were low on two landmarks, LI and RT-C, on CBCT measurement (ICC<0.5 and p<0.05). Conclusion: A generally strong accuracy between direct physical and CBCT measurements for most landmarks on posterior mandible were found. Reliability between two researchers were high on direct physical measurements. Meanwhile, two landmarks on CBCT which include LI and RT-C showed low inter-reliability. Hence, CBCT measurements proved to be a good tool for pre-operative assessment, since high inter-reliability and strong accuracy corresponding to direct physical were recorded.

Comparative efficacy of haloperidol and placebo for treatment of delirium induced by biperiden and LPS in adult male rats based on their learning style and change in their short-term spatial memory

Background and Objectives: Delirium refers to acute loss of consciousness and is characterized by confused thinking and impaired orientation. It is a life-threatening, but reversible syndrome manifested by cognitive impairment, abnormal psychomotor activity and sleep disturbances. Due to high prevalence in hospitalized patients and high rate of morbidity and mortality, delirium significantly decreases the prognosis of hospitalized patients. Materials and Methods: This experimental animal study evaluated 54 adult male Wistar rats over 2 months of age that weighed 200 to 230 g. Of all, 24 rats received biperiden (40 mg/kg) while the remaining 24 received 50 µg/kg LPS. Induction of delirium was ensured using a Y-maze after 3 hours. The control group included 6 rats The efficacy of different doses of haloperidol for treatment of delirium was assessed 3 h after injection using the Y-maze . Data were compared using one-way ANOVA followed by Tukey’s post-hoc test via GraphPad Prism. Results: Haloperidol at 0.1, 0.2 and 0.5 mg/kg dosage significantly increased the percentage of spontaneous alternation and improved the memory, consciousness and learning compared with biperiden and LPS groups (P<0.01). No significant difference was noted between the haloperidol groups regarding efficacy (P>0.05). Conclusion: Delirium is characterized by attention deficit, impaired orientation, changes in memory, consciousness, perception and mood, and psychotic symptoms. Detection of the complete spectrum of delirium signs and symptoms in an animal that cannot talk (rat) is obviously difficult .using of Y-maze can facilitate this problem .

The effect of using pineapple fresh juice to improve post-surgical pain, ecchymosis and swelling in maxillofacial region

Background: Facial plastic surgeries are usually associated with various post-surgical unde- sirable symptoms, particularly pain, Swelling, and ecchymosis. Depending on the nature of the procedures, these symptoms could last for days, sometimes over a week or more. Considering the optimal efficacy of Bromelain, this study is used to justify the benefits of pre-operative use of Bro- melain found in pineapple using fresh pineapple juice to reduce such complications. Materials and Methods: A randomized clinical study was performed among 100 patients undergoing various facial surgical operations; the patients were randomly divided into two groups; fifty patients received the pre-operative fresh pineapple juice (350ml glass) twice every day, a week before and continued for seven days after surgery. The pain level was determined using a visual an- alog scale, Swelling, and ecchymosis judged by visual inspection. Average scores for all symptoms were added to obtain the clinical sum score for each visit. Results: Pre-operative use of fresh pineapple juice was significantly reduced post-surgical pain, swelling, and ecchymosis with statistically significant results (p<0.005) in each pineapple groups. Conclusion: Bromelain found in pineapple fruit can be used as a successful therapy before var- ious facial surgical procedures to minimize and provide faster recovery from undesirable post-op- erative symptoms.

Ultrasound-guided FNA Efficiency in Diagnosing of Metastatic Nodes of Oral Squamous Cell Carcinoma; Article Review

Oral cancer comprises a group of neoplasms affecting any fields of the oral cavity, pharyngeal regions and salivary glands. However, this term tends to be used interchangeably with oral squamous cell carcinoma (OSCC), which represents the most common of all oral neoplasms. It is estimated that more than 90% of all oral neoplasms are OSCC. Oral SCC prefers to spread through the lymphatic system than the bloodstream, and in this region tongue tumors have the greatest potential for neck metastases.Primary tumor’s histopathologic features like depth of invasion, thickness, growth pattern, differentiation, lymphovascular or vascular invasion have a limited prognostic value for nodal disease. cervical lymph node status accurate assessment in HNSCC patients is critical issue because of its influences on prognosis and treatment decisions, USgFNAC proved widely accepted not only because of safety and availability in diagnosis but also it is repeatable, minimally invasive and cost-effectiveness.

Effect of light-emitting diode phototherapy on pain and trismus following surgical extraction of impacted mandibular third molars

Purpose: This study aimed to assess the effect of light-emitting diode (LED) phototherapy on pain and trismus following surgical extraction of impacted mandibular third molars. Materials and Methods: This double-blind randomized controlled clinical trial evaluated 50 patients between 20 to 35 years requiring extraction of their impacted mandibular third molars. The patients were randomized into two groups of LED phototherapy and control by flipping a coin. Patients in the LED group underwent LED phototherapy immediately after surgery with red light at 618nm wavelength, 20 mW/cm2 power density and 4 J/cm2 energy density in continuous-wave mode (irradiated area: 3.15cm×1.5cm=4.725cm2). The LED device was used in off mode in the control group (as placebo). The level of postoperative pain was measured by the numerical rating scale, and trismus of patients was evaluated by measuring the maximum mouth opening (MMO). The two groups were compared by the Mann-Whitney and NPar tests. Results: The mean difference in MMO postoperatively, compared with baseline, was lower in the LED group than the placebo group but not significantly (P=0.465). The two groups were not significantly different regarding the level of pain. Conclusion: LED phototherapy with the parameters applied in this study failed to significantly decrease the level of pain and trismus following surgical extraction of impacted mandibular third molars.

Reference point and confirming points two important guides in treatment of panfacial fractures of panfacial Fx: A case report

A therapeutic challenge to maxillofacial surgeons is management of panfacial fractures, especially when treating multiple comminuted bone fractures. One of the most important goals in these fractures is achieve and stablish a correct occlusal relationship of the mandibular-maxillary unit in parallel with the proper positioning of the jaws with the skull base and other facial units. Also, it is important to prevent long-term sequelae such as facial asymmetry, enophthalmos, and mal- occlusion that could be caused by inadequate correction. To achieve all these goals some usual guides of management are proposed as follow: “Bottom to up”, “Top to down”, “outside to inside,” or “inside to outside”. We present 3 cases of Panfacial fracture and the proposed methods were based on different sequences of management with introducing “reference point” as the most intact area to determine the management concept & “confirming point” as the areas that should be reduced and fixed completely. These points act as an orientation aid during surgery and aid to successfully restore the entire face contour and maxillomandibular occlusion and also to improves surgical procedure.

New Design of Bone Hook for Lefort I Osteotomy

This article discribes a new design by surgical Bone hook that is used for maxillary Le Fort 1 osteotomy. This instrument with high quality ,without damage to surrounding tissues can be used in maxillofacial surgeries.

Assessment of oral health status in chronic headache patients and its comparison with healthy control

Introduction: Headache is a common problem with intense side effects on quality of life. Dental and maxillofacial problems, including dental infections and temporomandibular disorders may trigger the onset of headache or have direct impact on the intensity of headache. The purpose of this paper is assessment of oral health indexes in chronic headache patients and compare it with a healthy control group. Material & Methods: Thirty chronic headache patients based on diagnosis by a neurologist were enrolled in our study and thirty healthy volunteers were recruited into the control group. Dental and periodontal examination were carried out in order to evaluate of the decayed, missing and filled teeth (DMFT) index, the assessment of community periodontal index of treatment needs (CPITN) index and determination of tooth wear status and oral health status. Statistical analysis was done using SPSS statistical package (version 20, IBM). Results: Mean age, educational level, tooth brushing, using dental floss and DMFT index was not statistically different between chronic headache patients and control group. There was no statistically significant difference in CPITN index between cases and control group (p-value=0.538). Conclusion: This study suggest that chronic headache patients have an acceptable oral hygiene which may be attribute to their attempts to omit pain from head and oral region. Considering high prevalence of chronic headache, planning a protocol for oral hygiene instruction is necessary. In this regard, coordination between neurologists and oral medicine specialists can be very effective.

Ascorbic Acid Effect on Morphine Withdrawal Symptoms in Rats

Introduction: Today, drug addiction is an important healthcare issue. Any helps to drug withdrawal may decrease its prevalence in the society. Ascorbic acid is a component, which can affect neurotransmitter systems as a regulator along with its cofactor role. Noradrenergic and dopaminergic systems are two important neurotransmitter systems in the opiate withdrawal syndrome. It seems that ascorbic acid can decrease the symptoms of opiate withdrawal through regulating the related systems. In this regard, the current study aimed to evaluate the effect of ascorbic acid on the symptoms of morphine withdrawal in Syrian mice. Materials and Methods: Male Syrian mice in eight experimental groups received incremental doses of morphine as 10, 20, 30 and 40 mg/kg within the first, second, third, and fourth days of the experiment, respectively, through intraperitoneal injection, twice a day, and the control group received and equal amount of saline. On the fifth day, six groups of morphine addicts received ascorbic acid with six doses of 10, 50, 100, 200,400 and 800 mg/kg through intraperitoneal injection. Then, naloxone 2 mg/kg was injected to all groups including morphine alone and morphine with acute does of ascorbic acid. Then, withdrawal symptoms were evaluated for 30 minutes. Results: Administration of an acute dose of ascorbic acid reduced dose dependent withdrawal symptoms in such a way that 10, 50, and 100 mg/kg doses of ascorbic acid reduced “writhing” symptom, 200 mg/kg reduced “jumping” symptom, and 400 and 800 mg/kg reduced “climbing, jumping, and standing” symptoms. Conclusion: It seems that ascorbic acid administration can improve the symptoms of opiate withdrawal syndrome. More studies on human population can also indicate the therapeutic effect of ascorbic acid on drug withdrawal.

Miniscrew-assisted rapid palatal expander (MARPE) therapeutic results: A review

Background: One of the most common maxillary abnormalities is transverse deficiency, which can be a contributory factor in malocclusions. There are some evidence of successful non-surgical treatment of this type of discrepancy after puberty by using maxillary expansion techniques. The Miniscrew-assisted rapid palatal expander (MARPE) method is a newly introduced method that has attracted the interest of many orthodontists. This study aimed to evaluate the therapeutic results of this technique in a systematic review. Method: In this study, various databases including PubMed, Scopus, and ISI (Web of science) were queried with proper keywords, provided by PICO strategy of research, from 1980 to December 2020. Relevant articles were collected with restrictions on the English language. The full text of papers with all inclusion criteria was assessed. The therapeutic outcomes of MARPE were evaluated in the selected studies. Results: A total of 14 studies were included in the systematic review. Totally, 5 case report studies, 8 retrospective studies, and 1 case series study were reviewed. Cone-beam computed tomography was used as an outcome measure in all studies. In all reviewed studies, maxillary expansion occurred with high success rates in patients. Moreover, respiratory characteristics were also assessed in two studies measuring respiratory muscle strength, airflow and nasal and nasopharyngeal airway volume, showing benefits of MARPE. A study also examined three-dimensional soft tissue stereophotogrammetry. Based on these studies, the indication for using this method was a maxillary transverse deficiency as well as upper and lower arches crowding. No serious complications were reported in any of the reviewed studies. However, most studies did not perform long-term follow-ups and the age range of the subjects was mainly between 12 and 24 years. MARPE has been suggested as a treatment modality for correction of maxillary transverse deficiency in young adults but patients under the age of 14 may also benefit from this treatment in special conditions. Conclusion: A general review of the results of studies showed the high efficiency of MARPE technique in correcting maxillary transverse deficiency.