Reza Tabrizi

Use of Lincomycin-Impregnated Demineralized Freeze-Dried Bone Allograft in the Periodontal Defect After Third Molar Surgery

PURPOSEnThe aim of the present study was to evaluate the periodontal regenerative capacity of demineralized freeze-dried bone allograft (DFDBA) alone or used with local lincomycin.nnnMATERIALS AND METHODSnIn the present single-blind, randomized, controlled clinical trial, 20 subjects 26 years old or older, requiring extraction of bilateral third molars (M3s), were included. Each subject was randomly assigned to receive either DFDBA or DFDBA plus lincomycin therapy. Within the subjects, 1 M3 site was randomly selected to be the experimental site and the contralateral served as the control and was permitted to heal without intervention. The primary variables were changes in the probing depth (PD), clinical alveolar bone levels (ABLs), and radiographic alveolar bone density (ABD) on the distal aspect of second molar between baseline (immediately postoperatively) and 26 weeks postoperatively (T26). Appropriate sample sizes and descriptive, bivariate, and multivariate statistics were computed.nnnRESULTSnFor both treatment and control sites, between T0 and T26, statistically significant improvements were seen in the ABLs and ABD (P < .05). Within-subject comparisons showed no significant differences in PD, ABL, or ABD between the treatment and control M3 sites at T0 or T26 (P > .05). Also, no significant differences were found in the PD, ABL, or ABD between the 2 treatment M3 sites at T26 (P > .05).nnnCONCLUSIONSnThe results of the present study have revealed that the PD, ABL, and ABD improved after M3 removal in subjects 26 years old or older, irrespective of the treatment or control group. Reconstructive procedures (e.g., DFDBA with or without lincomycin therapy) did not offer predictable benefits compared with a no-treatment protocol in patients younger than 30 years old.

Is the Frequency of Temporomandibular Dysfunction Different in Various Mandibular Fractures

PURPOSEnTrauma has been considered an important factor of temporomandibular dysfunction (TMD) etiology. The aim of the present study was to compare the frequency of TMDs in various mandibular fractures.nnnMATERIALS AND METHODSnThis was a retrospective cohort study. Mandibular fractures were subcategorized into 3 groups: group 1 had a unilateral condylar fracture, group 2 had a unilateral condylar fracture with a fracture of the contralateral body or angle of the mandible, and group 3 had a unilateral fracture of the body or angle of the mandible. TMD signs (click, pain) and maximum mouth opening (MMO) were the outcomes of the study, and fracture pattern was considered a predictor factor. Age, gender, and fixation methods were study variables. A χ(2) test was applied to compare TMD signs among groups. One-way analysis of variance was applied to compare MMO and age among groups.nnnRESULTSnNinety-nine patients in the 3 groups were examined for TMD signs. Results showed that 54.54% of patients in group 1, 69.69% of patients in group 2, and 24.24% of patients in group 3 had click in the temporomandibular joint (TMJ; unilaterally or bilaterally). Analysis of the data showed a significant difference among groups (P < .05). According to the results, 24.24% of patients in group 1, 73.91% of patients in group 2, and 12.12% of patients in group 3 had pain at the TMJ (unilaterally or bilaterally). There was a significant difference among groups for pain (P < .05). Analysis of the data did not show any difference for MMO among groups (P > .05).nnnCONCLUSIONnPatients who had a condylar fracture and a contralateral angle or body fracture seemed to have more TMD signs than those with a unilateral fracture.

Can Religious Beliefs be a Protective Factor for Suicidal Behavior? A Decision Tree Analysis in a Mid-Sized City in Iran, 2013

AbstractnThis study aimed to assess using tree-based models the impact of different dimensions of religion and other risk factors on suicide attempts in the Islamic Republic of Iran. Three hundred patients who attempted suicide and 300 age- and sex-matched patient attendants with other types of disease who referred to Kerman Afzalipour Hospital were recruited for this study following a convenience sampling. Religiosity was assessed by the Duke University Religion Index. A tree-based model was constructed using the Gini Index as the homogeneity criterion. A complementary discrimination analysis was also applied. Variables contributing to the construction of the tree were stressful life events, mental disorder, family support, and religious belief. Strong religious belief was a protective factor for those with a low number of stressful life events and those with a high mental disorder score; 72xa0% of those who formed these two groups had not attempted suicide. Moreover, 63xa0% of those with a high number of stressful life events, strong family support, strong problem-solving skills, and a low mental disorder score were less likely to attempt suicide. The significance of four other variables, GHQ, problem-coping skills, friend support, and neuroticism, was revealed in the discrimination analysis. Religious beliefs seem to be an independent factor that can predict risk for suicidal behavior. Based on the decision tree, religious beliefs among people with a high number of stressful life events might not be a dissuading factor. Such subjects need more family support and problem-solving skills.

Effect of Open Rhinoplasty on the Smile Line

PURPOSEnOpen rhinoplasty is an esthetic surgical technique that is becoming increasingly popular, and can affect the nose and upper lip compartments. The aim of this study was to evaluate the effect of open rhinoplasty on tooth show and the smile line.nnnPATIENTS AND METHODSnThe study participants were 61 patients with a mean age of 24.3 years (range, 17.2 to 39.6 years). The surgical procedure consisted of an esthetic open rhinoplasty without alar resection. Analysis of tooth show was limited to pre- and postoperative (at 12 months) tooth show measurements at rest and the maximum smile with a ruler (when participants held their heads naturally). Statistical analyses were performed with SPSS 13.0, and paired-sample t tests were used to compare tooth show means before and after the operation.nnnRESULTSnAnalysis of the rest position showed no statistically significant change in tooth show (P = .15), but analysis of participants maximum smile data showed a statistically significant increase in tooth show after surgery (P < .05). In contrast, Pearson correlation analysis showed a positive relation between rhinoplasty and tooth show increases in maximum smile, especially in subjects with high smile lines.nnnCONCLUSIONnThis study shows that the nasolabial compartment is a single unit and any change in 1 part may influence the other parts. Further studies should be conducted to investigate these interactions.

Evaluation of Mandibular Wing Osteotomy in Obstructive Sleep Apnea Cases with Retrognathia

ObjectiveThe aim of this study is to evaluate the efficacy of wing osteotomy for treating obstructive sleep apnea (OSA).Materials and MethodsWe performed mandibular wing osteotomy in subjects who had an apnea-hypopnea index (AHI) of more than 15, a previous unresponsive conservative treatment for the OSA, moderate to severe retrognathia and no suggested conventional orthognathic surgery because of dentition or lack of willingness. The subjects were evaluated using the Epworth Sleepiness Scale (ESS), AHI and posterior airway space (PAS) before and 1xa0year after surgery.ResultsWe evaluated 10 subjects (4 males, 6 females) who underwent wing mandibular osteotomy. The mean age of the subjects was 37.8xa0±xa07.26xa0years. Analysis of the data demonstrated a significant change in ESS and AHI 1xa0year after operation. However, PAS was not changed 1xa0year after surgery. Results did not show any correlation between age, ESS and AHI before and 1xa0year after surgery.ConclusionMandibular wing osteotomy is a novel procedure that improves signs of OSA. It may be a surgical option in retrognathic patients with OSA who are not candidates for conventional maxillomandibular advancement.

Evaluation of a Single Dose Intravenous Paracetamol for Pain Relief After Maxillofacial Surgery: A Randomized Clinical Trial Study

ObjectiveThe aim of this study was to evaluate, using a single dose of intravenous paracetamol, pain relief after maxillofacial surgery.Materials and MethodsThis is a controlled, randomized, uni- blind, clinical trial study to evaluate using a single dose of IV paracetamol for pain relief after maxillofacial surgery. The subjects were randomly divided into two groups with 40 subjects in each: group I received paracetamol (Apotel)* as a single dose and group II received placebo. Subjects were randomly allocated according to randomization lists. Paracetamol was used as a single dose (20xa0mg/kg in 100xa0cc of normal saline which was infused for 10xa0min after surgery in recovery room just before discharging). We used a visual analogue scale to investigate pain relief at various times.ResultsAnalysis of the data, did not show any significant difference for age, sex and weight between the treatment group and the control group. Pain decreased 6xa0h after paracetamol infusion; then it increased mildly. In the control group, pain severity increased after operation, then it decreased mildly. Results showed a correlation between duration of surgery and pain severity in both the groups.ConclusionParacetamol is effective on pain relief after maxillofacial surgeries. Operation time may be an important factor for induction of pain after the surgeries.

Do Angulated Implants Increase the Amount of Bone Loss Around Implants in the Anterior Maxilla

PURPOSEnThe aim of this study was to evaluate the relation between angulated implants and the bone loss around implants in the anterior maxilla.nnnMATERIALS AND METHODSnThe subjects studied had a missing tooth in the anterior maxilla and a bone deficiency that required restoration with an angulated dental implant. After mounting the casts on the articulator, the amount of direction was measured with a facebow by calculating the difference between the mean buccopalatal angulation of the 2 adjacent natural teeth and the buccopalatal angulation of the implant abutment to the occlusal plane. Radiography was performed in each patient immediately after loading and repeated a minimum of 36 months after loading.nnnRESULTSnFifty-eight subjects who received delayed-loading angulated implants were studied. The results showed that the mean implant angulation was 15.2° and the mean bone resorption was 0.87 mm. Analysis of the data showed a significant correlation between implant follow-up time and bone loss. No correlation was seen between the implant angulation and bone loss. An assessment of predictive factors showed a relation between the implant type and bone loss. The follow-up time had a significant effect on bone loss. The implant angulation did not change bone resorption on the mesial and distal surfaces of the implants.nnnCONCLUSIONSnThe angulation of implants was not associated with an increased risk for bone loss, and angulated implants may be a satisfactory alternative to vertical implants to avoid grafting procedures. The type of implant may be an important factor that affects bone resorption, although follow-up time was the strongest predictive factor.

Massive Craniofacial Teratoma: A Case Report

Teratoma is a germ cell tumor, which is derived from pluripotent cells. It is composed of different types of tissue originating from 1 or more of the 3 germ cell layers and is most often found in the ovary or testis. Rare teratomas in the head and neck region primarily arise from the Rathke pouch remnants in the sphenoid bone region, the lateral neck, and the tongue. The histologic appearance of these tumors is most often benign 1 and varies noticeably in terms of the differentiation and maturation of the involved tissues. Some lesions contain fingers, teeth, jawbone, or diminutive skeletons, whereas others do not show more than an admixture of various types of tissue, with no attempt at maturation or structural development. 2 Paraoral cases are mostly cystic and relatively undifferentiated. Oral lesions, however, have been known to contain tissues from many parts of the body, including brain, bone, cartilage, skin, lung, and gastrointestinal tract. 3 Treating a teratoma consists of conservative surgical removal, which often requires delicacy because of its close proximity to important anatomic structures in the head and neck region.