Background A number of patients with facial fractures have cerebrospinal fluid (CSF) leak that may result in meningitis and other central nervous system complications. Commonly, CSF leak occurs following trauma, but the etiology and pattern of this disorder are different from region to region. This study aims to evaluate the distribution of CSF leak in patients with maxillofacial fractures in Isfahan province, Iran. Patients and Methods In this retrospective cross-sectional study, 1,287 medical files of patients admitted to a medical center with head and face injuries were evaluated during a 7-year period (2004)(2005)(2006)(2007)(2008)(2009)(2010). Data was obtained using descriptive analysis. Results Of the 1,278 patients with head and maxillofacial fractures, 16 (1.25 %) males and one (0.07 %) female had CSF leak; all these cases had skull base fracture. Of these, 52.9 % had maxillary fracture, 23.5 % nasal fracture, 41.1 % orbital fracture, 11.7 % mandibular fracture, 23.5 % frontal fracture, and 41.1 % had more than one site of fracture. 58.8 % had rhinorrhea and 41.2 % otorrhea. Of all these patients with CSF leak, 8 (47 %), 2 (11.8 %), and 7 (41.2 %) cases were treated spontaneously, using lumbar drain placement, and by surgical intervention, respectively. Conclusions Cerebrospinal fluid leak was observed most frequently in patients with fracture in the zygomatic and maxillary bone, and mostly exhibited itself as rhinorrhea and/or otorrhea. All cases with CSF leak had skull base fracture as well. However, post-traumatic CSF leaks are uncommon and are generally treated without surgical intervention (59 %). Distribution of CSF leak varies from one region to another and knowing this fact helps to manage the injury and prevent the complications.

Recently published reports have suggested that antiangiogenic drugs such as sunitinib could potentiate the osteonecrosis of the jaw (ONJ) induced by bisphosphonates (BPs) and even induce this adverse effect per se. We reported a case of ONJ with renal cell carcinoma under sunitinib medication and history of BPs therapy. A 53-year-old man was referred to the oral surgery clinic complaining of painful exposed oral lesion and bone extraction from right lower jaw in the mouth. He underwent nephrectomy followed by 5 months treatment with cycles of 50 mg sunitinib (Sutent®) once a day for 4 weeks followed by 2 weeks drug free before lesion exposure in October 2016. However, the patient has encounter to intermittent mucositis and gingivitis in oral cavity several times. Our patient had a history of zoledronic acid (4 mg intravenously two times) administration due to primary cancer misdiagnosis. In our case, no dental procedure contributed to the occurrence of ONJ. The lesion was improved by sunitinib cessation and administration of antibiotics through 2 weeks. Mucosal injury induction as well as inhibition of angiogenic signaling pathways by sunitinib administration may have precipitated the occurrence of ONJ. In addition, a possible synergistic effect by previously BP treatment is another accused.

Background: Blood group is a genetic characteristic which is associated with some diseases and deformities. Multifactorial characteristics of facial development make it difficult to predict a genetic pattern in a specific maxillofacial deformity, but epidemiological evaluations can reveal relationships between such deformities and some genetic characteristics or accompanied diseases, and this will help to recognise and treat them. The aim of this study is evaluation of the relationship between blood groups and maxillofacial deformities. Materials and Methods: In this study, blood groups of 190 patients with maxillofacial deformities who had had orthognathic surgery in Alzahra hospital, Isfahan, were compared with the general Iranian population. Results: Among 190 patients, 93 cases (49%) were men and 97 cases (51%) were women. Fifteen cases (8%) were < 20 years old, 130 cases (68%) were 20-30 years old, and the others (45 cases, 24%) were > 30 years old. The blood group distribution in our samples was as follows: blood group O = 76 cases (40%), blood group A = 58 cases (30%), blood group B = 41 cases (22%), and blood group AB = 15 cases (8%). Among these patients, 31 cases (16%) had maxillary deformities and 27 cases (14%) suffered from mandibular deformities while the other 132 cases (70%) had bimaxillary problems. The Chi-square test showed statistically significant differences between the blood group distribution of the patients of this study and the normal Iranian population ( P < 0.001). Conclusion: It was shown that among different blood groups; those with blood group B have a greater likelihood of association with maxillofacial deformities. On the other hand, the probability of the association of such deformities was the least with blood group A.

Background:Blood group is a genetic characteristic which is associated with some diseases and deformities. Multifactorial characteristics of facial development make it difficult to predict a genetic pattern in a specific maxillofacial deformity, but epidemiological evaluations can reveal relationships between such deformities and some genetic characteristics or accompanied diseases, and this will help to recognise and treat them. The aim of this study is evaluation of the relationship between blood groups and maxillofacial deformities.Materials and Methods:In this study, blood groups of 190 patients with maxillofacial deformities who had had orthognathic surgery in Alzahra hospital, Isfahan, were compared with the general Iranian population.Results:Among 190 patients, 93 cases (49%) were men and 97 cases (51%) were women. Fifteen cases (8%) were < 20 years old, 130 cases (68%) were 20–30 years old, and the others (45 cases, 24%) were > 30 years old. The blood group distribution in our samples was as follows: blood group O = 76 cases (40%), blood group A = 58 cases (30%), blood group B = 41 cases (22%), and blood group AB = 15 cases (8%). Among these patients, 31 cases (16%) had maxillary deformities and 27 cases (14%) suffered from mandibular deformities while the other 132 cases (70%) had bimaxillary problems. The Chi-square test showed statistically significant differences between the blood group distribution of the patients of this study and the normal Iranian population (P < 0.001).Conclusion:It was shown that among different blood groups; those with blood group B have a greater likelihood of association with maxillofacial deformities. On the other hand, the probability of the association of such deformities was the least with blood group A.

Introduction. In order to minimize the required time to regain esthetic and function, immediately loaded implants were suggested. The aim of this study was to comparatively evaluate the Nisastan and XIve implants using biomechanical and histomorphometric tests. Materials and Methods. In this experimental study, 6 Nisastan one-piece immediately loaded screw type implant (OPILS) and 6 Xive implants with 3.4 mm diameter and 11 mm long were used. The implants were immediately loaded with temporary coating. After three months, the torque required to break bone-implant contact was measured and was recorded. All implants were extracted with surrounding bone and histologically were evaluated. The data were inputted into the SPSS 11.5 to run student T-test statistical analyses (α = 0.05). Results. The success rates of both types of implants was 100%, and none of them failed due to mobility or bone loss. The mean removal torque value (RTV) was 142.08 and 40 N/Cm for Xive and Nisastan implants, respectively, and their RTVs showed a significant difference between two mentioned implants (P = 0.004). None of the histomorphometric values showed significant differences between the two implants (P > 0.05). Discussion. both systems have the capability to induce osseointegration under immediate loads but that Xive implants showed higher capability for bone contact.