ObjectivesForeign bodies (FBs) account for 3.8% of all pathologies of the head and neck region, and approximately one third of them are missed on initial examination. Thus, FBs represent diagnostic challenges to maxillofacial surgeons, rendering it necessary to employ an appropriate imaging modality in suspected cases.Materials and MethodsIn this cross-sectional study, five different materials, including wood, metal, glass, tooth and stone, were prepared in three sizes (0.5, 1, and 2 mm) and placed in three locations (soft tissue, air-filled space and bone surface) within a sheep's head (one day after death) and scanned by panoramic radiography, cone-beam computed tomography (CBCT), and ultrasonography (US) devices. The images were reviewed, and accuracy of the detection modalities was recorded. The data were analyzed statistically using the Kruskal-Wallis, Mann-Whitney U-test, Friedman, Wilcoxon signed-rank and kappa tests (P<0.05).ResultsCBCT was more accurate in detection of FBs than panoramic radiography and US (P<0.001). Metal was the most visible FB in all of modalities. US was the most accurate technique for detecting wooden materials, and CBCT was the best modality for detecting all other materials, regardless of size or location (P<0.05). The detection accuracy of US was greater in soft tissue, while both CBCT and panoramic radiography had minimal accuracy in detection of FBs in soft tissue.ConclusionCBCT was the most accurate detection modality for all the sizes, locations and compositions of FBs, except for the wooden materials. Therefore, we recommend CBCT as the gold standard of imaging for detecting FBs in the maxillofacial region.
Patients with hemophilia need special care and attention in dentistry. Thus, we assessed the oral and dental health status in children and adolescents with hemophilia in Rasht, Iran. Materials and Methods: In this case-control study, 53 hemophiliac patients (A and B), 2-15 years of age, and 53 healthy children were assessed. A checklist including demographic data was filled out and the subjects were examined by one dentist. The patients were assessed for modified gingival index, plaque index (PI) and Decayed-missing-filled teeth [(DMFT) in permanent teeth and Decayed-missing-filled teeth (dmft) in primary teeth)] indices. Data were analyzed with SPSS 19 at a significance level of p<0.05. Results: The mean age of the subjects was 10.49±4.21 years in the case group and 10.5±4.07 years in the control group. 92.5% of the patients exhibited factor VIII deficiency and the most frequent blood group was A (34%). 63.2% of the subjects in the hemophilia group and 13.2% in the control group had a history of bleeding that was significant (p=0.0001). There were significant differences between the two groups in bleeding at tooth eruption and exfoliation sites of deciduous teeth (p=0.0001), flossing (p=0.046), toothpick use (p=0.02) and the history of dental education (p=0.014). No significant difference was found between dmft and DMFT scores between the two groups but DMFS was significantly higher in the hemophilia group (p=0.007). There was also a significantly higher PI in the hemophilia group (p=0.003). Conclusion: Considering some unsatisfactory oral health conditions in these patients, dental health care and prevention seems necessary and can be effective in the prevention of dental problems, bleedings and complex treatments.
Objectives: Melatonin induces human stem cells, converts pre-osteoblasts to mature osteoblasts, and reduces the duration of this transition. However, melatonin itself prevents activation of osteoclasts. Here, we evaluate the role of melatonin in prevention of bisphosphonate-related osteonecrosis of the jaw. Materials and Methods: In this experimental-interventional study, 30 rats were evaluated in 3 groups. The first and second groups received saline and zoledronic acid, respectively, for 4 weeks and the third group received 4 weeks of zoledronic acid and 3 weeks of melatonin simultaneously. Firstright-maxillary-molar extraction was performed for all animals, which were sacrificed after 4 weeks of recovery. The extraction sockets were examined histologically for the presence of osteonecrosis, number of osteoclasts and fibroblasts, severity of inflammation, and vascularization. Data were analyzed by chi-square, one-way ANOVA, Tukey, Kruskal-Wallis and Fisher's exact statistical tests (α=0.05). Results: Osteonecrosis was observed in 20%, 90%, and 70% of the first, second and third groups, respectively (P=0.008). The lowest number of osteoclasts and fibroblasts was seen in the third group. Conclusion: Melatonin may effectively prevent some undesirable side effects of bisphosphonates. However, further studies are required to confirm the results of this study.
Background and Aim: Ossifying fibroma (OF) is a benign fibro-osseous lesion, which is usually diagnosed between the ages of 20 and 40 years. The female to male ratio is 5:1, with affinity for posterior mandibular region. The aim of the present report is to discuss a case of OF and its clinical, radiological and pathological characteristics and the related surgical approach. Case presentation: A left mandibular impacted premolar with an associated lesion was incidentally found on a radiograph of a 27-year-old woman. The patient did not report any clinical symptoms. Inferior alveolar nerve involvement by the lesion was obvious in radiographic study. The tooth was extracted and the associated lesion was enucleated under general anesthesia through step-by-step surgery and after releasing the inferior alveolar nerve. Conclusion: Surgical treatment of Ossifying fibroma consists of enucleation and curettage in small and well-defined lesions, while larger lesions are usually resected. Prognosis is good with a low recurrence rate even with enucleation and after longterm follow-up.
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