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Background Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with IAN injury in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Methods Of an initial sample of 545 mandibular third molars, a total of 75 JAR+ and 75 JAR− teeth were evaluated by CBCT. We assessed the relationship between the presence of JAR in cone-beam computed tomography (CBCT) images and the presence of IAN injury after mandibular third molar surgeries. Moreover, we investigated whether the presence of IAN injury is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis. Results A significant relationship was found between JAR and temporary IAN injury (P = 0.036). However, there was no case of permanent IAN injury. IAN injury showed no significant relationship with the tooth angulation, position to IAN and proximity to the mandibular canal, lingual cortical plate thinning, sex, and age. Conclusions JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary IAN injury. JAR may increase the risk of nerve injury during the surgical removal of third molars.

Objective: approximately 6.3% of adult teeth have apical periodontitis; the commonest kinds of periapical lesions are cyst and abscess (55-6%) and granuloma (46-84%). This systematic review and meta-analysis evaluated the accuracy of the diagnostic test of ultrasound imaging for endodontic. Methods: Using the electronic databases, we searched Cochrane Library, PubMed, and Embase for performing a systematic review of literature during the last decade from February 2011 to May 2021. Then, we employed the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool to assess the quality of the obtained investigations included in the present meta-analysis. In order to extract the required data, two reviewers blindly and individually dealt with the data extraction from the respective abstracts and full-texts of investigations. Diagnostic odds ratio, positive and negative likelihood ratio with a confidence interval (CI) of 95%, random-effects model, and REML method have been computed. Moreover, we assessed Meta-analysis using a statistical software called Stata/MP 16, the fastest version of Stata. Results: Totally, 94 topics and abstracts with potential relevance have been obtained in the electronic searches and eight studies required for this systematic review. Specificity and Sensitivity of ultrasonography for diagnosing the periapical granulomas equaled 92% (ES,0.92 95% CI 0.77,1.07) and 89% (ES,0.89 95% CI 0.74,1.04) and specificity and Sensitivity of ultrasonography for diagnosing periapical cyst equaled 92% (ES,0.92 95% CI 0.77,1.07) and 98% (ES,0.92 95% CI 0.83,1.13). Conclusion: Ultrasonography can be one of the alternative tools for differential diagnosis of periapical lesions (cysts and granulomas) with an endodontic origin.

Background: Considering the severity of the COVID-19 outbreak and its rapid person-to-person transmission and the challenges it has brought about in dentistry, especially in intraoral radiography, following the established guidelines in prescribing radiographs is of great prominence. Objectives: We aimed to evaluate the necessity of prescribed intraoral radiographs and to estimate the number of unnecessary prescriptions during the COVID-19 pandemic. Methods: This cross-sectional study was conducted among 143 patients with a mean age of 29.36 ± 14.11 years who visited the Radiology Department of Shiraz Dental School during the peak of the COVID-19 outbreak. Information, including gender, age, systemic diseases, referring department, and type and urgency of radiography, was collected using a checklist. Chi-squared test and Fisher’s exact test were run to assess the relationships between variables. Results: Among all the patients referred to the Radiology Department, the endodontics and oral medicine departments accounted for the highest percentage of referrals. The relationship between the necessity of radiography prescriptions and dental departments was significant (P < 0.05). The lowest rate of unnecessary referrals was reported in the Department of Endodontics (13.3%), whereas the highest rate of unnecessary referrals was attributed to the aesthetic and restorative dentistry departments (73.3%). There was a significant association between dental department and the type of prescribed radiographs (extraoral/intraoral). The Orthodontics Department was the only department with more extraoral radiograph prescriptions than intraoral radiographs. One-third of the prescribed intraoral radiographs and half of the extraoral radiographs were unnecessary, with a significant difference during the pandemic (P = 0.019). Conclusions: Although there has been some success in the development of COVID-19 vaccines, this pandemic will not be easily eradicated. Therefore, it is crucial to follow the established guidelines and postpone unnecessary dental procedures to improve the safety of our community and the world in general.

The anterior wall of the maxilla is a very thin bone. Thus, when isolated anterior wall fractures of the maxilla occur, it is highly likely that comminuted fractures with several small bone fragments develop. Comminuted fractures are difficult to reduce and fix using conventional methods that use plates and screws due to the thin anterior wall of the maxilla and the presence of small fragments. If the fractured anterior wall of the maxillary sinus is not properly restored, complications, such as rhinitis, sinusitis, prolapse of facial soft tissue, and mucosal irritation may occur. 6 Fixation using absorbable mesh allows for relatively accurate reduction and has the advantage of having a reduced operation time as compared to the conventional internal fixation method using plates and screws. However, complications, such as rhinitis, purulence, pain, and swelling, were reported due to the development of inflammatory reactions such as foreign body reactions when reconstruction was performed using mesh. 1 The maxillary sinus is the largest air cavity in the human body and plays a role in improving the respiratory function of the nose. The maxillary sinus plays an important role in the immune system of the nasal cavity and is involved in the production of nitrogen monoxide (NO). 7 The mucous membrane of the maxillary sinus continuously synthesizes and acts as a reservoir of NO. Therefore, it is important to preserve the mucosal layer of the maxillary sinus by minimizing dissection when reconstructing a fracture of the anterior wall of the maxillary sinus. 8 Fibrin glue is a surgical formulation used to form fibrin clots for hemostasis or wound healing. 9 A syringe containing plasma proteins, fibrinogen, and factor XIII and a syringe containing calcium chloride, thrombin, and aprotinin are packaged separately and mixed directly before use. An active form of a fibrin clot is formed upon mixing of the contents. Fibrin glue lowers the infection rate in wound healing. If fibrin glue is applied after sufficient reduction of comminuted fracture fragments, it can also promote healing of the mucosa as well as fibrocartilaginous callus formation, which is the healing process of a fractured bone. 10 As such, fibrin glue can decrease the shearing force by increasing the adhesion to the surrounding tissues and maintaining the restoration. 11 The adhesion strength of fibrin glue with human tissue is reported to be 811.1 mN/cm2. 12,13 Although this strength is inadequate to fix the facial buttress with great force, it is thought to be sufficient to fix thin, comminuted, and light fragments.The limitation of this study is its small sample size. However, fixation using only fibrin glue showed better or similar results in this study in terms of the length of hospital stay, follow-up period, and acute complication rates. Furthermore, no chronic complications were reported. Follow-up radiologic imaging tests showed a wellmaintained and adequately fused reduced site. CONCLUSIONSThe surgical method using only fibrin glue after th...