Search

Introduction: Klippel-Trenaunay syndrome (KTS) is a congenital disorder characterized by a clinical triad of capillary malformation; varicose veins; and soft tissue and/or bony hypertrophy. This rare syndrome has an estimated incidence of about 2–5/100,000 live births. KTS usually affects the extremities but occasionally can manifest in the craniofacial region, including the oral cavity. Case Presentation: Our patient, a 17-year-old girl, presented with large areas of port wine stain, unilateral hypertrophy of the facial region, and varicose veins. She was diagnosed with KTS. Orthodontic treatment followed by orthognathic surgery was performed to address her complaint of facial asymmetry and poor chewing efficacy. Treatment resulted in significant improvement in her appearance and dental occlusion and our patient was very satisfied with the results. Conclusion: This report illustrates an orthodontic and surgical treatment approach of a case with KTS. Effective management of orthodontic and facial manifestations of KTS considerably enhances the patient’s function, appearance, and overall quality of life.

This study aimed to compare skeletal age determination by using the ratio of third and fourth cervical vertebral dimensions (CVDs) versus the cervical vertebral maturation (CVM) method in an Irania...

Background: Oral cancer accounts for 3% of all malignancies. Progression to malignancy occurs with a gradual process. Oral potentially malignant disorders (OPMD) are associated with the development of malignant transformation toward oral cancer. Objectives: This registry aimed at introducing an exact data gathering method for detecting, managing, and monitoring patients with OPMD to decrease the occurrence of oral cancer. Methods: In this registry, all patients with OPMD such as leukoplakia, erythroplakia, and oral lichen planus at Shahid Beheshti Dental School, Tehran, Iran were included. Patients' information including demographics, clinical, and histopathological features, the type of OPMD, treatment measures, and lesion changes in follow-up intervals were recorded in the registry software. In addition, a quality assurance team supervised and guaranteed the quality control of the entire registry process. Results: The following measures have been accomplished so far: development of an ethically-approved proposal, development of a comprehensive data form, development of web-based registration software, development of a manual of operation, signing of a collaborative contract with more than 8 dental schools throughout Iran, identification of 100 eligible patients, signing a contract with the Research Deputy of Shahid Beheshti University of Medical Sciences, and codification of a verified and ethically approved quality assurance proposal. This registry is getting the advantage of being supervised and sponsored by the Disease Registry Center of Shahid Beheshti University of Medical Sciences. Conclusions: The prospect of this registry is to provide patients with OPMD with a nationwide diagnostic service and continuous monitoring protocol through a collaborative network of all dental schools in Iran.

Tina Matini,1 Amir Haghparast,1 Laleh Rezaee,2 Sakineh Salehi,2,3 Azita Tehranchi,4 Abbas Haghparast2 1School of Dentistry, International Branch of Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Neuroscience Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Department of Medicine, Ardabil Medical Sciences Branch, Islamic Azad University, Ardabil, Iran; 4Dental Research Center, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, IranCorrespondence: Abbas HaghparastNeuroscience Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, P O Box 19615-1178, Tehran, IranTel/ Fax +98-21-2243-1624Email Haghparast@yahoo.comAzita TehranchiDental Deformities Research Center, Dental Research Institute, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, IranEmail Azitatehranchi@yahoo.comIntroduction: The ventral tegmental area (VTA), as one of the classical components of the brain reward circuitry, shares large neural networks with the pain processing system. We previously showed the role of VTA dopamine receptors in modulation of lateral hypothalamus (LH)-induced antinociception in acute pain conditions. However, considering the fact that the neural systems involved in the mediation of tonic pain are not the same as those that mediate phasic pain. In the present study, we aimed to examine the role of intra-VTA dopamine receptors in LH-induced antinociceptive responses during tonic orofacial pain conditions.Methods: Male Wistar rats weighing 230– 250 g were implanted with two separate cannulae into the LH and VTA on the same side. Different solutions of carbachol (62.5, 125 and 250 nM), as a non-selective cholinergic receptor agonist that activates the LH projecting neurons, were microinjected into the LH. In the other groups, D1-like dopamine receptor antagonist, SCH-23390 (0.25, 1 and 4 μg/03 μL saline) or D2-like dopamine receptor antagonist, Sulpiride (0.25, 1 and 4 μg/0.3 μL DMSO 12%) were microinjected into VTA, 5 min prior intra-LH carbachol (250 nM), then subjected to orofacial formalin test. Intra-LH carbachol microinjection dose-dependently attenuated biphasic orofacial pain.Results: Intra-VTA administration of SCH-23390 or Sulpiride dose-dependently decreased intra-LH carbachol-induced antinociception during both phases of orofacial formalin test with further effects in the late phase.Discussion: The findings suggest that chemical stimulation of the LH by carbachol possibly activates the orexin projecting neurons and subsequently, the VTA dopaminergic neurons involved in the orofacial pain modulation. Detecting such neural circuitry offers an alternative approach in the development of more efficient therapies for such debilitating pain conditions.Keywords: pain, D1-like dopamine receptor, D2-like dopamine receptor, ventral tegmental area, lateral hypothalamus, orofacial formalin test

Lateral hypothalamus (LH) contains a large population of orexinergic neurons. Many studies have investigated the function of these neurons and it is clear that they are involved in pain modulation. The nucleus accumbens (NAc) receives many orexinergic projections, and accumbal neurons express both receptors of orexin (OX1R and OX2R). In this study, we investigated the role of accumbal orexinergic receptors in the LH-induced antinociception during formalin-induced orofacial pain. Male adult Wistar rats weighing 230-250 g were used in this study. Cannulae were unilaterally implanted in their skull for microinjections. SB334867 (OX1 receptor antagonist) or TCS OX2 29 (OX2 receptor antagonist) at the doses of 3, 10 and 30 nM were injected into the NAc with/without intra-LH microinjection of carbachol (250 nM/rat). Carbachol was used for chemical stimulation of orexinergic neurons in the LH. Our results showed that intra-LH carbachol following injection of formalin into animals' upper lip reduced nociception in both phases of formalin test. SB334867 and TCS OX2 29 were able to reduce LH-induced antinociception in both phases. Although the highest dose of SB334867 and TCS OX2 29 (30 nM) was effective in both phases, the TCS OX2 29 but not SB334867 at the dose of 10 nM could not reduce the antinociceptive responses induced by LH stimulation during the first (early) phase. It suggests that contribution of accumbal orexinergic receptors in the first phase of formalin test is more than the second (late) phase, and these results provide further evidence for the involvement of orexinergic system in the modulation of inflammatory orofacial pain.

This study was designed to investigate the changes in nasal soft tissue following maxillary Lefort I advancement with and without impaction in subjects presenting a skeletal class III malocclusion, using a 3D photogrammetry scanner.Patients with class III malocclusion undergoing Lefort I advancement with and without impaction and bilateral sagittal split osteotomy with the standard technique were included in this study. Patients were divided into two groups: maxillary Lefort I advancement alone (group 1) and combined with impaction (group 2). Facial soft tissue landmarks of the nose including nasal height (NH), nasal length (NL), nasal tip projection (NTP), alar width (AW), alar base width (ABW), subalar width (Sbal), nasolabial angle (NLA), nasofrontal angle (NFA), and columella inclination (CI) before and at least 4 months after surgery were obtained by a 3D scanner.Twenty-one patients were included in this study (Group 1: 11 and Group 2: 10). NH, NTP, and NL decreased significantly in both groups following surgery. In addition, Sbal decreased only in group 2. On the other hand, NLA and CI increased significantly in group 2. The inter-group comparison revealed a statistically significant difference in the alterations in NH, NL, and CI between the two groups.Changes in the nose soft tissue occurred after both surgeries, but their type and extent were different. Actions taken to reduce unwanted changes need to be further investigated. To evaluate the changes, 3D photogrammetry scan is a feasible imaging technique that can be used, providing numerous benefits.

Objectives: This study aimed to assess the efficacy of low-intensity pulsed ultrasound (LIPUS) for orthodontic pain control. Materials and Methods: This spilt-mouth randomized controlled clinical trial was performed on 44 mandibular first molars of 22 orthodontic patients at the Orthodontics Department of Shahid Beheshti Dental University. Elastomeric separators were placed at the mesial and distal of mandibular right and left first molars by separating pliers. Randomly, LIPUS was used at one side for 7 min and the same device with 0-degree intensity was used as sham for the other side on the facial skin. The same procedure was repeated after 24 h. Patients recorded their level of pain at 1, 6, and 24 h, and also on days 2 to 7 after, using a visual analog scale (VAS). Results: The effect of type of treatment (P=0.019), time of assessment (P

Context: The labial cortical bone may influence the outcomes of several treatments including fresh socket implant placement and orthodontic treatments. A thin labial plate may contribute to increased risks of periodontal consequences during dental procedures. Acknowledgment of the average values may guide clinicians to take particular considerations in making treatment decisions. Therefore, this study aimed to systematically review the labial cortical bone thickness (LBT) in the anterior maxillary teeth. Objective: The primary purpose of this study was to review the LBT in the anterior maxillary teeth to present the range of average LBT in the global population. Evidence Acquisition: An electronic search was conducted in PubMed, Embase, ProQuest, Web of Science, and Scopus databases. English studies that measured the LBT in the maxillary anterior teeth using CT or CBCT scans were deemed relevant. Only studies performed on adult patients with a lack of periodontal disease were included. Results: A total of 49 studies were included. Mean LBT ranged 0.13 - 3.08, 0.29 - 4.2, and 0.36 - 4.5 mm in maxillary central incisor, lateral incisor, and canine, respectively. Expectedly, LBT was affected by the vertical level of the measurement point and increased toward the apex. In total, the LBT in the anterior maxilla ranged from 0.13 to 4.5 mm. In comparison with other populations, a relatively thin labial plate was evidenced in the Iranian populations. Conclusions: This study showed a wide range of LBT in the esthetic zone. A thin plate in the esthetic area necessitates caution in orthodontic treatments, particularly when tooth expansion or proclination is required. Additionally, wide ranges of reported values which are mostly under 2 mm, highlight the importance of CBCT acquisition before any fresh socket implant placement.

Summary Objective To systematically review and meta-analyse the Alveolar Bone Thickness (ABT) overlying healthy teeth. The secondary objective was to review the association of ABT with gender, age, and smoking. Materials and methods The PubMed, Embase, Scopus, ProQuest, Web of Science, and Cochrane Library databases were searched up to July 2020. English articles (sample size ≥ 10) which had used CT or CBCT to measure the ABT at clearly defined reference points were included. The maximum likelihood approach meta-analysis was used to estimate the means (95% CIs). Results A total of 68 articles were included. The meta-analysis results were as follows: In the anterior maxilla, the mean labial plate thickness ranged from 0.42–1.75 mm, while it was thicker for the posterior teeth (0.78–4.31 mm). The palatal plate thickness ranged from 0.97–8.13 mm. In the anterior mandible, the thickness of labial and lingual plates ranged from 0.4–3.71 mm and 0.38–5.44 mm, respectively. The alveolar bone was thicker for the posterior teeth both at the labial (0.66–6.31 mm) and lingual (2.31–7.77 mm) sides. Meta-regression revealed a significant relationship between gender and ABT at several points. There was a controversy regarding the association of ABT with age. No significant difference was evidenced between smokers and non-smokers. Conclusions This study presents a clear image of the alveolar bone structure. Since it has pooled ABT values from various populations, outcomes could be acknowledged as global averages. Therefore, it could provide perspective for several dental procedures, including orthodontic treatments and immediate implant placement.

OBJECTIVE To conduct a systematic review and meta-analysis of studies that evaluated the association between gingival phenotype (GP) and the underlying alveolar bone thickness (ABT). DESIGN An electronic search was performed in PubMed, Embase, Scopus, ProQuest, and Web of Science. The following inclusion criteria were applied: English original studies that compared the ABT in periodontally healthy patients presenting thin versus thick GPs. Studies that evaluated the correlation between gingival thickness (GT) and ABT were also included. Pooled mean difference (95% confidence interval) was estimated using random-effects maximum likelihood model meta-analysis. RESULTS From a total of 1427 retrieved articles, 17 were included. The majority of eight studies that compared the ABT between thick and thin GPs, reported a significantly greater ABT associated with a thick phenotype. Based on the meta-analysis results of six studies, the mean difference between the two phenotypes (0.33 mm) was statistically significant (P

Objective: The aim of this study was to evaluate the effect of LPRF, placed in extraction sockets, on orthodontic tooth movement (OTM). Materials and Methods: Thirty extraction sockets from eight patients (five males, three females, with a mean age of 17.37 years; range 12–25 years) requiring extraction of first premolars based on their orthodontic treatment plan participated in this split-mouth clinical trial. In one randomly selected quadrant of each jaw, the extraction socket was preserved as the experimental group by immediate placement of LPRF in the extraction socket. The other quadrant served as the control group for secondary healing. Immediately, the teeth adjacent to the defects were pulled together by a NiTi closed-coil spring with constant force. A piece of 0.016 × 0.022-inch stainless steel wire was used as the main arch wire. The amount of OTM was measured on the study casts at eight time points with 2-week intervals for 3 months. Analysis of random effect model was performed for the purpose of comparison between the experimental and control groups. Results: According to the random effect model, a statistically significant difference was found between the experimental and control group in rate of OTM (P = 0.006). Conclusion: According to the results, application of LPRF, as an interdisciplinary approach combining orthodontics and surgery, may accelerate OTM, particularly in extraction cases.

Despite the fact that recent medical advances have improved the quality of life and increased the life expectancy of patients suffering from thalassaemia, no standard strategy or clinical guidelines are available for the correction of the presenting craniofacial anomalies. The aim of the present study is to review the craniofacial features of affected patients, and to discuss the orthodontic and orthognathic surgical treatment options available to manage the associated and characteristic facial deformity.

Tissue regeneration has become a promising treatment for craniomaxillofacial bone defects such as alveolar clefts. This study sought to assess the efficacy of lateral ramus cortical plate with buccal fat pad derived mesenchymal stem cells (BFSCs) in treatment of human alveolar cleft defects. Ten patients with unilateral anterior maxillary cleft met the inclusion criteria and were assigned to three treatment groups. First group was treated with anterior iliac crest (AIC) bone and a collagen membrane (AIC group), the second group was treated with lateral ramus cortical bone plate (LRCP) with BFSCs mounted on a natural bovine bone mineral (LRCP+BFSC), and the third group was treated with AIC bone, BFSCs cultured on natural bovine bone mineral, and a collagen membrane (AIC+BFSC). The amount of regenerated bone was measured using cone beam computed tomography 6 months postoperatively. AIC group showed the least amount of new bone formation (70±10.40%). LRCP+BFSC group demonstrated defect closure and higher amounts of new bone formation (75±3.5%) but less than AIC+BFSC (82.5±6.45%), suggesting that use of BFSCs within LRCP cage and AIC may enhance bone regeneration in alveolar cleft bone defects; however, the differences were not statistically significant. This clinical trial was registered at clinicaltrial.gov with NCT02859025 identifier.

Background: Adequate Vitamin D is essential for dental and skeletal health in children and adult. The purpose of this study was to assess the correlation of serum Vitamin D level with external-induced apical root resorption (EARR) following fixed orthodontic treatment. Materials and Methods: In this cross-sectional study, the prevalence of Vitamin D deficiency (defined by25-hydroxyvitamin-D) was determined in 34 patients (23.5% male; age range 12–23 years; mean age 16.63 ± 2.84) treated with fixed orthodontic treatment. Root resorption of four maxillary incisors was measured using before and after periapical radiographs (136 measured teeth) by means of a design-to-purpose software to optimize data collection. Teeth with a maximum percentage of root resorption (%EARR) were indicated as representative root resorption for each patient. A multiple linear regression model and Pearson correlation coefficient were used to assess the association of Vitamin D status and observed EARR. P < 0.05 was considered statistically significant. Results: The Pearson coefficient between these two variables was determined about 0.15 (P = 0.38). Regression analysis revealed that Vitamin D status of the patients demonstrated no significant statistical correlation with EARR, after adjustment of confounding variables using linear regression model (P > 0.05). Conclusion: This study suggests that Vitamin D level is not among the clinical variables that are potential contributors for EARR. The prevalence of Vitamin D deficiency does not differ in patients with higher EARR. These data suggest the possibility that Vitamin D insufficiency may not contribute to the development of more apical root resorption although this remains to be confirmed by further longitudinal cohort studies.

Objective: Growth prediction plays a significant role in accurate diagnosis and treatment planning of orthodontics patients. It was hypothesized that the unique pattern of pneumatization of the frontal sinus as a component of craniofacial structure would influence the skeletal growth pattern and may be used as a growth predictor. Materials and Methods: A total of 144 subjects (78 females and 66 males) with a mean age of 19.26 ± 4.66 years were included in this retrospective study. Posterior-anterior and lateral cephalograms (LCs) were used to measure the frontal sinus dimensions. The skeletal growth pattern and relations of craniofacial structures were analyzed on LC using variables for sagittal and vertical analyses. Correlation between the frontal sinus dimensions and cephalometric indices was assessed by the Pearson's correlation coefficient. Results: The SN-FH and SNA angles had significant associations with frontal sinus dimensions in all enrolled subjects (P < 0.05). In males, the SN-FH, sum of posterior angles, Pal-SN, and Jarabak index were significantly associated with the size of frontal sinus (P < 0.05). In females, the associations of SN-FH and gonial angles with frontal sinus dimensions were significant (P < 0.05). Conclusion: The results show that larger size of frontal sinus was associated with reduced inclination of the anterior cranial base, increased anterior facial height (in males), and increased gonial angle (in females) in the study population.

The aim of this study was to assess the dental arch curvature in subjects with normal occlusion in an Iranian population and propose a beta function formula to predict maxillary arch form using the mandibular intermolar widths (IMW) and intermolar depths (IMD). The materials used were study casts of 54 adolescents with normal occlusion and mean age of 14.1 years (25 males, 29 females, age range 12–16 years). Curve-fitting analyses were carried out and the curves passing through the facial-axis point of the canines, premolars, first molars, and the incisal edges of the anterior teeth were studied using a 3D laser scanner. Using the measured IMW and IMD of the dental arches at the maxillary and mandibular first molar region, a beta function formula proposed for predicting maxillary arch form. The accuracy of the proposed formula was assessed on 10 randomly selected dental casts. The mean (SD) of the maxillary and mandibular IMW and IMD were 57.92 (4.75), 54.19 (5.31), and 31.59 (2.90) and 28.10 (2.59) mm, respectively. There was no gender dimorphism (P > 0.05) for both variables (IMW, IMD). There was a strong positive association (n = 10, Pearson r = 0.98, P

Etiology of open bite malocclusion is multifactorial; therefore, elimination of the main etiologic factor is the key for successful treatment. Tongue size and posture can cause open bite; thus, glossectomy is one of the treatment choices in severe cases. A 19 year old girl with a chief complaint of extra-large tongue and anterior open bite due to hemangioma was referred to us. Hemangioma removal and partial glossectomy were performed. With no other intervention, the anterior open bite decreased 10 millimeters within 3 years. Since the patient refused orthognathic surgery, the remaining malocclusion was resolved by orthodontic treatment using skeletal anchorage.

An increasing number of patients with psychological conditions with or without drug regimens are seeking orthodontic treatment and orthognathic surgery to address jaws dysmorphology. Depression and bipolar affective disorders are relatively common. These disorders may interfere with the presurgical orthodontics, surgical intervention and postsurgical treatments and thus requires careful considerations. The aim of this article is to report of a case with bipolar disorder and review the orthodontics and orthognathic surgery considerations of patients with bipolar disorder.

Aim: This study evaluated radiographic variations and measured dimensions of the non-pathologic frontal sinuses. Study Design: Retrospective. Place and Duration of Study: Orthodontics Department, Dental School, Shahid Beheshti University of Medical Sciences, 2003 to 2012. Methodology: Subjects older than 12 years with no sinus pathology were included. Borders of the frontal sinus were traced. Line drawings were scanned, and sinus dimensions were calculated by computer software by two examiners. In addition, asymmetry and shape of superior margin of sinus were evaluated. Gender differences were analyzed by independent sample t-test and chi square with a 0.05 level of significance. Results: A total of 66 subjects were included (40 female and 26 male). Height, width and area of the frontal sinus in the sagittal plane were 2.26 cm, 1.13 cm and 1.37 cm 2 , respectively. The corresponding numbers in the frontal plane were 2.79 cm, 5.00 cm and 7.04 cm, respectively. Original Research Article Tehranchi et al.; BJMMR, 8(5): 464-462, 2015; Article no.BJMMR.2015.467 455 Although all dimensions were larger in men than in women, it was not significant (P>0.05). Most of the cases had relatively symmetric frontal sinus. Conclusion: Size and shape of the frontal sinus varies among individuals. Frontal sinus is relatively larger in men than women.

Highlights • We described the orthodontic treatment of a girl diagnosed with VWS. • Multidisciplinary techniques resulted in satisfactory outcomes. • Genetic testing determined a known putative splice site mutation., Introduction Van der Woude syndrome (VWS) is the most frequent form of syndromic cleft lip and palate (SCLP) accounting for 2% of all patients with CLP. Case presentation We describe the orthodontic treatment of a girl diagnosed with VWS referred by her family dentist for her cosmetic concerns. Discussion Comprehensive orthodontic treatment, secondary bone graft, distraction osteogenesis (for a deficient maxilla), secondary palatoplasty and excision of lower lip pits, as well as orthodontic and prosthetic procedures may provide a satisfactory outcome. Genetic testing showed a known putative splice site mutation (c.174 + 1 G/A) as the prime cause of VWS in our patient and her family. Conclusion SCLP has significant effects on facial aesthetics and the psychosocial status. Parents should be assessed and counseled appropriately. This condition is treatable in the absence of life threatening systemic anomalies. An interdisciplinary team approach is advocated.

Secondary bone grafting simultaneous to premaxillary repositioning is a well-recognized surgical procedure for the management of bilateral cleft lip and palate patients. Proper stabilization of the repositioned premaxilla is considered as a key factor for the success of secondary bone grafting because the mobility of the premaxillary segment jeopardizes graft integration. This case series reports a reliable method of premaxillary stabilization that incorporated the intrasurgical application of resin bone cement to cover and reinforce the arch bars or orthodontic brackets applied on the maxillary teeth. Occlusal loads were reduced by application of posterior bite blocks on the mandibular teeth. The stabilization method was performed on 7 patients (5 women and 2 men) with a mean age of 12.4 years. During postsurgery follow-ups, the repositioned premaxillary segments did not show mobility in any of the patients. The palatal fistulae were completely closed. Panoramic radiographies taken 2 months after surgery demonstrated acceptable graft integration. The patients have now been followed up to 5 years. No evidence of relapse has been observed. This technique seemed to be undemanding, included minimal laboratory procedure, and maintained the labial mucosa overlying the repositioned segment intact.

Introduction To correct dentofacial deformities, a combination of orthodontic treatment and orthognathic surgery is needed. Prediction software packages are beneficial in treatment planning and achieving improved outcomes, but before using any software, its reliability and reproducibility must be assessed. The aim of this study was to evaluate the accuracy of 2-dimensional Dolphin (version 10; Dolphin Imaging & Management Solutions, Chatsworth, Calif) and 3-dimensional Maxilim (Medicim, Sint-Niklaas, Belgium) softwares in predicting the soft-tissue profiles of patients who had Le Fort I osteotomies. Methods The presurgical and postsurgical cone-beam computed tomography synthesized lateral cephalograms of 13 patients were collected. Using the Dolphin and Maxilim softwares, the postsurgical profiles were predicted. The positions of the soft-tissue landmarks in profile views were compared with landmarks in the postsurgical photographs. The data were analyzed with the coefficient of reliability and paired-sample t tests. Results The alpha values of the interclass correlations for each landmark in the x and y planes were between 0.96 and 0.99, except for stomion superior in Maxilim (0.83). The 95% confidence interval and the absolute mean of the error showed that errors in the Dolphin software were greater than those in the Maxilim software, but the differences were not significant (P >0.05), except for soft-tissue A-point. The greatest errors were seen in the chin region. The prediction errors of the nasolabial and mentolabial angles were greater; the prediction error in the Dolphin software was 9°, which has clinical significance. Conclusions The Dolphin and Maxilim softwares are both appropriate for clinical use. Their inaccuracies in the prediction of the chin region should be considered in complicated surgical planning.

Although the precise prediction of the results before distraction is important, performing three-dimensional (3D) simulations for all distraction osteogenesis patients is not practical. Formulating general guidelines based on the factors affecting the 3D results of distraction treatment is recommended. This study was performed on a 3D mandible based on a finite element method. Three surgical cuts (oblique, vertical and horizontal) were made in the right side of the mandible. The amount and direction of movement of proximal and distal segments were evaluated after simulation of 15 mm of distraction. In the distal segment, the maximum displacement in the pogonion occurred in the vertical cut. In the proximal segment, the maximum displacement occurred in the coronoid process in horizontal and oblique cuts in a superior direction. The condylar process rotated in the clockwise direction when the vertical cut was used and the coronoid process moved inferiorly. To make the gonial angle more prominent the vertical cut should be used. A horizontal cut is used to lengthen the ramus. Vertical and oblique cuts can be used in patients with long anterior facial height, but all other conditions being equal horizontal cuts are better used in short faced patients.

Objectives: Evaluation of the effectiveness of a school-based oral health promotion intervention on preadolescents' gingival health. Methods: A community trial designed for a 3-month intervention study in a representative sample of 9-year-olds (n = 457) in 16 schools in Tehran, Iran. The schools were randomly assigned to three intervention groups and one control group, each group comprising two boys' and two girls' schools. The first group of children (n = 115) received intervention via class work, solving a set of puzzles containing oral health messages, under supervision of their health counsellor. The second group (n = 114), intervention via parents, included an oral health education leaflet and a brushing diary for supervising the child's tooth-brushing; the third group (n = 111) received a combination of both these interventions. The control group (n = 117) had no intervention. Effects of the intervention were assessed as changes in dental plaque and gingival bleeding. Improvements in gingival health were recorded when half of the index teeth with plaque at baseline became clean (acceptable oral hygiene) or when all index teeth with bleeding at baseline became healthy (healthy gingiva). Statistical analysis included chi square, anova, t-test, Number Needed to Treat (NNT) and generalized estimating equations (GEE). Results: At baseline, none of the children were free of plaque and all except for three boys had bleeding. After the trial, acceptable oral hygiene was more frequent in the parental-aid (P < 0.001) and the combined groups (P < 0.05), and healthy gingiva in both groups (P < 0.001) in comparison with the control group. Outcomes in the class- work group did not differ from those in the control group. The GEE models confirmed a strong intervention effect on healthy gingiva in both groups where parents were involved: parental-aid group (OR = 7.7, 95% CI: 2.2-27.7) and combined group (OR = 6.6, 95% CI: 2.0-22.1). In all intervention groups more girls than boys achieved healthy gingiva (OR = 2.5-2.6). Parents' education showed no impact on the outcome. Conclusions: When a school-based oral health intervention involves parents it may result in a significant improvement in the gingival health of preadolescents with poor gingival health at baseline.

The purpose of this study was to evaluate the enhancing effect of recombinant platelet derived growth factor on human mesenchymal stem cells (hMSCs) in secondary alveoloplasty. Three patients with 4 alveolar defects were selected for this study. Mesenchymal stem cells were cultured from a posterior iliac bone aspirate. MSCs were mounted on biphasic scaffolds and combined with platelet derived growth factor (PDGF) in the operating room to make a triad of the scaffold, growth factor, and cells. The triads were placed in anterior maxillary cleft defects and closed with lateral advancement gingival flaps. The postoperative cleft bone volume was measured with cone beam computed tomography scans. A mean of 51.3% fill of the bone defect was calculated 3 months post-operation. Our data suggests the use of recombinant platelet derived growth factor with hMSCs may enhance the regeneration capacity of the cells.

Debonding of ceramic brackets due to their high bond strength and low fracture toughness is one of the clinician's complications. The purpose of this study is to evaluate the effect of a laser on shear bond strength, site of debonding, and ARI index during debonding of ceramic brackets and then compare it to the conventional method used for this procedure. Thirty polycrystalline alumina (G & H Series, Germany) brackets were bonded to 30 intact extracted first and second maxillary premolars and stored in a 1% thymol solution. A chemically cured orthodontic composite resin (No-mix, Unitek, USA) was used for bonding the brackets to the enamel surface on all teeth. All brackets were positioned 4 mm from the incisal edge of the teeth with an orthodontic bracket-positioning device. Then the teeth with bonded brackets were embedded in auto-polymerized polymethylmethacrylate (2.2.3 cm) blocks using a special device to make their slots horizontally parallel. These 30 teeth were then divided into two subgroups: control or no-lased (n = 15) and super pulse CO(2) laser (n = 15). To characterize the peak of SBS in two groups, we used an Instron machine while its blade was moving at a constant speed of 1 mm/min. For evaluating the site of debonding and the adhesive remnant index (ARI index), a light microscope and the Photoshop program were used. Means and standard deviations of the SBS in two subgroups shows that in the control group, the teeth have definitely higher values in comparison to the experimental group. The results of the two groups drew no substantial differences with respect to the surface of debonding, which was mostly within the adhesive. However, observing the results of ARI presented a significant distinction between the control and experimental group. This index denoted that the debonding site in the control group was closer to the enamel adhesive interface and, consequently, the rate of enamel damage in this group would be greater. The present study shows that a CO(2) laser has the potential to replace the conventional method for debonding ceramic brackets due to less debonding force and more adhesive remnant index on the tooth surface.

This study investigated the role of mothers in their preadolescents' oral self-care (OSC) and oral health in Tehran, Iran.In 2005, two self-administered questionnaires provided data on a random sample of 9-year-old children (N = 416) and their mothers. Brushing frequency, use of fluoridated dentifrice and the number of sugary snacks between meals served as OSC assessment criteria for both children and their mothers. Supervision of the child's tooth brushing and control of the child's sugary snacking indicated the mother's role that was defined as either active or inactive. Decayed, missing or filled teeth (DMFT + dmft) values facilitated the assessment of children's dental status in a voluntary clinical examination for children. The child's twice-daily tooth brushing, sound dentition and good oral hygiene were taken as the outcome measures for evaluating the impact of the mother's role. The chi-square test and logistic regression model were used for the analyses.Half of the mothers were assessed as active in the supervision of their children's tooth brushing. Supervision was clearly more frequently reported by the mothers whose own OSC was favourable. In the logistic regression model, the strongest factors contributing to the explanation of twice-daily tooth brushing were the child's female gender (odds ratio, OR = 1.6; 95% confidence interval, 95% CI = 1.1 to 2.4) and the mother's active supervision (OR = 1.5; 95% CI = 1.0 to 2.2). Having sound dentition was most strongly explained by the mothers' active supervision of their children's tooth brushing (OR = 2.4; 95% CI = 1.3 to 4.5).The mothers' supporting role positively reflects on twice-daily tooth brushing and sound dentition in preadolescents. More preventive efforts through mothers should be considered during the planning of promotion programmes for preadolescents.

Recently tissue engineering has become available as a regenerative treatment for bone defects; however, little has been reported on the application of tissue engineering for regeneration of cleft defect tissues. Mesenchymal-derived stem cells were applied to different kinds of bone substitute and compared in different animal models, but their usage in human critical defects remained unclear. In this study we report 2 patients with unilateral alveolar cleft, treated with the composite scaffold of demineralized bone mineral and calcium sulphate (Osteoset) loaded with mesenchymal stem cells (MSCs). Computed tomograms showed 34.5% regenerated bone, extending from the cleft walls and bridging the cleft after 4 months in one case and in the other there was 25.6% presentation of bone integrity. The available data revealed the conventional bone substitute was not a suitable scaffold for the MSC-induced bone regeneration.

Amis: This was to investigate the association between parents’ educational level and oral health of Iranian primary school children. Methods: Data came from the voluntary clinical examination in 2005 of a random sample of 459 third-year primary school children in the 16 schools in Tehran, together with a self-administered questionnaire regarding information on the educational level of the parents. The study used the dmft/DMFT values for dental status, and the CPI, and PI to assess periodontal condition. Statistics: One-Way ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used. Results: The mean dmft value was 4.2 (SD±2.9) in boys and 3.4 (SD±2.6) in girls for the whole study group. The children of the low education parents had more dental caries than those of high education parents in both primary (p< 0.01) and in permanent teeth (p< 0.05). A strong association was found between high parental education and restorations in primary teeth (p< 0.001), but only a trend for restorations in permanent teeth. Mean number of sextants with a CPI score 0 was significantly associated with parents’ educational level (p< 0.01). Conclusion: The disparities in the oral health of children need to be considered when developing oral health promotion programmes.

Purpose: The long-term outcomes and clinical results of costochondral transplants used for the treatment of condylar ankylosis of the mandible in children with and without application of postoperative activator appliances are evaluated and compared. Materials and Methods: A nonrandomized, retrospective clinical study of 13 cases of condylar ankylosis (16 joints) of the mandible surgically treated during a 9year period from 1988 to 1997 was performed. All 13 patients were treated by condylectomy and immediate costochondral rib grafts. Nine of these patients underwent long-term postoperative therapy using removable activator appliances. Four patients did not undergo activator therapy postoperatively. Casts, radiographs, photographs, computed tomography (CT) scans, magnetic resonance imaging (MRI) and 99Tc bone scans were used postsurgically to evaluate graft take, condylar growth and function, occlusion, and facial and condylar symmetry. Results: The postoperative and long-term clinical results in both groups showed costochondral growth center transplants to be effective in restoring mandibular growth of the affected side. However, symmetry, arch coordination, correction of occlusal canting, mandibular deviation, facial growth, and prevention of reankylosis were obtained and better controlled only in those cases that underwent long-term orthodontic activator therapy postoperatively and were followed closely. Conclusions: Children with long-standing condylar ankylosis of the mandible and its resultant facial asymmetry and occlusal canting (secondary to a nonfunctional joint and maxillary compensation) treated with condylectomy and immediate costochondral rib graft reconstruction of the affected joint were treated more favorably when activators were used postsurgically. The patients that failed to comply with or continue activator therapy postsurgically developed complications relating to mandibular deviation, occlusal dysharmony, asymmetry and, in one case, reankylosis of the temporomandibular joint (TMJ).