Concurrent Odontogenic Keratocyst and Odontoma: Report of an Unusual and Rare Entity.

Hybrid lesions of jaws are rare entities defined as two different lesions co-occurring in the same location, with identical histopathological origin. Ameloblastoma, calcifying cystic odontogenic tumor and odontoma are among the most common lesions that have been reported to combine with other lesions. In this study, a hybrid lesion of odontogenic keratocyst (OKC) and odontoma in the mandible of a forty-five years old male reported. Additional to the rarity of this hybrid lesion, the present case had unique radiologic features, including atypical location and extension of the lesion and profound knife-edge root resorption of the teeth in the area, which was not a common feature for any of the two lesions. The surgical procedure was marsupialization to reduce the size of the lesion. As a result of the surgery, the healing of the surgical wound was uneventful. In addition, careful follow-up for the patient was conducted, which had no recurrence till now (after 15 months).

Educational Intervention of Improve Student's Oral Health: A Systematic Review and Meta-Analysis School-Based.

Background: The present research aimed to assess the effects of oral health intervention programs at school level on students' oral hygiene in developing countries. To this aim, a systematic review and meta-analysis approach was employed. Methods: The present research was done by surfing electronic databases with MEDLINE Ovid (Embase Ovid, Scopus), Web of Science from 2000 to Mar 2020. The data were collected using a standard type of data collection including specific studies to observational ones, and the data entered RevMan 2014. The eligibility criteria were individually randomized controlled trials (RCTs) or cluster-RCTs including quasi-experimental papers with oral health interventions. The RevMan 2014 package was used for a meta-analysis done through random-effects models. Results: Meta-analyses revealed statistically significant divergences in terms of knowledge (SMD 3.31, 95% CI 2.52 to 4.11; I2 = 98; P<0.001), attitude (SMD 1.99, 95% CI 0. 43 to 3.54; I2 = 99; P<0.001), behavior (SMD 4.74, 95% CI 3.70 to 5.77; I2 = 99; P<0.001), plaque index (SMD -1.01, 95% CI -1.50 to -0. 51; I2 = 97; P<0.001) and Gingival index (SMD 0. 33, 95% CI -0. 36 to 1. 02; I2 = 98; P=0.34) in the case of students who received educational interventions versus those with ordinary care. Conclusion: The present findings attested to the effectiveness of the educational interventions in improving oral health knowledge, attitudes, behaviors, and so on which can presumably contribute to a better oral hygiene, lower incidence of oral diseases, and lower costs of the treatments imposed by oral diseases.

Evaluation of Extension Type of Canalis Sinuosus in the Maxillary Anterior Region: a CBCT Study.

OBJECTIVE: To evaluate the extension of canalis sinuosus (CS) into the alveolar crest for surgical reference in the anterior maxilla. METHODS: In this cross-sectional study, 485 CBCT images were evaluated in three orthogonal planes (axial, coronal and sagittal). The type of extension of CS into the alveolar ridge in the anterior maxilla was evaluated. The alveolar ridge was divided into four equal parts in a vertical and horizontal direction. In a vertical direction from apical to incisal and in a horizontal direction from labial to palatal, the four parts were designated as types 0, I, II and III, respectively. The extension of CS into the alveolar ridge was then traced. RESULTS: CS was present in 380 subjects (78.35%), and the extension type was unilateral in 217 of them (57.11%) and bilateral in 163 of them (42.89%). There was no significant relationship between incidence of CS and sex. Regarding the distribution of vertical and horizontal types, type II (the third quadrant of the ridge from apical to incisal and from labial to palatal, respectively) was significantly more prevalent than other types. CONCLUSION: The most common location of CS into the alveolar ridge in both horizontal and vertical directions was type II (which is not close to the cortex). Awareness about the presence and possible locations of CS helps to reduce the risk of unjustifiable postoperative complications.

Assessing the efficacy of a modified crushing technique for the management of concha bullosa: a cone beam computer tomography study / Avaliando a eficácia de uma técnica de esmagamento modificada para o manejo da concha bolhosa: um estudo com tomografia por feixe cônico

Abstract Introduction: Although many surgical techniques exist to manage obstructive concha bullosa, there continues to be a drive to find the least invasive technique with the fewest complications and best results. Objectives: The purpose of this study is to describe and assess the short- and long-term efficacy of a modified crushing technique for concha bullosa management. Methods: Patients who met inclusion criteria underwent a detailed nasal examination and cone beam computed tomography imaging prior to and after septoplasty with crushing surgery for obstructive concha bullosa. Patients were divided into short- and long-term groups based on their followup period such that the short-term group had a mean followup of 15.14 months (range 6->22 months) and the long-term group had a mean followup of 56.66 (range 29->80) months. Results: Twenty-four cases of obstructive concha bullosa were included in this study with 13 short-term and 11 long-term follow-ups. All patients showed a significantly decreased postoperative CB size (p< 0.001). There was no correlation between age and postoperative CB change in area (p = 0.39) and no significant difference in the amount of postoperative CB area reduction between the short-term and long-term groups (p = 0.35). No patients experienced bleeding, synechia, conchal destruction, or olfactory dysfunction on followup evaluations. Conclusion: Our modified crushing technique is a simple, effective, and lasting treatment option for concha bullosa. From our experience, there have been no complications and no instances of concha bullosa reformation during the follow-up period.

Resumo Introdução: Embora existam muitas técnicas cirúrgicas para o tratamento da concha bolhosa, ainda se busca encontrar uma técnica menos invasiva com menor número de complicações e melhores resultados. Objetivos: Descrever e avaliar a eficácia em curto e longo prazo de uma técnica de esmagamento modificada para o manejo da concha bolhosa. Método: Os pacientes que preencheram os critérios de inclusão foram submetidos a exame nasal detalhado e tomografia computadorizada de feixe cônico antes e após septoplastia com cirurgia de esmagamento de concha bolhosa. Os pacientes foram divididos em grupos de curto e longo prazo de acordo com o período de seguimento, de modo que o grupo de curto prazo teve um seguimento médio de 15,14 meses (intervalo de 6 a 22 meses) e o grupo de longo prazo teve uma média de seguimento de 56,66 (variação de 29 a 80) meses. Resultados: Vinte e quatro casos de concha bolhosa foram incluídos neste estudo, com 13 seguimentos de curto prazo e 11 de longo prazo. Todos os pacientes apresentaram uma redução significante no tamanho da concha bolhosa no pós-operatório (p< 0,001). Não houve correlação entre a idade e a mudança na área da concha bolhosa no pós-operatório (p = 0,39) e nem diferença significante na redução da área da CB no pós-operatório entre os grupos de curto e longo prazo (p = 0,35). Nenhum paciente apresentou sangramento, sinéquia, destruição da concha ou disfunção olfatória nas avaliações de seguimento. Conclusões: Nossa técnica de esmagamento modificada é uma opção de tratamento simples, eficaz e duradoura para a concha bolhosa. Com base nessa experiência, não houve complicações e qualquer caso de recorrência na formação da concha bolhosa durante o período de seguimento.

Symphysis morphology and mandibular alveolar bone thickness in patients with ß-thalassemia major and different growth patterns.

OBJECTIVE: The present study aimed to assess the morphology of symphysis and alveolar bone thickness (ABT) surrounding mandibular incisors in thalassemic patients, as compared to unaffected individuals. METHODS: This case-control study was conducted on lateral cephalograms of 60 thalassemic and 60 unaffected patients with Class II malocclusion seeking orthodontic treatment at Dental School, Shiraz University of Medical Sciences. The sample was divided into three subgroups including hyperdivergent, normodivergent, and hypodivergent, according to the Jarabak index. Symphysis dimensions and alveolar bone thickness surrounding mandibular incisors were measured using AutoCad software. Finally, the correlation between alveolar bone thickness and symphysis morphology was assessed. RESULTS: In general, chin dimensions and bone thickness at different levels of mandibular incisor roots (cervical, middle, apical) were smaller in thalassemic adolescents than controls. Concerning the total sample as well as the normodivergent subgroup, significantly lower values were observed in thalassemic patients for symphysis width, total ABT at the cervical, and lingual ABT at the apical root area compared to controls (p < 0.05). The hypodivergent growth pattern was not associated with any statistical differences between the groups (p> 0.05). In both thalassemic and control subjects, symphysis width showed a weak to moderate positive correlation with ABT of lower incisors (p< 0.05), whereas symphysis height showed a moderate positive correlation with cervical ABT in only ß-thalassemia patients (p< 0.05). CONCLUSIONS: Compared to controls, ß-thalassemia patients showed thinner alveolar bone at different levels of lower incisor roots and smaller symphysis dimensions. There were significant correlations between symphysis dimensions and alveolar bone thickness of mandibular incisors in the sample.

Assessing the efficacy of a modified crushing technique for the management of concha bullosa: a cone beam computer tomography study.

INTRODUCTION: Although many surgical techniques exist to manage obstructive concha bullosa, there continues to be a drive to find the least invasive technique with the fewest complications and best results. OBJECTIVES: The purpose of this study is to describe and assess the short- and long-term efficacy of a modified crushing technique for concha bullosa management. METHODS: Patients who met inclusion criteria underwent a detailed nasal examination and cone beam computed tomography imaging prior to and after septoplasty with crushing surgery for obstructive concha bullosa. Patients were divided into short- and long-term groups based on their followup period such that the short-term group had a mean followup of 15.14 months (range 6-22 months) and the long-term group had a mean followup of 56.66 (range 29-80) months. RESULTS: Twenty-four cases of obstructive concha bullosa were included in this study with 13 short-term and 11 long-term follow-ups. All patients showed a significantly decreased postoperative CB size (p < 0.001). There was no correlation between age and postoperative CB change in area (p = 0.39) and no significant difference in the amount of postoperative CB area reduction between the short-term and long-term groups (p = 0.35). No patients experienced bleeding, synechia, conchal destruction, or olfactory dysfunction on followup evaluations. CONCLUSIONS: Our modified crushing technique is a simple, effective, and lasting treatment option for concha bullosa. From our experience, there have been no complications and no instances of concha bullosa reformation during the follow-up period.

Symphysis morphology and mandibular alveolar bone thickness in patients with β-thalassemia major and different growth patterns

ABSTRACT Objective: The present study aimed to assess the morphology of symphysis and alveolar bone thickness (ABT) surrounding mandibular incisors in thalassemic patients, as compared to unaffected individuals. Methods: This case-control study was conducted on lateral cephalograms of 60 thalassemic and 60 unaffected patients with Class II malocclusion seeking orthodontic treatment at Dental School, Shiraz University of Medical Sciences. The sample was divided into three subgroups including hyperdivergent, normodivergent, and hypodivergent, according to the Jarabak index. Symphysis dimensions and alveolar bone thickness surrounding mandibular incisors were measured using AutoCad software. Finally, the correlation between alveolar bone thickness and symphysis morphology was assessed. Results: In general, chin dimensions and bone thickness at different levels of mandibular incisor roots (cervical, middle, apical) were smaller in thalassemic adolescents than controls. Concerning the total sample as well as the normodivergent subgroup, significantly lower values were observed in thalassemic patients for symphysis width, total ABT at the cervical, and lingual ABT at the apical root area compared to controls (p < 0.05). The hypodivergent growth pattern was not associated with any statistical differences between the groups (p> 0.05). In both thalassemic and control subjects, symphysis width showed a weak to moderate positive correlation with ABT of lower incisors (p< 0.05), whereas symphysis height showed a moderate positive correlation with cervical ABT in only ß‐thalassemia patients (p< 0.05). Conclusions: Compared to controls, ß-thalassemia patients showed thinner alveolar bone at different levels of lower incisor roots and smaller symphysis dimensions. There were significant correlations between symphysis dimensions and alveolar bone thickness of mandibular incisors in the sample.

RESUMO Objetivo: O presente estudo teve como objetivo avaliar a morfologia da sínfise e a espessura do osso alveolar (EOA) ao redor dos incisivos inferiores de pacientes com talassemia, em comparação a indivíduos sem a doença. Métodos: Esse estudo de caso-controle foi conduzido por meio da análise de radiografias cefalométricas de pacientes Classe II à procura de tratamento ortodôntico na Clínica Odontológica da Shiraz University of Medical Sciences, sendo 60 pacientes com talassemia e 60 sem a doença. A amostra foi dividida em três subgrupos, de acordo com o índice de Jarabak: hiperdivergente, normodivergente e hipodivergente. As dimensões da sínfise e a espessura do osso alveolar ao redor dos incisivos inferiores foram medidas no programa AutoCAD. Por último, foi avaliada a correlação entre a espessura do osso alveolar e a morfologia da sínfise. Resultados: No geral, as dimensões do mento e a espessura do osso nos diferentes níveis da raiz dos incisivos inferiores (cervical, médio e apical) foram menores em adolescentes talassêmicos do que nos pacientes controle. Tanto na amostra total quanto no subgrupo normodivergente, valores significativamente menores foram observados nos pacientes talassêmicos para a largura da sínfise, EOA total no terço cervical e EOA lingual no terço apical da raiz, comparados aos pacientes controle (p< 0,05). O padrão de crescimento hipodivergente não foi associado a qualquer diferença estatisticamente significativa entre os grupos (p> 0,05). Em ambos os grupos de pacientes, talassêmicos e controle, a largura da sínfise mostrou uma correlação positiva de fraca a moderada com a EOA dos incisivos inferiores (p< 0,05), enquanto a altura da sínfise mostrou uma correlação positiva moderada com a EOA cervical apenas nos pacientes com talassemia beta (p< 0,05). Conclusões: Comparados aos pacientes controle, os pacientes com talassemia beta apresentaram um osso alveolar mais fino em diferentes níveis das raízes dos incisivos inferiores e dimensões menores da sínfise. Houve correlação significativa entre as dimensões da sínfise e a espessura do osso alveolar dos incisivos inferiores na amostra.

Maxillary Sinus Myxofibrosarcoma Mimicking Nodular Fasciitis: A Rare Case Report.

Myxofibrosarcoma (MFS) is a fibroblastic soft tissue sarcoma that is extremely rare in the maxillofacial region. Due to its non-specific clinicoradiographic findings and challenging histopathological features, the diagnosis is difficult. Here, we present a case of MFS which was first diagnosed as nodular fasciitis. The initial examination of the incisional biopsy showed a benign-appearing proliferation of fibroblasts without features of malignancy. The patient returned with recurrence four months after surgical excision of the primary lesion. The second histologic study revealed a high-grade spindle cell sarcoma with myxoid features most compatible with MFS. Definitive diagnosis of MFS was confirmed by these histopathologic features and supportive immunohistochemical stains. Unfortunately, the patient died of disease 3 months later.

Assessment of mandibular characteristics in patients affected with ß-thalassaemia major: A retrospective case-control study.

OBJECTIVE: Thalassemia is the most common hereditary blood disorder across the world. This study aimed to identify some mandibular features of thalassaemic patients and compare them with unaffected counterparts. MATERIAL AND METHODS: This retrospective case-control study was carried out on lateral cephalograms of 60 subjects (26 males, 34 females) with class II malocclusion and age range of 11 to 15 years. The control group consisted of 60 non-thalassaemic subjects with class II malocclusion and similar chronological age, gender and vertical facial dimension. Based on the Jarabak index, the case and control subjects were classified into hyperdivergent, normodivergent and hypodivergent growth patterns. Four linear (ramus height, ramus width, mandibular depth, and antegonial notch depth) and 3 angular (symphyseal angle, gonial angle, and mandibular arc angle) cephalometric parameters were measured to represent mandibular morphology. The data were analysed using Chi-square test and Student's t-test. RESULTS: No significant difference was found in linear measurements between thalassaemic patients and controls. The symphysis angle was significantly greater and the mandibular arc angle was significantly smaller in the total thalassaemic sample than the control individuals (P<0.001 and P=0.004, respectively). The difference in symphysis angle was significant in both hyperdivergent and normodivergent subjects (P=0.004 and P=0.002, respectively), whereas the difference in mandibular arc angle was only significant in the normodivergent subgroup P=0.001). CONCLUSIONS: The smaller mandibular arc angle in the thalassaemic sample suggests a more superior than posterior growth direction of condyles compared with healthy individuals. The difference in symphyseal angle represents inherent differences in chin morphology between thalassaemic subjects and controls.

Marriage Related Suicide Fatality Rates.

Objective: The present study aimed at estimating the case fatality rates of suicide acts in different marital status subgroups and to find interrelation with a population living in Bushehr province along the coastal region of the Persian Gulf coast in southwest of Iran. Method : In this analytical and observational study, suicidal data were gathered in 5 successive years (2008-2012) in the population of Bushehr. Data were extracted from suicide registration forms provided by the Psychiatric Health Unit of Ministry of Health. Questions mainly focused on demographic characteristics, including age, sex, literacy, residency, marital status, birth rank, the number of previous suicide attempts, and probable reasons of suicide, such as family conflicts or/and psychiatric complications. Fatality rates in different subgroups (male/female; married/unmarried; etc.) were compared and odds ratios were computed. The main limitation of this study was the lack of a specific grouping for those who cohabited together (Those who live together and have a sexual relationship without being married). The logistic regression model was used in data analysis. Results: Case mortality rates of suicides were found to be 3.5% for both sexes, 5.2% in males and 2.7% in females. However, among the single population, either divorced or widowed, the probability of death due to suicide was 3.5 times higher (95% CI: 1.5-2.9) as compared to the unmarried. Age as a confounding factor in fatality rates made a significant difference between married and unmarried people, and differences disappeared after adjusting for age. However, fatality rate was still higher in the widowed /divorced group compared to other groups even after adjusting for age. Conclusion: Fatality rate was higher in married people compared to the unmarried, however, after adjusting for age as a determinant factor, no significant difference was observed between the 2 groups. The highest death rate belonged to the age-specific widowed /divorced individuals as compared to all other marital status subgroups.

The relationship of general health, hardiness and spiritual intelligence relationship in Iranian nurses.

OBJECTIVE: Nursing is one of the stressful jobs that affect nurse's well-being. The aim of this study was to assess the relationship between spiritual intelligence, hardiness and well-being among Iranian nurses. METHODS: Samples of this cross- sectional study selected by Randomized stratified sampling, 125 nurses who have been working in different wards of Bushehr university hospitals. Data were collected using spiritual intelligence, hardiness, well-being and demographic characteristics questionnaires. Correlation, t-test, ANOVA, Tukey and regression analysis were applied. RESULTS: The results revealed a significant relationship between spiritual intelligence and hardiness, spiritual intelligence and well-being, Hardiness and well-being. It also showed that among the demographic characteristics (age, gender, working ward, marital status, job experiences, and education) working ward significantly correlated with spiritual intelligence. CONCLUSION: Improvement of spiritual intelligence and reinforcement of hardiness could help increase the well-being of nurses.