The Relationship Between Serum Level of Vitamin D3 and Osseointegration Around the Dental Implant.

At present, dental implants are used more than before, and their high success rate is attributed to sufficient osseointegration, which depends on prosthetic-, implant-, and patient-related factors. The quality and quantity of bone and the host response are the main patient-related factors. Vitamin D3 affects bone metabolism by stimulating both osteoclasts and osteoblasts. This study aimed to review the human studies on the efficacy of vitamin D3 for dental implant osseointegration. Search of the literature yielded only 4 studies on human models, of which 2 showed the optimal efficacy of vitamin D3 for dental implant osseointegration, whereas the remaining 2 did not report any positive effect. However, this finding may be related to the small sample size of the vitamin D3-deficient group, which can compromise statistical analyses. In conclusion, vitamin D3 seems to be effective for dental implant osseointegration, although further research is required on human models.

Developing a new intelligent system for the diagnosis of oral medicine with case-based reasoning approach.

OBJECTIVE: Since the clinical manifestations of many oral diseases can be quite similar despite the wide variety in etiology and pathology, the differential diagnosis of oral diseases is a complex and challenging process. Intelligent system for differential diagnosis of oral medicine using the artificial intelligence (AI) capabilities helps specialists in achieving differential diagnosis in a wide range of oral diseases. MATERIALS AND METHODS: First, the essential data elements to design and develop an intelligent system were identified in a cross-sectional descriptive study. The case-based reasoning method was selected to design and implement the system, which consists of three stages: collect the clinical data, construct the cases database, and case-based reasoning cycle. The problem is solved by CBR method in a cycle consisting of four main stages of retrieval, reuse, review, and retention. The evaluation process was conducted in a pilot-based way through the evaluation of the system's performance in the clinical setting and also using the usability assessment questionnaire. RESULTS: The output of the present project is a web-based intelligent information system, which is developed using the Visual Studio 2015 software. The database of this system is the Microsoft SQL Server version 2012, which has been programmed based on Net framework (version 4.5 or higher) using Visual Basic language. The results of the system evaluation by specialists in clinical settings showed that the system's diagnosis power in different aspects of the disease is influenced by their prevalence and incidence. CONCLUSIONS: System development using the artificial intelligence capabilities and through the clinical data analysis has potential to help specialists to determine the best diagnostic strategy to achieve a differential diagnosis of a wide range of oral diseases. The results of evaluation present the potential of the system to improve the quality and efficiency of patient care.

In vitro Effect of 810 nm and 940 nm Diode Laser Irradiation on Proliferation of Human Gingival Fibroblasts and Expression of Procollagen Gene.

Factors promoting fibroblast proliferation and collagen synthesis can subsequently enhance wound healing. This study aimed to assess the effect of 810 and 940 nm diode laser on fibroblast proliferation and procollagen gene expression. In this study, human gingival fibroblasts were cultured in Dulbecco's modified Eagle's medium and underwent 810 and 940 nm diode laser irradiation once, twice, thrice and four times at 1, 3, 5 and 7 days after culture. The methyl thiazolyl tetrazolium assay was performed to assess the proliferation while the real-time polymerase chain reaction was performed to assess the expression of procollagen gene at the mRNA level. We applied two-way ANOVA and Tukey's test for analysis. Wavelength had no significant effect on the proliferation of gingival fibroblasts, but increasing the number of irradiation sessions of both wavelengths increased the proliferation of human gingival fibroblasts. Significant differences were noted in the number of human gingival fibroblasts between groups irradiated 1 and 4 and also 2 and 4 times. Procollagen gene was well expressed in all groups but its expression was significantly higher in 940 nm laser group after four irradiation cycles. Four times radiation of 940 nm laser seems to be more effective than all others.

Comparison of clinical efficacy of temporalis myofascial flap and dermal graft as interpositional material in treatment of temporomandibular joint ankylosis.

UNLABELLED: Temporomandibular joint (TMJ) ankylosis is a very distressing structural condition. Interpositional arthroplasty has become the acceptable standard for the primary surgical management of TMJ ankylosis. Up to now, diverse interpositional materials have been proposed in this regard, with especial advantages and limitations. The temporalis muscle and facial flap, as well as the dermal graft, are among the most popular ones. This study aimed to compare the short-term clinical consequences between these 2 interpositional materials in patients with operated TMJ ankylosis. MATERIALS AND METHODS: Twenty patients with TMJ ankylosis were randomized in 2 age- and sex-matched 10-patient groups and received either a temporalis muscle and facial flap or a dermal graft as the interpositional material. The maximal incisal opening (MIO) and the amount of lateral excursion (LE) were measured before and 3 months after surgery, and the mandibular deviation (MD) at the mouth opening 3 months after operation was compared between the 2 groups. RESULTS: Twenty patients were enrolled in the study. The presurgical MIO and LE were not significantly different between the 2 groups. Three months after the operation, evaluation of the patients did not reveal a significant difference considering the amount of the MIO, LE, or MD. The mentioned parameters were significantly improved 3 months after the operation in both groups. CONCLUSIONS: The interpositional arthroplasty in TMJ ankylosis patients using either a temporalis muscle and facial flap or a dermal graft would yield a comparable and almost satisfactory clinical outcome.

Comparing the effect of 3 orthognathic surgical methods on the mandibular range of movement.

BACKGROUND: Mandibular setback for the treatment of mandibular prognathism is a common orthogenetic surgical procedure carried out using various intraoral and extraoral methods. Reduced mandibular movement range (MMR) is one of the common complications of this surgery. OBJECTIVES: The aim of this study was to compare the reduction of MMR after 3 surgical procedures including sagittal split osteotomy (SSO), intraoral vertical ramus osteotomy (IVRO), extraoral vertical ramus osteotomy (EVRO). METHODS: In this clinical trial, 150 patients with mandibular prognathism were divided into 3 groups of 50 patients. In the first group, mandibular setback was performed using SSO; in the second group, we used IVRO, and EVRO was the method used in the third group. In each group, before and 3 months after the surgery, maximum interincisal opening and the range of right and left lateral and protrusive movements were measured and compared. RESULTS: Although the mean amount of MMR reduced in all the groups, it was not equal in all the groups. Sagittal split osteotomy and the EVRO resulted in the most and least reduction of MMR, respectively. CONCLUSIONS: Reduced MMR is one of the complications of SSO, IVRO, and EVRO; however, SSO resulted in the most and EVRO in the least effect on limitation of movement after surgery.

A Comparative Study of Low-Level Laser Therapy and Transcutaneous Electrical Nerve Stimulation as an Adjunct to Pharmaceutical Therapy for Myofascial Pain Dysfunction Syndrome: A Randomized Clinical Trial.

OBJECTIVES: Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular disorders. Because of the multifactorial nature of the problem, its management usually involves several treatment modalities to maximize their synergistic effects. This randomized clinical trial aimed to assess the efficacy of low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) as an adjunct to pharmaceutical therapy for treatment of MPDS. MATERIALS AND METHODS: This clinical trial evaluated 108 MPDS patients. First, the initial pain intensity of patients was determined using a visual analogue scale (VAS). The first phase of the study included education, awareness, self-care, behavior and relaxation therapy. After 1 month, the pain score was measured again using VAS. Patients who acquired a pain score >1 were divided into three groups of LLLT with diode (GAAlAr) laser with 0.2 W power, TENS, and control, using block randomization. All groups received 10 mg fluoxetine once daily, 0.25 mg clonazepam once daily and 10 mg baclofen three times a day. ANOVA was used to compare the recovery rate of the three groups. RESULTS: Pain in the trapezius muscle and pain on mouth opening resolved faster in the laser + medication group. The recovery rate was faster in the mean muscle pain, general pain reported by patients, pain in the masseter and pterygoid muscles and pain and limitation in lateral movements in both laser + medication and TENS groups. CONCLUSION: Combination of LLLT and TENS with medication accelerated pain relief and resolved movement restrictions in MPDS patients.(IRCT registration number: IRCT201411113144N4).

Evaluation of levels of knowledge about etiology and symptoms of oral cancer in southern Iran.

BACKGROUND: Knowledge regarding risk factors and primary signs of oral cancer in the general population can help them to avoid risky behaviour and seek timely advice from a physician. The aim of this study was to survey adult knowledge about risk factors and signs of oral cancer in Shiraz Dental University. MATERIALS AND METHODS: In this descriptive cross-sectional study using an investigator-made questionnaire, 783 adults who were referred to Shiraz Dental University participated. Questionnaire data were analyzed by ANOVA and T-test. RESULTS: The results showed that 32.3% of participants were aware of oral cancer and gained their knowledge from the media. The risk factors mentioned by these participants was as follows: sunlight 30.8%, hot and peppery food 40.7%, alcoholic drinks 47.4% and smoking 73.6% (there was significant relationship for drinking alcohol and gender, education and times of using dental service, p<0.05). They also mentioned the primary signs of oral cancer as follows: red patch without pain 27.8%, white patch without pain 13.5% and prolong scarring without pain 56.7% (there was significant relationship between these three signs and education and times of using dental service, p<0.05). The mean knowledge about the risk factors and signs of oral cancer were 1.94 from 5 with 1.14 standard deviation and 0.96 from 3 with 0.93 standard deviation. CONCLUSIONS: The observed low level of knowledge of people regarding both risk factors and signs of oral cancer emphasizes the need for more efforts to be made about the above mentioned issues by the media.

The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection.

BACKGROUND AND AIMS: Dentists administer thousands of local anesthetic injections every day. Injection to a highly vascular area such as pterygomandibular space during an inferior alveolar nerve block has a high risk of intravascular needle entrance. Accidental intravascular injection of local anesthetic agent with vasoconstrictor may result in cardiovascular and central nervous system toxicity, as well as tachycardia and hypertension. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections. MATERIALS AND METHODS: Three experienced oral and maxillofacial surgeons performed 359 inferior alveolar nerve block injections using direct or indirect techniques, and reported the results of aspiration. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases. Data were analyzed using t-test. RESULTS: 15.3% of inferior alveolar nerve block injections were aspiration positive. Intravascular needle entrance was seen in 14.2% of cases using direct and 23.3% of cases using indirect block injection techniques. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between direct or indirect block injection techniques (P = 0.127) and between right and left injection sites (P = 0.778). CONCLUSION: According to our findings, the incidence of intravascular needle entrance during inferior alveolar nerve block injection was relatively high. It seems that technique and maneuver of injection have no considerable effect in incidence of intravascular needle entrance.

Central giant cell granuloma of the posterior maxilla: a case report.

Central giant cell granuloma (CGCG), formerly called giant cell reparative granuloma, is a non-neoplastic proliferative lesion of unknown etiol-ogy. It occurs most commonly in the mandible. The case reported here resembled a wide variety of conditions that led to a misdiagnosis both on clinical and radiographic examinations but was histopathologically diagnosed as CGCG. We describe a case of CGCG arising from the poste-rior maxilla to highlight the importance of histo-pathology in the diagnosis of this enigmatic le-sion.