NIR irradiation of human buccal fat pad adipose stem cells and its effect on TRP ion channels.

The effect of near infrared (NIR) laser irradiation on proliferation and osteogenic differentiation of buccal fat pad-derived stem cells and the role of transient receptor potential (TRP) channels was investigated in the current research. After stem cell isolation, a 940 nm laser with 0.1 W, 3 J/cm2 was used in pulsed and continuous mode for irradiation in 3 sessions once every 48 h. The cells were cultured in the following groups: non-osteogenic differentiation medium/primary medium (PM) and osteogenic medium (OM) groups with laser-irradiated (L +), without irradiation (L -), laser treated + Capsazepine inhibitor (L + Cap), and laser treated + Skf96365 inhibitor (L + Skf). Alizarin Red staining and RT-PCR were used to assess osteogenic differentiation and evaluate RUNX2, Osterix, and ALP gene expression levels. The pulsed setting showed the best viability results (P < 0.05) and was used for osteogenic differentiation evaluations. The results of Alizarin red staining were not statistically different between the four groups. Osterix and ALP expression increased in the (L +) group. This upregulation abrogated in the presence of Capsazepine, TRPV1 inhibitor (L + Cap); however, no significant effect was observed with Skf96365 (L + Skf).

Comparison of gingival depigmentation with Er,Cr:YSGG laser and surgical stripping, a 12-month follow-up.

Gingival melanin hyperpigmentation is an esthetic concern for many individuals. In this study, we compared the standard surgical removal method with two different Er,Cr:YSGG laser settings in order to find the best treatment method. In 33 dental arches, the following three treatment groups were comparatively evaluated: (1) surgical stripping, (2) removal with laser setting 1 (4.5 W, 50 Hz, 100% water, 80% air, 60 µs, 800 µm Tip; MZ8), and (3) laser setting 2 (2.5 W, 50 Hz, 20% water, 40% air, 700 µs, 800 µm Tip; MZ8). We comparatively evaluated pain, patient satisfaction and wound healing, treatment time, and the amount of bleeding. Re-pigmentation was evaluated after 1 and 12 months by Hedin and Dummet pigmentation scores. Laser setting 1 had the best results regarding pain and patient satisfaction, although not statistically significant (P > 0.05). Wound healing results were better using lasers compared to surgical stripping (P < 0.05). Laser setting 1 was a faster procedure with mild amounts of bleeding. The least amount of bleeding was seen with laser setting 2. After 1 month, only two cases of the laser setting 2-treated areas showed an isolated pigmented area in the papilla; at 12 months, the mean Hedin indexes were still less than 2 and mean Dummett index less than 1 in all treatment techniques, with the lowest scores seen in the laser setting 1 sites. Based on our results, Er,Cr:YSGG laser can be more convenient for gingival depigmentation compared to surgical blade. Although not statistically significant, laser setting 1 with shorter pulse duration and higher water spray showed better overall results. However, laser setting 2, with longer pulse duration and less water spray, resulted in better coagulative effects and can be used to control bleeding wherever necessary in clinical practice.

Three-Dimensional Finite Element Analysis of Stress Distribution and Displacement of the Maxilla Following Surgically Assisted Rapid Maxillary Expansion with Tooth- and Bone-Borne Devices.

OBJECTIVES: The aim of this study was to investigate the displacement and stress distribution during surgically assisted rapid maxillary expansion under different surgical conditions with tooth- and bone-borne devices. MATERIALS AND METHODS: Three-dimensional (3D) finite element model of a maxilla was constructed and an expansion force of 100 N was applied to the left and right molars and premolars with tooth-borne devices and the left and right of mid-palatal sutures at the first molar level with bone-borne devices. Five computer-aided design (CAD) models were simulated as follows and surgical procedures were used: G1: control group (without surgery); G2: Le Fort I osteotomy; G3: Le Fort I osteotomy and para-median osteotomy; G4: Le Fort I osteotomy and pterygomaxillary separation; and G5: Le Fort I osteotomy, para-median osteotomy, and pterygomaxillary separation. RESULTS: Maxillary displacement showed a gradual increase from G1 to G5 in all three planes of space, indicating that Le Fort I osteotomy combined with para-median osteotomy and pterygomaxillary separation produced the greatest displacement of the maxilla with both bone- and tooth-borne devices. Surgical relief and bone-borne devices resulted in significantly reduced stress on anchored teeth. CONCLUSION: Combination of Le Fort I and para-median osteotomy with pterygomaxillary separation seems to be an effective procedure for increasing maxillary expansion, and excessive stress side effects are lowered around the anchored teeth with the use of bone-borne devices.

A 7-year study of 1,278 patients with maxillofacial trauma and cerebrospinal fluid leak.

BACKGROUND: A number of patients with facial fractures have cerebrospinal fluid (CSF) leak that may result in meningitis and other central nervous system complications. Commonly, CSF leak occurs following trauma, but the etiology and pattern of this disorder are different from region to region. This study aims to evaluate the distribution of CSF leak in patients with maxillofacial fractures in Isfahan province, Iran. PATIENTS AND METHODS: In this retrospective cross-sectional study, 1,287 medical files of patients admitted to a medical center with head and face injuries were evaluated during a 7-year period (2004-2010). Data was obtained using descriptive analysis. RESULTS: Of the 1,278 patients with head and maxillofacial fractures, 16 (1.25 %) males and one (0.07 %) female had CSF leak; all these cases had skull base fracture. Of these, 52.9 % had maxillary fracture, 23.5 % nasal fracture, 41.1 % orbital fracture, 11.7 % mandibular fracture, 23.5 % frontal fracture, and 41.1 % had more than one site of fracture. 58.8 % had rhinorrhea and 41.2 % otorrhea. Of all these patients with CSF leak, 8 (47 %), 2 (11.8 %), and 7 (41.2 %) cases were treated spontaneously, using lumbar drain placement, and by surgical intervention, respectively. CONCLUSIONS: Cerebrospinal fluid leak was observed most frequently in patients with fracture in the zygomatic and maxillary bone, and mostly exhibited itself as rhinorrhea and/or otorrhea. All cases with CSF leak had skull base fracture as well. However, post-traumatic CSF leaks are uncommon and are generally treated without surgical intervention (59 %). Distribution of CSF leak varies from one region to another and knowing this fact helps to manage the injury and prevent the complications.

Can ambient orange fragrance reduce patient anxiety during surgical removal of impacted mandibular third molars?

PURPOSE: To investigate whether ambient orange fragrance, compared with no fragrance, can reduce patient anxiety before and during surgical removal of an impacted mandibular third molar. MATERIALS AND METHODS: In the present randomized clinical trial, the patients who required extraction of an impacted mandibular third molar and fulfilled the predetermined criteria were included. A dental anxiety scale (DAS) questionnaire was used to determine the anxiety level of the patients before surgery. Only patients with moderate and high anxiety levels (DAS scale ≥ 9 to ≤ 14) were included. The predictor variable was fragrance exposure. The fragrance group was exposed to orange fragrance, and the control group was exposed to no fragrance. The outcome variables were physiologic measures related to anxiety, including the mean blood pressure, respiratory rate, and pulse rate. The physiologic vital changes were determined before and during the surgical procedure. The data were analyzed using the independent t test, χ(2) test, and Mann-Whitney U test (Statistical Package for Social Sciences, version 16; α = 0.05). RESULTS: A total of 56 patients fulfilled the inclusion criteria (fragrance group, 19 males and 9 females; no-fragrance group, 12 males and 16 females). Before entering the waiting room, the patients' vital signs were recorded twice. No significant differences were found between the 2 groups. The mean blood pressure, pulse rate, and respiratory rate were significantly lower in the fragrance group during surgery (from sitting in the dental chair to the end of surgery; P < .05). CONCLUSIONS: The results of our study have shown that orange fragrance is effective in reducing the anxiety related to surgical removal of an impacted mandibular third molar.

Maxillary repositioning according to Frankfort horizontal plane during orthognathic surgery.

CONTEXT: There are a lot of disagreements among surgeons over controlling the maxillary position during orthognathic surgery. AIM: To investigate maxillary repositioning according to Frankfort horizontal plane in orthognathic surgery. MATERIALS AND METHODS: Fourteen patients were selected who were submitted to maxillary or bimaxillary surgery. Maxillary model surgery was performed based on the treatment planning and an intermediate splint was made. The surgical technique in this study was based on maxillary osteotomy according to the findings of the model surgery, in a manner that the osteotomy line was parallel to the Frankfort horizontal plane. Intermediate splint was used for repositioning of the maxilla in the new position and the vertical position of that was determined according to external reference point and fixed on this position. The upper central incisor designed from prediction tracing and post-operative cephalometry on the first tracing. The new position of maxilla was evaluated horizontally and vertically. STATISTICAL ANALYSIS USED: A paired t-test was used to compare the predicted maxillary position and the actual position. Association between these two groups of variables was evaluated with Pearson correlation. RESULTS: The mean difference between the maxillary planned position and post-operative cephalometric radiography varied between 0.3 mm and 0.9 mm vertically (P value = 0.315) and 0.0 mm and 0.9 mm horizontally (P value = 0.034). The averages of horizontally and vertically observed changes were 0.3 mm and 0.17 mm respectively (P < 0.001). CONCLUSION: Good surgical accuracy in repositioning of the maxilla can be achieved according to Frankfort horizontal plane during the surgery. By eliminating the ramping effect the accuracy of surgery increases.