Being a front-line dentist during the Covid-19 pandemic: a literature review.

Coronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract and to a lesser extent the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The disease caused by the 2019 novel coronavirus (2019-nCoV) was called Covid-19 by the World Health Organization in February 2020. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered. Accordingly, dental practice can be a potential risk for dental staff, and there is a high risk of cross-infection. This article addresses all information collected to date on the virus, in accordance with the guidelines of international health care institutions, and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.

Transcutaneous Alar Rim Graft: An Effective Technique to Manage Alar Deformity.

Rhinoplasty is one of the most challenging cosmetic surgical procedures. Although different techniques have been introduced for grafting the osteocartilaginous part of the nose, the alar rim remains vastly unexamined. The form and strength of the alar rim are crucial in nasal tip esthetics and function. External valve collapse may occur owing to trauma, congenital weakness, or malposition of the lower lateral cartilage (LLC). Alar pinching and collapse are possible outcomes if there is any over-resection of the cephalic portion of the LLC. Traditionally, the closed technique creates a tunnel, dissected along an incision made in the soft triangle lining near the most anterior portion of the nostril rim. Alar rim grafts also can run through the marginal incision. The main goal of this study was to introduce a straightforward and effective technique for alar rim grafting, which can help surgeons with more precise placement. A total of 84 patients (61 female and 13 male patients) underwent transcutaneous alar rim grafting. After the alar base resection, a 2-mm stab incision was made in the bulk of the incised alar, using a No. 11 blade. Thereafter, a pocket was created through the alar fibrofatty tissue, which crossed the ala up to near the dome, and a cartilage graft was inserted in the tunnel. Transcutaneous alar rim grafting is a simple and effective approach to provide support for the external nasal valve and increase alar harmony. If the nasal tip analysis shows malpositioned LLC, alar flaring, an over-projected nasal tip, mild retraction, or contour asymmetries, this type of grafting may prove effective in primary or secondary rhinoplasty.

A mini review on the common methods of pain reduction before filler and botulinum toxin injection.

BACKGROUND: As the desire for beauty and youthful appearance has increased in recent years, cosmetic injections are getting more attention. However, patients discomfort during these injections is a challenging issue. AIM: This review explores common approaches to reduce pain and discomfort during cosmetic injections through the available literature. METHODS: The eligible studies through searching in PubMed have been entered to evaluate the common methods of pain reduction for cosmetic injections. RESULTS: According to reviewed studies, vibration, local anesthesia, and vapocoolant anesthesia are common methods applied in order to reduce pain and discomfort in patients. All of these methods are able to reduce pain through their affects on neuron fibers. CONCLUSION: It seems that all common approaches can result in some amount of pain reduction. Using a combination of these methods during injections, practitioners can successfully reduce the pain of injection.

Use of piezoelectric surgery and Er:YAG laser:which one is more effective during impacted third molar surgery?

BACKGROUND: Reduction in postoperative complications is of vital considerations in impacted third molar teeth surgery. The aim of this study was to compare postoperative complications of impacted third molar surgeries for bone removal using laser, piezoelectric equipment, and conventional rotary instruments. METHODS: To address the research purpose, the investigator designed the prospective double-blind clinical trial study. The sample size was determined 20 (40 teeth) by sampling formula in any kind of operation. The data of patients were obtained in the different periods in terms of pain, trismus, swelling, ecchymosis, and patient's satisfaction and then analyzed using SPSS 20 software via paired t test and Wilcoxon and McNemar's tests. RESULTS: The pain immediately after surgery and 2 days and 7 days after surgery was higher in the laser group. The swelling immediately after surgery was more in the laser group but not significant. The amount of mouth opening immediately after surgery and 2 days and 7 days after surgery was significantly lower in the laser group than in the piezosurgery group. The total duration of surgery and duration of osteotomy were significantly longer in the laser group. The patient's satisfaction from surgery with piezosurgery was more than that with laser, but this difference was not significant. CONCLUSION: Due to the rising demand for impacted wisdom tooth surgery, the present study suggests that hard tissue laser surgery and piezosurgery can clear the future of impacted molar surgery, and these approaches are more efficient in reducing postoperative complications compared to the conventional surgeries.

Stress distribution in maxillary first molar periodontium using straight pull headgear with vertical and horizontal tubes: A finite element analysis.

BACKGROUND: One of the most effective ways for distal movement of molars to treat Class II malocclusion is using extraoral force through a headgear device. The purpose of this study was the comparison of stress distribution in maxillary first molar periodontium using straight pull headgear in vertical and horizontal tubes through finite element method. MATERIALS AND METHODS: Based on the real geometry model, a basic model of the first molar and maxillary bone was obtained using three-dimensional imaging of the skull. After the geometric modeling of periodontium components through CATIA software and the definition of mechanical properties and element classification, a force of 150 g for each headgear was defined in ABAQUS software. Consequently, Von Mises and Principal stresses were evaluated. The statistical analysis was performed using T-paired and Wilcoxon nonparametric tests. RESULTS: Extension of areas with Von Mises and Principal stresses utilizing straight pull headgear with a vertical tube was not different from that of using a horizontal tube, but the numerical value of the Von Mises stress in the vertical tube was significantly reduced (P < 0/05). On the other hand, the difference of the principal stress between both tubes was not significant (P > 0/05). CONCLUSION: Based on the results, when force applied to the straight pull headgear with a vertical tube, Von Mises stress was reduced significantly in comparison with the horizontal tube. Therefore, to correct the mesiolingual movement of the maxillary first molar, vertical headgear tube is recommended.

A succinct review of botulinum toxin in dermatology; update of cosmetic and noncosmetic use.

Botulinum toxin A has a wide variety of clinical applications in medical and dermatologic sciences. Nowadays, researchers introduce some other indications for botulinum toxin in cosmetic and especially noncosmetic aspects of dermatology such as medical rhinoplasty, hypertrophic scar, chemical brow lift, supraciliary wrinkles, pompholix, eccrine angiomatosis, Hailey-Hailey, dermatochalasis, lichen simplex, nosthalgia parestetica, and granulosis rubra nasi. In this general overview of the use of botulinum toxin in dermatology, an extensive literature search was carried out to updates of all dermatology-oriented experiments and clinical trials on the mentioned aspect of botulinum toxin.