Influence of a novel suturing technique on periodontal health of mandibular second molar following impacted third molar surgery: a split-mouth randomized clinical trial.

BACKGROUND: Surgical extraction of the third molar is the most common surgical procedure in the oral surgery field and is associated with several complications. This study aimed to compare the effects of a newly presented suturing technique with the routine suture after surgical removal of the third molar on the postoperative complications. MATERIALS AND METHODS: This randomized clinical trial was designed as a split-mouth double-blinded investigation. Twenty patients were involved in the current study. After the surgical removal of the third molar, the new suturing technique was used to close the wound on one side of the patient randomly (case side), and the other side was sutured by the routine simple interrupted stitches (control side). Pain, edema, trismus, pocket depth, and the attachment loss of the distal of the second molar were assessed following the surgery. The data were statistically analyzed and compared between the sides. RESULTS: Pain and edema following the surgery in the control side were significantly less than in the case side. The pocket depth and the gingival attachment loss of the distal aspect of the second molar in the case side were significantly less than in the control side. No case of dry socket was observed in the case side. CONCLUSION: It seems that the newly presented suturing technique is able to keep the wound margins close to each other and may be helpful in reducing the periodontal complication of the second molar following the surgical removal of the impacted third molars.

Comparison of the Effect of Sling and Single Interrupted Sutures on Periodontal Parameters after Surgical Extraction of Impacted Mandibular Third Molars.

OBJECTIVES: This study aimed to compare the sling and single interrupted sutures regarding dehiscence, probing pocket depth (PPD), and clinical attachment loss (CAL) of adjacent second molars after surgical extraction of impacted or semi-impacted mandibular third molars. MATERIALS AND METHODS: This randomized clinical trial, with a split-mouth design, involved 25 patients with similar bilateral impaction of their mandibular third molars. The same surgeon performed surgical procedures, including a triangular flap and osteotomy. After surgical extraction of third molars, the distal surface of the flap was sutured with sling sutures on one side and single interrupted sutures on the other side. The allocation of suture type to the side of the jaw was random, and the patient was blinded to it. Patients were examined for dehiscence after 7 and 14 days. The PPD and CAL were recorded at the baseline and after 17 weeks. Data were analyzed using the Wilcoxon signed-rank test and generalized estimating equation (GEE) regression model. RESULTS: The sling suture was significantly superior regarding the improvement of PPD (P=0.041) and CAL (P=0.016). The dehiscence was significantly smaller in the single interrupted suture group 7 days postoperatively (P=0.059). This difference was not significant 14 says postoperatively (P=0.852). CONCLUSION: The results of this study show that the sling suture was superior to the single interrupted suture regarding PPD and CAL. However, the technique of suturing does not seem to have a significant long-term effect on wound dehiscence.

Decompression or Marsupialization; Which Conservative Treatment is Associated with Low Recurrence Rate in Keratocystic Odontogenic Tumors? A Systematic Review.

Various treatment modalities have been reported for keratocystic odontogenic tumors (KOT), with different recurrence rates. Marsupialization and decompression are two different conservative surgical techniques for the treatment of KOTs. This study aimed at comparing the recurrence rate between marsupialization and decompression in the treatment of KOTs with or without adjunctive treatments. This is a systematic review study. The research sources utilized were PubMed (MEDLINE), Google scholar, Ovid MEDLINE and Cochrane Library. The keywords which were selected based on Medical Subject Heading (MeSH) terms and PICOS criteria were odontogenic keratocyst, keratocyst odontogenic tumor AND marsupialization OR decompression OR cystectomy OR enucleation OR curettage. Statistical analyses were performed to compare the recurrence rate between marsupialization and decompression with or without adjunctive treatments, regarding various follow-up times. The number of subjects that underwent marsupialization was 182. There was a significant difference for the recurrence rate between the marsupialization and decompression groups without considering adjunctive treatments (p= 0.001). However, considering adjunctive treatments, there was no difference between marsupialization and the decompression groups (p= 0.18). It appears that decompression without any adjuvant treatment may have a lower recurrence rate than marsupialization. The recurrence rate was not different when enucleation or cystectomy was performed after decompression and marsupialization.

Mandibular Setback as an Adjunctive Strategy for Reconstruction after Tumor Resection: A Technical Note and Case Report.

Mandibular defects due to surgical resection of pathologies are common challenges for maxillofacial surgeons. In some clinical situations, alteration or combination of different surgical procedures is needed to reduce the size of bony defects and improve the success rate of bone grafts. In the current study, an 18-year-old female with a pathological lesion (ameloblastoma) in the mandible is presented. After tumor resection, bony defect reconstruction with autogenous bone graft was combined with a mandibular setback to facilitate the procedure. In this case, the simultaneous combination of orthognathic mandibular setback movement with tumor resection in a single surgical session helped to reduce the bony defect size. The adoption of this approach led to a decrease in the volume of graft harvesting and improved the success rate of the grafting procedure.

Bond Strength of an Orthodontic Adhesive Containing an Antibiofilm Agent (Octafluoropentyl Methacrylate).

OBJECTIVE: The objective of this study was to determine whether an adhesive containing antibiofilm agent octafluoropentyl methacrylate (OFPA) has an acceptable bond strength as an orthodontic adhesive. METHODS: Sixty human premolars were divided into four groups. In Groups 1 and 2, brackets were bonded to the teeth using experimental nanohybrid adhesive containing OFPA (ENH-OFPA) and Transbond XT (TXT) was used in Groups 3 and 4. In Groups 1 and 3, the samples were stored in water at 37°C for 24 h and in Groups 2 and 4 thermocycled between 5°C and 55°C. The entire samples were debonded utilizing a universal testing machine. Two-way ANOVA test employed to compare the shear bond strength (SBS) between two adhesives. Independent Student's t-test was utilized to compare the SBS at 24 h and followed thermocycling in each adhesive group. Adhesive remnant index (ARI) evaluated in different groups using Chi-square test. RESULTS: The mean value for SBS in ENH and TXT groups were 8.13 MPa and 8.10 MPa, respectively. The inference of P = 0.260 was observed and concluded to be nonsignificant for adhesives in terms of SBS. Statistically, differences that observed in SBS at 24 h and following thermocycling in TXT (P = 0.288) and ENH-OFPA (P = 0.145) groups did not consider to be significant. Comparing ARI scores with bracket failure mode resulted in no significant difference (P = 1) between two adhesives in both 24 h and following thermocycling. CONCLUSION: Adding OFPA does not compromise SBS of the experimented orthodontic adhesive.

Cervical Dentin Changes in Curved Root Canals after Using WaveOne and Reciproc Files with Full Rotation versus Reciprocation Movement: An Ex vivo Study.

AIM: The aim of the current study was to compare the effect of WaveOne and Reciproc files in reciprocation versus reverse full rotation movements on cervical dentin thickness by virtue of cone beam computed tomography (CBCT) analysis in curved mesial canals of mandibular first molars. METHODS: Mesiobuccal canals of 60 mandibular molars were randomly divided into 4 groups (n = 15): Group 1; WaveOne/Reciprocation, Group 2; WaveOne/Full-Rotation, Group 3; Reciproc/Reciprocation, and Group 4; Reciproc/Full-Rotation. Pre- and post-instrumented CBCT scans were prepared for assessment of cervical dentin thickness changes (2 mm, 4 mm below the highest point of the root furcation) in both groups. Data statistically analyzed using two-way ANOVA test. RESULTS: There was no statistically significant difference between four experimental groups in terms of remaining dentin thickness at 2 and 4 mm levels below the highest point of the furcation (P > 0.05). No separation of instruments occurred in any group. CONCLUSION: WaveOne and Reciproc files with two different motions have similar effects on cervical of root canals in terms of dentin thickness changes.

Comprehensive Treatment of Upper Lip Arteriovenous Malformation.

Arteriovenous malformations are uncommon congenital disorders in vascular development. They frequently involve craniofacial structures and result in a morphogenic abnormality with ominous arteriovenous shunting. We present a huge AVM of the upper lip in an 18-year-old patient who was successfully treated by the combination method of presurgical endovascular embolization and complete resection of the lesion. Subsequent surgical defect in upper lip, which involved more than two-third of the lip length, was reconstructed via Webster's modification of cheek advancement flap.

Nonsyndromic Isolated Temporal Bone Styloid Process Fracture.

INTRODUCTION: Fracture of the styloid process (SP) of the temporal bone is a rare traumatic injury in normal individuals who are not suffering from Eagle's syndrome. Diagnosis and management of this problem requires comprehensive knowledge about its signs and symptoms. This study aimed to present an isolated styloid process fracture in a nonsyndromic patient. CASE PRESENTATION: A 50-year-old male patient was referred to our department with a complaint of sore throat. However, presentation of the problem resembled the symptoms of temporomandibular joint disorder (TMD). Fracture of the SP of the temporal bone was detected on the radiographs. Conservative treatment was undertaken for the patient. The symptoms diminished after about four months. CONCLUSIONS: Physicians should be aware of the signs and symptoms of different pain sources to prevent misdiagnosis and maltreatment.

Diagnostic Factors of Odontogenic Cysts in Iranian Population: A Retrospective Study Over the Past Two Decades.

BACKGROUND: Early diagnosis of odontogenic cysts due to their silent progression is always a challenging problem for clinicians. OBJECTIVES: The current study aimed to evaluate the frequency of odontogenic cysts and related factors in a selected Iranian population. PATIENTS AND METHODS: The current cross-sectional study was conducted on 312 patients' recorded data in Taleghani Hospital, Tehran, Iran, from April 1993 to December 2013. All related data were extracted from the records and categorized in tables. The correlation between the variables was analyzed by either chi-square or multinominal logistic regression tests. The P values < 0.05 were considered significant. RESULTS: Evaluation of 312 patients' records (185 males and 127 females) with the mean age of 27.6 showed that Odontogenic Keratocyst (OKC) was the most common odontogenic cyst of all followed by the dentigerous cyst as the second most common lesion. Most of the patients were in the second or third decades of their lives, although there was no statistically significant age distribution. The finding of the current study showed that calcifying odontogenic cyst (COC) occurrence was significantly related to the history of trauma. Enucleation and curettage of the odontogenic cysts were the most common treatment plans of all. CONCLUSIONS: The current study showed that clinicians should consider the many factors associated with the occurrence of odontogenic cysts.

Giant Osteoma of Mandible Causing Dyspnea: A Rare Case Presentation and Review of the Literature.

Osteomas are benign slow growing tumors of bone. Tumors are usually asymptomatic until they attain remarkable size and cause asymmetry or dysfunction. In view of few reported cases of giant osteoma of mandible, this article presents a case of giant osteoma of left mandible in a 53-year old male causing dyspnea due to compression of air way space.

Microleakage of Four Dental Cements in Metal Ceramic Restorations With Open Margins.

BACKGROUND: Fixed prosthodontics is a routine dental treatment and microleakage is a major cause of its failure. OBJECTIVES: The aim of this study was to assess the marginal microleakage of four cements in metal ceramic restorations with adapted and open margins. MATERIALS AND METHODS: Sixty sound human premolars were selected for this experimental study performed in Tehran, Iran and prepared for full-crown restorations. Wax patterns were formed leaving a 300 µm gap on one of the proximal margins. The crowns were cast and the samples were randomly divided into four groups based on the cement used. Copings were cemented using zinc phosphate cement (Fleck), Fuji Plus resin-modified glass ionomer, Panavia F2.0 resin cement, or G-Cem resin cement, according to the manufacturers' instructions. Samples were immersed in 2% methylene blue solution. After 24 hours, dye penetration was assessed under a stereomicroscope and analyzed using the respective software. Data were analyzed using ANOVA, paired t-tests, and Kruskal-Wallis, Wilcoxon, and Mann-Whitney tests. RESULTS: The least microleakage occurred in the Panavia F2.0 group (closed margin, 0.18 mm; open margin, 0.64 mm) and the maximum was observed in the Fleck group (closed margin, 1.92 mm; open margin, 3.32 mm). The Fleck group displayed significantly more microleakage compared to the Fuji Plus and Panavia F2.0 groups (P < 0.001) in both closed and open margins. In open margins, differences in microleakage between the Fuji Plus and G-Cem as well as between the G-Cem and Panavia F2.0 groups were significant (P < 0.001). In closed margins, only the G-Cem group displayed significantly more microleakage as compared to the Panavia F2.0 group (P < 0.05). Paired t-test results showed significantly more microleakage in open margins compared to closed margins, except in the Fuji Plus group (P = 0.539). CONCLUSIONS: Fuji Plus cement exhibited better sealing ability in closed and open margins compared to G-Cem and Fleck cements. When using G-Cem and Fleck cements for full metal ceramic restorations, clinicians should try to minimize marginal gaps in order to reduce restoration failure. In situations where there are doubts about perfect marginal adaptation, the use of Fuji Plus cement may be helpful.