Department Of Oral Maxillofacial Surgery Research Articles

Tooth Extraction using Vertical, Conventional, and Surgical Techniques in Sebha Dental College: A Descriptive “Cross-sectional Study”

Objective: This study aimed to describe different techniques (vertical, conventional, and surgical) used in routine exodontia as well as the most teeth extracted per procedure. Methods: A descriptive cross-sectional study using data collected at the Department of Oral Maxillofacial Surgery, the Faculty of Dentistry, Sebha University, from March to December 2021, included 509 participants. The patient's age and gender, techniques of extraction, and tooth type were recorded. Results: The study included 509 participants aged 16 to 90. About 38.1% of the participants were male, and 61.9% were female. The conventional technique was the most performed (70.0%), followed by vertical (elevator) (26%), and then the surgical technique. The third molar was the most common tooth extracted by conventional technique. The vertical approach was the most successful for single and multirooted teeth. Conclusion: The result of this study suggests that the vertical extraction method may be used with a high success rate for the extraction of teeth unsuitable for conventional techniques. Therefore, the effectiveness of the exodontia technique is influenced by root morphology, position, and type of tooth.

Patient Satisfaction among Different Age Groups Who Underwent Aesthetic and Functional Rhinoplasty in Sulaymaniyah

Background: Cosmetic surgery is performed to improve an individual’s satisfaction with their appearance and to improve their psychological health by improving self-confidence. Our study aimed to evaluate patient satisfaction regarding nose appearance and function. Objective: To evaluate the satisfaction of patients who underwent rhinoplasty by using the Rhinoplasty outcomes evaluation (ROE) questionnaire and to determine the impact of patient age on the outcomes. Patients and Methods: A prospective study of 90 patients who underwent open rhinoplasty procedures, including other nasal procedures like septoplasty or turbinoplasty, in both private and public Sulaimani Surgical Teaching Hospitals (department of oral maxillofacial surgery) from October 2020 to March 2022. The Rhinoplasty Outcomes Evaluation (ROE) questionnaire was used for esthetic and functional assessment. Results before and after surgery were compared. Results: In this study, ninety patients participated by completing the questionnaires and the follow-up period six months postoperatively. The main reasons for rhinoplasty in our patients were: esthetic 50% (n=45), functional 8.9 % (n=8), and a combination of both esthetic and functional in 41.1% (n=37) of patients. There was a significant overall increase in patient satisfaction with functional and esthetic outcomes post-surgery (p < 0.01), and there was no significant difference among different age groups postoperatively (p > 0.01) based on ROE. Conclusion: There was a significant overall increase in patients’ satisfaction with functional and aesthetic outcomes post-surgery. There was no significant difference in satisfaction among different age groups. Keywords:Rhinoplasty, Esthetic, Patient satisfaction, Questionnaire, Functional assessment

Patient Satisfaction among Different Age Groups Who Underwent Aesthetic and Functional Rhinoplasty in Sulaymaniyah

Background: Cosmetic surgery is performed to improve an individual’s satisfaction with their appearance and to improve their psychological health by improving self-confidence. Our study aimed to evaluate patient satisfaction regarding nose appearance and function.
 Objective: To evaluate the satisfaction of patients who underwent rhinoplasty by using the Rhinoplasty outcomes evaluation (ROE) questionnaire and to determine the impact of patient age on the outcomes.
 Patients and Methods: A prospective study of 90 patients who underwent open rhinoplasty procedures, including other nasal procedures like septoplasty or turbinoplasty, in both private and public Sulaimani Surgical Teaching Hospitals (department of oral maxillofacial surgery) from October 2020 to March 2022. The Rhinoplasty Outcomes Evaluation (ROE) questionnaire was used for esthetic and functional assessment. Results before and after surgery were compared.
 Results: In this study, ninety patients participated by completing the questionnaires and the follow-up period six months postoperatively. The main reasons for rhinoplasty in our patients were: esthetic 50% (n=45), functional 8.9 % (n=8), and a combination of both esthetic and functional in 41.1% (n=37) of patients. There was a significant overall increase in patient satisfaction with functional and esthetic outcomes post-surgery (p < 0.01), and there was no significant difference among different age groups postoperatively (p > 0.01) based on ROE.
 Conclusion: There was a significant overall increase in patients’ satisfaction with functional and aesthetic outcomes post-surgery. There was no significant difference in satisfaction among different age groups.

Thyroglossal duct cysts, a case series in Oral Maxillofacial surgery Department of G. Papanikolaou Hospital of Thessaloniki.

Introduction A thyroglossal duct cyst (TGDC) is the most frequent embryonic-origin cervical mass situated in the anterior of the neck. This anomaly occurs in approximately in 7% of people, usually in children. Mainly it presents as a mobile, non-tender, usually inferior to the hyoid bone (~75% of patients) painless swelling but it can be painful when accompanied by local inflammation. The recommended management for TGDC is the Sistrunk procedure, ensuring removal of the full length of the duct remnants by including the midportion of the hyoid bone. Case series presentation The aim of this paper is to present a case series of five patients who were operated in the OMFS department of Papanikolaou Hospital of Thessaloniki within 2.5 years (9/2019-2/2022). The patients were four males (80%) (mean age 50.5 years, outliers 36 and 71years) and one (20%) 63 years old female. All of them presented with a mobile painless neck swelling and they had normal thyroid function. All patients underwent a surgical excision of thyroglossal cyst including the midportion of hyoid bone (Sistrunk procedure). None of them presented a recurrence. Conclusion A TGDC, although it is rare in adults as it is typically diagnosed and treated surgically in childhood, it can be complicated with inflammation. In any case, surgical resection and histological confirmation are required as cases of malignant lesion have been reported.

Craniofacial morphology and growth in Muenke syndrome, Saethre-Chotzen syndrome, and TCF12-related craniosynostosis

ObjectivesTo determine whether the midface of patients with Muenke syndrome, Saethre-Chotzen syndrome, or TCF12-related craniosynostosis is hypoplastic compared to skeletal facial proportions of a Dutch control group.Material and methodsWe included seventy-four patients (43 patients with Muenke syndrome, 22 patients with Saethre-Chotzen syndrome, and 9 patients with TCF12-related craniosynostosis) who were referred between 1990 and 2020 (age range 4.84 to 16.83 years) and were treated at the Department of Oral Maxillofacial Surgery, Special Dental Care and Orthodontics, Children’s Hospital Erasmus University Medical Center, Sophia, Rotterdam, the Netherlands. The control group consisted of 208 healthy children.ResultsCephalometric values comprising the midface were decreased in Muenke syndrome (ANB: β = –1.87, p = 0.001; and PC1: p < 0,001), Saethre-Chotzen syndrome (ANB: β = –1.76, p = 0.001; and PC1: p < 0.001), and TCF12-related craniosynostosis (ANB: β = –1.70, p = 0.015; and PC1: p < 0.033).ConclusionsIn this study, we showed that the midface is hypoplastic in Muenke syndrome, Saethre-Chotzen syndrome, and TCF12-related craniosynostosis compared to the Dutch control group. Furthermore, the rotation of the maxilla and the typical craniofacial buildup is significantly different in these three craniosynostosis syndromes compared to the controls.Clinical relevanceThe maxillary growth in patients with Muenke syndrome, Saethre-Chotzen syndrome, or TCF12-related craniosynostosis is impaired, leading to a deviant dental development. Therefore, timely orthodontic follow-up is recommended. In order to increase expertise and support treatment planning by medical and dental specialists for these patients, and also because of the specific differences between the syndromes, we recommend the management of patients with Muenke syndrome, Saethre-Chotzen syndrome, or TCF12-related craniosynostosis in specialized multidisciplinary teams.

Esthetic and Functional Assessment of Sixty Five Patients who Underwent Rhinoplasty (A maxillofacial surgeon’s experience)

Objective: This study aims to assess patient satisfaction according to the shape and function of the nose using a rhinoplasty outcome evaluation (ROE) questionnaire, pre, and post rhinoplasty procedure. &#x0D; Methods: A prospective study of sixty-five rhinoplasty patients who underwent open rhinoplasty procedures, including other nasal procedures like septoplasty or turbinoplasty in Sulaimani Surgical Teaching Hospital, department of oral maxillofacial surgery. The Rhinoplasty Outcome Evaluation (ROE) questionnaire was used for esthetic and functional assessment. &#x0D; Results: In this study, sixty-five patients participated by completing the questionnaires and the follow-up period. The main reasons for rhinoplasty in our patients were: esthetic 55.4% (n=36), functional 3.1 %( n=2), and a combination of both in 41.5% (n=27) patients. Although there were no statistically significant gender differences for outcomes of rhinoplasty, statistically significant improvements were identified between the preoperative and postoperative scores for both genders. In the preoperative stage, patients recorded worse scores for anxiety and insecurity (p &lt; 0.05). There were no differences in gender, age, cause, or literacy level in the mean postoperative scores (p &gt; 0.05). &#x0D; Conclusions: The present study suggests that the rhinoplasty cases carried out by maxillofacial surgeons have high satisfaction rates regarding final esthetic and functional results. The rhinoplasty results have a great psychological impact on the patients’ lives.

Evaluation of dental maturity in Muenke syndrome, Saethre-Chotzen syndrome, and TCF12-related craniosynostosis.

ObjectivesTo determine whether dental maturity (dental development) was delayed in patients with Muenke syndrome, Saethre-Chotzen syndrome, and TCF12-related craniosynostosis, compared with a Dutch control group without syndromes.Materials and methodsThis study included 60 patients (38 patients with Muenke syndrome, 17 patients with Saethre-Chotzen syndrome, and 5 with TCF12-related craniosynostosis), aged 5.8–16.8 years that were treated at the Department of Oral Maxillofacial Surgery, Special Dental Care, and Orthodontics, in Sophia Children’s Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands. Dental age was calculated according to Demirjian’s index of dental maturity. The control group included 451 children without a syndrome.ResultsCompared with the control group, dental development was delayed by an average of one year in 5- to 8-year-old patients with Muenke syndrome (P = 0.007) and in 8- to 10-year-old patients with Saethre-Chotzen syndrome (P = 0.044), but not in patients with TCF12-related craniosynostosis.ConclusionsOur results indicated that dental development was delayed by one year, on average, in patients with Muenke syndrome and Saethre-Chotzen syndrome, compared with a Dutch control group without syndromes.ImplicationsOur findings have improved the understanding of dental development in patients with Muenke and Saethre-Chotzen syndrome. These results can provide guidance on whether the orthodontist needs to consider growth disturbances related to dental development.

Sialendoscopy: A Four-Year Single Center Experience

Sialendoscopy is a relatively new technique designed to diagnose and treat benign obstructive salivary gland disease using a minimally invasive approach. The purpose of this study is to present our experiences regarding the use of sialendoscopy in the form of a 4-year, single center experience and to demonstrate its usefulness in oral and maxillofacial practice. We collected data on patients who underwent sialendoscopy at the Oral-Maxillofacial Surgery Department of UZ Leuven between November 2015 and August 2019, including age, gender, sex, initial clinical presentation and symptoms, gland involvement, type of diagnostic investigations, diagnosis, localization of the obstruction, therapeutic intervention, surgeon, type of anesthesia, materials used, complications, secondary treatment, duration of follow-up, and outcome. Statistical analyses were performed, chi-squared was used to compare the different variables with P < .05 being considered significant. During the 4-year timeframe, a total of 44 patients (31 female, 13 male) underwent sialendoscopy in a total of 47 procedures. The average age at time of sialendoscopy was 47.4 years. The most frequent cause of obstruction was sialolithiasis (70%). Cone-beam computed tomography (CBCT) was the most accurate preoperative investigation for the diagnosis of lithiasis (57%). Symptom improvement occurred in 57.9% of patients, with a complication rate of 11%. None of the complications were permanent. Sialendoscopy can be considered safe and effective for both the diagnosis and treatment of benign obstructive salivary gland disease, with a useful place in oral and maxillofacial surgical practice. We recommend the inclusion of CBCT and/or ultrasound in the diagnostic workup prior to endoscopy.

Frequency of Satisfactory Outcome after Surgical Management in Isolated Orbitozygomatic Fractures

Objective: To determine the frequency of satisfactory outcome after Surgical Management in Isolated Orbitozygomatic fractures.&#x0D; Study Design: Case series Descriptive study.&#x0D; Place and Duration: Oral Maxillofacial Surgery Department of Dentistry, Liaquat University of Medical Health Science, Jamshoro ,from 11thAugust 2020 to10thMarch 2021.&#x0D; Methodology: Total 87 patients of Isolated Orbitozygomatic fractures with Enophthalmos and or Diplopia were included. All patients were operated, open reduction and internal fixation of zygoma at 3 points. Postoperatively Diplopia was ruled out by a range of eye movements and Enophthalmos was measured by Hertel Exophthalmometer. Final assessment was done after six weeks postoperatively. Descriptive statistics were calculated. Stratification was done and poststratification chi square test or t-test was applied. P-value ≤0.05 was considered as significant.&#x0D; Results: There was 85.1% male and 14.9% female. Mean age was 33.45±7.93 years. 73.6% were classified as ASA-I and 26.4% were classified as ASA-II. At first, third and sixth week, 4.6% patients were found with positive upward gaze, 2.3% with positive down gaze, 0% with positive horizontal gaze and 2.3% with positive secondary peripheral gaze while 85.1% with &lt; 3 mm Enophthalmoson Hertel Exopthelmommeter and 13(14.9%) with &gt;3 mm Enophthalmoson Hertel Exopthelmommeter. The satisfactory outcome was 88.5%.&#x0D; Conclusion: Our study results showed 88.5% satisfactory outcome. The long-term prognosis after repair of zygomaticomaxillary complex fractures is very good.

Cemento-ossifiying fibroma of the maxilla: A rare case report

ABSTRACT Introduction: Benign fibro-osseous lesions of the jaw are often a problem in diagnosis and classification. Cemento ossifying fibroma is one of the odontogenic tumor fibro-osseous lesions originating from the periodontal ligament's remaining cells, which occurs in the jaw and is rarely found. These lesions are often clinically and radiographically similar to other fibro-osseous lesions of the jaw. This case report aims to discuss its clinical, radiological, and histopathological features of cemento-ossifying fibromas that are often confused with other fibro-osseous lesions. Case Report: A 53 years old man reported to the Department of Oral Maxillofacial Surgery, Hasan Sadikin General Hospital, with a chief complaint that had lumped in his right upper jaw. About four years ago, a 2x2x2 cm lump appeared around the right maxillary gum after trauma from brushing, the lump did not hurt, and the patient did not seek any treatment. Approximately three months ago, the lump was getting bigger without pain, uncomfortable because it filled the oral cavity with a clinical picture of a lump on the palate that does not bleed easily without pain, the color of the lump is the same as the surrounding tissue, and there is no ulcer. At first, the patient was diagnosed with peripheral ossifying fibroma. Histopathological examination results showed cemento ossifying fibroma. The therapy is excision. Conclusion: Cemento ossifying fibroma is fibro-osseous lesions that develop from the periodontal ligament and are composed of cementum, bone, and fibrous tissue. In this case, the result of the histopathological examination is a definitive diagnosis.

Immediate implant placement with immediate provisionalization in the maxillary esthetic zone using mixture of allograft and xenograft vs xenografts to augment the jumping gap (A Randomized Clinical Trial)

AIM: The aim of the study is to evaluate the efficacy of grafting material in the jumping gap and their effect on the marginal bone loss in upper esthetic zone by using mixture of allograft and xenograft versus xenograft. Material and methods: A total of 20 extractions sockets, with 17 patients had non-restorable maxillary teeth in the esthetic zone indicated for implant placement. They were selected from the outpatient clinic of the oral Maxillofacial surgery Department, Faculty of Dentistry, Cairo University. • Xenograft as jumping gap filling material is successful for preservation labial cortical plate in immediate implant placement in the aesthetic zone. Summary: This study was performed to evaluate marginal bone loss using mixture allograft and xenograft versus xenograft in immediate implant placement with temporization in esthetic area. Twenty implants were conducted in twenty fresh extraction sockets in 17 patients with one or more hopeless teeth indicated for extraction in the region of maxillary anterior teeth. All patients were systemically free and with reasonable oral hygiene. Conclusion: •Immediate implant with immediate temporization is a viable technique for emergence profile preservation which subsequently adds to better result regarding radiographic bony changes and pink esthetic score.

Dental students' OMFS-related experiences and interest in OMFS careers: An exploration.

While the numbers of oral maxillofacial surgery (OMFS) residents increased over time, women and residents from underrepresented minority backgrounds are still underrepresented. The objectives were to assess dental students' OMFS-related personal and educational experiences and attitudes and explore which factors correlate with their interest in future OMFS careers. Data were collected from 493 dental students in 1 dental school and 206 students from 15 other US and Canadian dental schools. The students in the national sample were more likely to have experienced an OMFS procedure themselves (64.6%vs. 50.7%; P=0.001), have shadowed an OMFS in an operating room (23.2%vs. 14.9%; P=0.009) prior to coming to dental school and to be much/very much interested in an OMFS career (36.4%vs. 12%; P<0.001) than the students at the home school. While the majority of both groups rated their experiences with rotations in the OMFS department in the dental school (68%vs. 62.5%) and in the hospital (80.3%vs. 85.7%) as very interesting, the students in the national sample were more likely to agree/strongly agree that they were satisfied with their OMFS experiences (68.1%vs. 36.3%; P<0.001) and had learned a lot from the OMFS faculty (57.9%vs. 30.8%) than the students in the home school. For both groups, the degree of interest in an OMFS career correlated with having had more personal OMFS experiences (home: r=0.28; P<0.001/other: r=0.39; P<0.001), more interesting OMFS experiences in the dental school (r=0.23; P<0.05/r=0.40; P<0.001) and the hospital (0.33; P<0.05/r=0.50; P<0.001) and more positive attitudes toward OMFS faculty (r=0.26; P<0.001/r=0.37; P<0.001). Positive personal and educational OMFS experiences and positive attitudes toward OMFS faculty were associated with an interest in OMFS careers. These findings provide a basis for developing educational interventions aimed at increasing the percentage of women and residents from URM backgrounds in OMFS programs.

Analysis of Root Stumps in Middle Aged Group

Tooth extraction is one of the dental treatments which should be considered the last option. A decrease in thenumber of teeth may result in poor dietary habits and deterioration of quality of life. The number of extractedteeth can serve as an indicator of socio-economic and oral hygiene level. Extraction of permanent teeth isperformed for several reasons including dental caries, periodontal disease, orthodontic reasons, impactedteeth and root stumps.To assess the prevalence of root stumps in middle aged in Chennai A retrospectivecross-sectional study was conducted using the patient records from the Department of Oral maxillofacialsurgery, Saveetha Dental College, Chennai from February 2019 to February 2020, and patients who hadroot stumps were selected by nonprobability sampling. Data was collected and then subjected to statisticalanalysis.Microsoft Excel/2016 data spreadsheet was used and later exported to the Statistical Package forSocial Science for Windows (version 20.0, SPSS Inc., Chicago Ill., USA).The prevalence of root stumpswas more in males and age groups of 50-55 years showed maximum root stumps. There is no significantdifference between gender and the number of root stumps in each patient P=0.562 The study concluded thatthe prevalence of root stumps in the middle age group seems to be high when compared to other literature.Considering the limitations of this study extensive research needs to be done to find the prevalence of rootstumps in other populations and to spread awareness among the public about root stumps which are in situ.

Authors' Comments—Long-Term Postoperative Cone-Beam Computed Tomography Analysis of Secondary Bone Grafting in 79 Patients With Unrepaired Alveolar Clefts

Authors' Comments—Long-Term Postoperative Cone-Beam Computed Tomography Analysis of Secondary Bone Grafting in 79 Patients With Unrepaired Alveolar Clefts

Evolution of distraction osteogenesis in the oral and maxillofacial surgery

Distraction osteogenesis which is also called as callus distraction orcallotasis is used to restore the skeletal deformities and in reconstructive surgery. Most commonly, it is carried out in the department of oral maxillofacial surgery, orthopaedics and paediatric surgery. It is a very favourable and effective method for stable long-term effects. The use of distraction osteogenesis is found to have increased multiple folds in the last decade. And this is attributed to its advantages like little relapse, bigger movements range, generation of soft tissue, less likelihood of nerve injury, less likelihood of idiopathic condylar resorption. Some important applications of distraction osteogenesis are as an alternative to conventional surgery for maxillary and mandibular lengthening and reconstruction of alveolar segmental defects after tumour resection before implant installation.1 The distracter devices are found to transfer forces and they act as a rigid support for bone consolidation to occur. In this article, an attempt has been made to review the evolution of distraction osteogenesis over eons. Keywords: Distraction osteogenesis

A COMPARATIVE STUDY OF DICLOFENAC SODIUM WITH PIROXICAM IN PATIENTS UNDERGOING SURGICAL REMOVAL OF THIRD MOLAR

The current study was aimed at assessing the efficacy of Piroxicam verses diclofenac sodium as an analgesic after removal of third molars when given post operatively. The study was a comparative evaluation between two drugs. Methods - The current study was done in Department of Oral Maxillofacial Surgery, after the due approval of the Institutional Ethical Committee. A prospectiverandomized study conducted with 30 patients that required removal of mesio angularly impacted mandibular third molar. The systematical statistical analysis was performed after the data collection was done. Results- Pain intensity at the postoperative 15 mints, 30 mints, 45 mints,60mints, 2nd, 3rd, 7th day postoperative was less in Piroxicam group than Diclofenac and there was significant difference seen statistically (p

Management of Mandible Fractures by the Oral Maxillofacial Surgery Department at University of Maryland: A Quality Assessment Initiative

Purpose Repair of isolated mandibular trauma has been well documented in the literature. Outcomes based on methods of fixation, tooth extraction in the line of fracture, and treatment complications have been well documented. At the University of Maryland Oral and Maxillofacial Surgery (OMFS) unit, isolated mandibular factures are treated immediately, and rigid fixation is preferred. We performed a quality assessment of our treatment protocol for treated isolated mandible fractures, focusing on postoperative complications, such as surgical site infections (SSIs), nonunion, and malocclusion. Methods A retrospective chart review of patients who received intervention for mandibular fractures was conducted from December 2013 to July 2017 at the University of Maryland OMFS unit. All included patients were treated in an operating room (OR) setting. Demographics (age, gender, and race), mechanism of injury, location of fracture(s), type of fixation/number of plates used, tooth in line of fracture, length of maxillomandibular fixation, and time to OR were recorded. Complications, such as SSIs, wound dehiscence, dental mobility/sensitivity, malocclusion, and nonunion, were recorded. Primary outcome measured was mandibular union. Results One hundred and sixty-eight patients with a total of 301 fractures were identified. 80% were males, and 61.3% were African Americans. Homelessness, substance abuse, and incarceration were highly prevalent in our patient population. Assault was the most common cause of mandibular trauma (58%). Individuals in their third (35%) and fourth (22%) decades of life were most commonly affected. Symphysis and parasymphysis (32%) were the most commonly affected sites, followed by mandibular angle (29%). Sixty-six percent of individuals had 2 or more fractures. Seventy-seven percent of patients underwent definitive repair within 48 hours of presentation. Overall rate of postoperative complications was 10%; SSI (4%) was the most common, followed by wound dehiscence (2%), dental pain or dental mobility at the line of fracture (1.6%), malocclusion (1%), and nonunion (1%). Conclusions In our study, the primary goal of union was achieved in 98.6% patients. Four patients with nonunion were treated secondarily, with good results. An overall complication rate of 10% was noted with an SSI rate of 4%. These are both lower than those reported in literature. In conclusion, it is essential to tailor treatment in accordance with the challenges posed by the individual patient.

Evaluation of Success of Inferior Alveolar Nerve Block Technique Applied by Dental Students at Different Educational Levels

Introduction: Unfortunately, the most important consideration that is ignored in evaluation of the success rate of IANB technique is the teaching and learning of the correct injection technique in the academic atmosphere of universities and during the study period. Only a limited number of studies have evaluated this matter. Therefore, the present study was undertaken to evaluate the success rate of the IANB technique administrated by dental students in Tabriz University of Medical Sciences in order to promote the dental educational programs. Materials and Methods: The subjects in the present consisted of patients referring to the Department of Oral Maxillofacial Surgery, Tabriz Faculty of Dentistry, who required surgery in the lower jaw. The dental students evaluated in the present study consisted of the third-, fourth- and fifth-year students who were selected randomly. A total of 30 patients underwent a local anesthetic technique by the third-, fourth- and fifth-year dental students each. Anesthetic agent cartridges containing 1.8 mL of 2% lidocaine with adrenalin were used for the local anesthetic technique. The success of the anesthetic technique was analyzed 2 and 5 minutes after injection with the use of an electric pulp tester (EPT). In addition, the severity of pain was tested with the use of VAS. Results: there was no significant difference in the success rate of the IANB technique between male and female students. Comparison of the success rate of the IANB technique between the third-, fourth- and fifth-year dental students showed no significant differences in response to EPT, perception of pain and feeling of the dental explorer between the three groups of students. However, the frequency of the success rate of the IANB technique showed that the success rates were 86.3%, 93.3% and 83.3% for the third-, fourth- and fifth-year dental students, respectively. Discussion: the success of this technique has been reported to be low in references for some reasons. In this context, unfortunately the most important fact that is not taken into account in the evaluation of the reasons for the failure of the IANB technique is the teaching and learning of the correct technique in universities and during university studies and only a limited number of studies have evaluated it. Conclusion: Previous studies have reported a 70% success rate for the IANB technique administrated by dental students; however, the results of the present study showed a success rates &gt;70 for this technique administered by the third-, fourth- and fifth-year dental students in Tabriz University of Medical Sciences. The discrepancy between the results might indicate the important role of proper education in decreasing the failure rate of this technique.

Pattern of distribution of reactive localised hyperplasia of the oral cavity in patients at a tertiary health institution in Nigeria.

Reactive localized hyperplastic lesions of the oral cavity (RHLs) are relatively common peripheral lesions which present as a range of clinically similar lesions at dental centers. Diagnosis can be challenging if dentists are unfamiliar with their clinicopathological across various populations. This study reviews the pattern of distribution of RHLs of the oral mucosa in a hospital- the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife. We reviewed 10 years data from the archives of the Department of Oral Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University, Nigeria. Information on RHLs were extracted and recorded on standardized data forms and analyzed using STATA. The most common lesions were pyogenic granuloma (43.7%) and focal fibrous hyperplasia (39.7%), respectively. RHLs were found to be more frequent in women (66.7%) than men (33.3%). The most common locations of involvement was the gingivae (84.6%), and lesions were more common in the 9-29 year age group and the mean age was 37.7 (±21.1) years. The relationship between age group and reactive lesions was however not statistically significant. The major benefit of this study is an improved knowledge of the frequency and distribution of oral reactive lesions in sub-Saharan Africa which may be highly beneficial when establishing a diagnosis and treatment plan in clinical practice.

Clinical research of extensive alveolar cleft treatment with computer assistant distraction osteogenesis

Objective: To evaluate the feasibility and outcome of computer assisted distraction osteogenesis in the treatment of extensive alveolar cleft. Methods: Four patients [1 male and 3 females, aged (15.5±3.7) years] received treatment in the Department of Oral-Maxillofacial Surgery and Plastic Surgery, School of Stomatology, China Medical University from June 2016 to April 2018 were involved in this study. All the patients with extensive alveolar cleft [cleft width (7.64±1.29) mm] were performed orthodontic treatment to expand the dental arch and interdental space between the first molar and premolars. Three-dimensional (3D) model of the maxilla and the osteotomy guider were printed according to the CT data. The fix wings of the distractor were pre-shaped according to the 3D model. The osteotomy was performed at the interdental space and horizontal plate of palate to dissociate the alveolar bone segment. The distractor was fixed on the predetermined position. Distraction (0.4-0.8 mm/day) was performed in 7 days later and stopped when the incision connected with the canine. The distractor was removed after six months. Results: The distraction period was (10.8±2.5) d in four cases. The cleft was completely closed with interdental bone anchored distraction in four cases. The imaging examination in six months showed good new bone structure in the distraction zone and bone connection of the cleft. Conclusions: Computer assisted distraction osteogenesis was effective and feasible to close the extensive alveolar cleft and provide sufficient new bone tissue.