مسعود یغمایی

Oral and dental injuries commonly occur during oral and nasal intubation and comprise one third of lawsuits against anesthesiologists. This study sought to assess dental traumas(especially minor injuries like cracks) due to oral and nasal intubation and related risk factors. This observational prospective study was conducted on 60 patients (30 patients in the oral and 30 in the nasal intubation groups) during 2010-2011 in Taleghani Hospital in Tehran. Patients were examined using a disposable sterile clinical examination kit, a periodontal probe and a light curing unit. Maxillary central incisors had the highest incidence of new cracks (60% and 63.3% in the oral and nasal intubation groups, respectively). Gender, BMI, ASA class, Angle’s classification, and experience of the operator who inserted the tube had no significant association with higher frequency of cracks in the two groups. Incidence of visible dental injuries following nasal and oral intubation was 1.7% and 10%, respectively. Invisible dental injuries due to intubation are highly prevalent. These injuries are mostly disregarded by the anesthesiologists since they are not visible and do not cause any complication or problem during anesthesia. Enhancing the knowledge of anesthesiologists about dental anatomy, physiology and pathology and use of teeth-guard are necessary measures to prevent such injuries.

This is an epidemiological study of patterns of condylar fractures. The aim of this study was to assess the incidence and etiology of condylar fractures. Methods & Materials: In this retrospective study, data were obtained by means of special questionnaire regarding age, gender, anatomic site, pattern, causes of injury, treatment modalities and complications. During an 11 years period (1994-2004) 475 patients represented 134 condylar fractures (28.2%) admitted to Dr. Shariati Hospital of Tehran – Iran. Of the 134 patients, 105 (78%) were men and 29 (22%) were women (ratio 3.6:1). Patient's age at the time of injury ranged from 2 to 75 years, with a mean age 24.7 years. The highest incidence was seen in the third decade of life (27.6%). The predominant causative factors in this study was motor vehicle accident (42%) followed by falls and assaults. Most patients (88.8%) were treated by close reduction surgery. The seasonal distribution showed that summer accounted a highest percentage (31%) of all fractures. The condylar fractures included 28.2 percentages of all mandibular fractures in this study. The most common part of condylar fractures was subcondylar site (76.1%). The most common causes were traffic accidents (42.2%). The most common treatment method was close reduction (88.2%). The most common fixation method was maxillomandibular fixation (MMF). Fracture rate in men was more than women (78.4% Vs. 21.6%). The most important associated complications with condylar fractures was ankylosis (2.98%).

Surgical removal of lower third molars is a frequently performed procedure but prescribing antibiotic in third molar surgery remains controversial. This study determined the effects of preoperative and postoperative antibiotic therapy on the prevention of infections in bony impacted mandibular third molar's surgery. Methods & Materials: In a prospective study of more than 9 months, a total of 100 bony impacted lower third molars were removed. The patient didnt show any sign of inflammation, swelling and systemic disease at the time of removal. Two groups were established. The first group (n=50) received 2 gr Amoxicillin one hour preoperatively. The second group (n=50) received oral Amoxicillin 500 mg for five days post-operatively. Clinical and radiologic features were recorded for each case. All patients were recalled on the seventh day after surgery to assess the pain, swelling, amount of mouth opening, the state of the wounds and the incidence of infection. Descriptive statistics, t and Mann- whitney tests were used to analyze the data. The incidence of infection was 2% in the patients. There was no significant difference regarding the evaluated parameters between the two groups. The study showed that preoperative prophylactic antibiotic therapy in comparison with post operative oral prophylactic antibiotic treatment in the removal of lower third molars doesn’t contribute to a better wound state, less pain, decreased swelling, increased mouth opening and prevention of infection after surgery.

Patients referred for dental treatment may have some systemic diseases. The aim of this study was to assess the history of using medicine in the patients referred to dental school. Methods & Materials: In this descriptive epidemiologic investigation performed with cross sectional method and simple randomized sampling, data forms were completed with only one questionnaire. Age, gender and the history of medication were evaluated in 600 patients refer to Oral Medicine department. From the 600 referred patients, 56% were female and 44% were male. The range of age was from 15 to 75 years, most of the patients had 25-35 years of age. 34% of them had systemic disease. The most common disease in all of them were allergy (6.83%), gaster intestinal disease (6.33%), cardiac disease (5.5%) hypertension (4.16%), tyroid disease (3.63%) and renal disease, anemia-diabetes and arthroskeletal disease. 30.83% of the all were using drugs, The prevalence of using drug was different in the males and females. The most common drugs used by all of them was NSAID and analgesics – Antyhistamins, antibiotics. GI drugs, cardiac drugs, antihypertension and tyroid drugs had the next prevalence. In the present study, we found that there is high usage of drugs in patients who need dental treatments regarding to the probability of drugs interactions it’s necessary for dental students to become well educated in this aspect.

One of the most important aspects in oral and maxillofacial surgery is the healing process after periapical surgery during apicotomy, transplantation or pathological surgeries. Past studies with the vascular supply to surgically mobilized dentoalveolar segments, apicotomized transplanted teeth and root resected teeth in periodontal disease, have mentioned occasional encounters with vital root resection and have noted varying degrees of pulpal response to this insult. The purpose of this investigation was to observe the pulpal and periapical responses of dog dental tissues to intentional apical vital root amputation over six months postoperative period. Methods & Materials: Four adult German – Canadian dogs were used in this experimental study. One root of multirooted teeth in left quadrant of each jaw were surgically transected and mandibular quadrants for 12, 13, 24 and 25 weeks following surgery were obtained after the animals were sacrificed by formalin perfusion of the left and right carotids. The tissue blocks were prepared by routine histological methods. Fisher exact test were used for data analysis. The results demonstrated a disruption of the normal pulpal architecture, with initial pulpal degeneration and subsequent early replacement by the periodontal ligament tissue. An intermediate cemental lining of the root canal occurred in all specimens. There was fat tissue in the apical part of the root in some specimens. Pulpal regeneration were seen in 75% of upper molars and 25% of lower molars. Resorption were took place only in two specimens (12.5%). Severe hyperemia were seen in 62.5% of all specimens. The pulp of multirooted teeth, remain vital after transaction of apical part of the root in dogs.

It is important for dentists and specialists to know about impacted wisdom teeth before and after surgery. In this surgery, postoperative complications like infection, bleeding and etc occur by the extraction of this kind of teeth. In this study, the post operative wound infection associated with 100 surgical operations performed during 2000 at OMFS Dept. Shahid Beheshthi Dental School, are reported (4 weeks follow up). Method & Material: This descriptive epidemiological study is performed by completing a data form after observation. This investigation is performed on 100 patients who were physically in a fair status. The patients were accessible easily and they examined at the end of the second and third weeks and the existing signs have been registering. The patients who were suspected of the infection have been following within the next 24 hours. At the end, the last following was performed to evaluating the subperiostal infection after one month. Antibiotics were used in the cases which the surgeon had been used micromotor during the surgery. T-test and one – way and chi – square analysis were used for calculation of the data. The conclusion is announced by p value and if the finding were less than 0.05, they were valuable. The post surgical wound infection rate overall was 6% and the other 94% have passed the usual procedure of recovery. The incidence of infection in the mandible was more than maxilla, and also there was a higher probability of infection in the hard tissue surgery specially in which the surgeon had used micromotor. The triangular flap is caused to infection more than the envelope flap. Most important findings in 100 impacted third molars (100 patients) were:1. In the complicated impacted third molars (like a Cl III or Cl C depth impaction) a new technique with a high concentration are needed. 2. There was relationship between tooth position, flap design, micromotor using and incidence of wound infection that means in all cases with the symptoms of wound infection, impacted wisdom teeth was in the lower jaw, flap design was triangular and practitioner had been used micromotor for removal of third molar. 3. Rate of wound infection not related to the prophylactic use of antibiotic.