gholamreza shirani

Eyebrow position is one of the most critical features of facial beauty. Patients undergo rejuvenation procedures due to the congenital condition of drooping eyebrows and senile changes in the area around the eyes, which often cause drooping eyebrows. This study reviews the subcutaneous and subperiosteal (endoscopic) dissection techniques in the temporal eyebrow lift procedures.

In this review study, the PubMed, Embase, and Scopus databases and 100 first hits of Google Scholar were searched from 2000 to 2023. The following keywords were included: temporal lift, lateral brow lift, lateral brow hooding, lateral brow ptosis, subcutaneous dissection, subperiosteal dissection, endoscopic brow lift, and dissection plan. Articles meeting the inclusion criteria were included in this study.

Thirteen studies met the inclusion criteria. Most of the studies were retrospective and reported high patient satisfaction with an acceptable risk profile. The subcutaneous dissection method has advantages, including safety, shorter operation time, the possibility to perform under local anesthesia, long-term and stable outcomes with a low probability of complications, and high patient satisfaction. The best indications for an endoscopic brow lift are patients with short or normal forehead height, flat forehead, and those whose hairline has receded, with no or a minimum amount of excess skin medially. On the other hand, eyebrow lift with the endoscopic method is minimally invasive as an advantage.

The subcutaneous dissection method is a reliable, safe, cheap, and repeatable option for lateral eyebrow lift. Clinical studies with standardization of outcome criteria in eyebrow rejuvenation are recommended. On the other hand, the endoscopic method has the same efficacy for eyebrow lift procedures and is minimally invasive.

Statement of the Problem: 

For many years, practitioners have been encountered with dental rehabilitation of atrophic jaws. Among many of alternatives, free iliac graft can be a reasonable and also problematic choice to be accomplished.   

The aim of this study was to evaluate the implant survival rate and bone loss in implants inserted in reconstructed jaws with free iliac graft.

In this clinical trial study, twelve patients that underwent bone reconstruction with free iliac graft were included in this retrospective study. The patients underwent surgery over a 6-year period from September 2011 to July 2017. Panoramic images were taken immediately after implant insertion and at the follow-up session. The parameters that were assessed included implant survival rate, bone level changes, and surrounding tissue conditions.

One hundred and nine implants were placed in eight female and four male patients, of which 65 (59.6%) were inserted in the reconstructed maxilla and 44 (40.3%) in the reconstructed mandible. The interval between the reconstruction surgery and follow-up session was 28.75 months and the mean interval between implant insertion and the follow-up session was 21.75 months, ranging from 6 to 72 months. The total average of crestal bone resorption was 2.44 mm (range: 0 to 5.43 mm).

This study found that rehabilitation of atrophic jaws with dental implants placed in free iliac graft was associated with acceptable marginal bone loss, survival rate, satisfaction, and esthetic results among the patients.

Bilateral sagittal split ramus osteotomy is one of the most versatile techniques in orthognathic surgery that allows for the repositioning of the mandible in all directions. This osteotomy splits the mandible into two proximal condyle-bearing segments and one distal tooth-bearing segment.Intraoperatively, the surgeon is usually focused primarily on the proper positioning of the distal segment to achieve the planned amount of advancement or setback. However, particular attention should be paid to the position of the proximal segment, as improper positioning of the proximal segment during fixation gives rise to immediate or late relapse of the surgical outcomes. The goal of this paper is to provide some background knowledge about the proximal segment for the novice surgeons, based on a review of the relevant literature. What is the proper position of the proximal segment, and what is the best technique to guide the proximal segment into its proper position?. These questions do not have clear-cut answers that the majority of surgeons agree on.

Temporomandibular joint disorders (TMJDs) are the main musculoskeletal cause of orofacial pain.  This study aimed to assess the efficacy of manual therapy and routine treatment compared with routine treatment on pain, maximum mouth opening (MMO), and cervical range of motion (ROM) in patients with the temporomandibular joint disorder (TMJD).  

This study was performed at the biomechanics laboratory of the physiotherapy department of Iran University of Medical Sciences, Tehran, Iran.  A total of 30 patients with TMJD were randomized into 2 groups: an intervention group (manual therapy plus routine treatment) and a control group (conventional treatment). Treatment included 10 sessions. The primary outcome was pain intensity and the secondary outcomes were MMO, and range of cervical flexion and extension. The outcomes were measured at the baseline, at the end of the treatment, and after a 4-week follow-up period. The repeated measures analysis of variance was used to assess group × time interaction, and the Bonferroni adjustment was used for between-group comparisons. The effects size of Cohen's d was used to determine the magnitude of between-group differences.  

The results showed that there were significant group × time interactions for pain, MMO, and the cervical flexion ROM (P<0.001). In comparion with the baseline, the intervention group showed significant improvements in jaw pain, MMO, and cervical flexion ROM (P<0.001), while in the control group, compared with the baseline, only pain and MMO significantly improved (P<0.05). Results of between-group comparisons revealed that there were significant and clinical differences between the 2 groups after treatment, and the intervention group had lower jaw pain, more MMO, and cervical flexion than the control group (P<0.001). In addition, the efficacy of manual therapy based on the Cohen's d was large for the outcomes of pain, MMO, and cervical flexion.  

The findings showed that adding manual therapy of the upper cervical spine and TMJ to the routine treatment could be an effective intervention for patients with TMD.

Any physiologic or pathologic situation can affect oral and dental health. Obesity and Bariatric surgery are two different factors which have their own signs and symptoms in the oral cavity. Soft tissue, hard tissue, oral flora and saliva can manifest changes in these patients and some intervention would be needed to control it. Our goal is to review oral manifestations in obese and bariatric patients to attract attention to oral care in these patients.

This study aimed to assess the effect of light-emitting diode (LED) phototherapy on  pain and trismus following surgical extraction of impacted mandibular third molars.

This double-blind randomized controlled clinical trial evaluated 50 patients between 20 to 35 years requiring extraction of their impacted mandibular third molars.  The patients were randomized into two groups of LED phototherapy and control by flipping a coin. Patients in the LED group underwent LED phototherapy immediately after surgery with red light at 618nm wavelength, 20 mW/cm2 power density and 4 J/cm2 energy density in continuous-wave mode (irradiated area: 3.15cm×1.5cm=4.725cm2). The LED device was used in off mode in the control group (as placebo). The level of postoperative pain was measured by the numerical rating scale, and trismus of patients was evaluated by measuring the maximum mouth opening (MMO). The two groups were compared by the Mann-Whitney and NPar tests.

The mean difference in MMO postoperatively, compared with baseline, was lower in the LED group than the placebo group but not significantly (P=0.465). The two groups were not significantly different regarding the level of pain.

LED phototherapy with the parameters applied in this study failed to significantly decrease the level of pain and trismus following surgical extraction of impacted mandibular third molars.

Medication related osteonecrosis of the jaw (MRONJ) is a chronic condition of the oral cavity resulting in mucosal ulceration and exposure of underlying necrotic bone, and the ensuing secondary complications. The aim of this study was to evaluate the relationship between vitamin D deficiency and osteonecrosis of the jaw related to bisphosphonates.

This was a case-control study. The samples were 20 patients taking bisphosphonates, that 10 of them were with MRONJ and 10 were non-MRONJ. Clinical examination of patients was performed to diagnose jaw osteonecrosis. Demographic data of the patients were recorded including age, sex, type of drug, duration and cause of drug intake, and measurement of serum vitamin D levels. Data were analyzed using SPSS software.

In the patients without MRONJ, the mean age was 60.60 (±14.975) years, and in the patients with MRONJ, the mean age was 68.30 (69.92) years. As a whole, of the 16 female patients in this study, 10 cases (62.5%) were non- MRONJ and 6 cases (37.5%) were suffered by MRONJ. All of the male patients presented with MRONJ. In control group mean of vitamin D was 63.990 ng/ ml (±29.796) and in case group mean of vitamin D was 29.510 ng/ml (±23.723). The serum level of vitamin D (25-OHD) was significantly higher in control group than in the case group (p=0.010).

According to our result, there were statistically significant relationship between age, sex, type of drug, vitamin D level, and MRONJ (p>0.05).

Phototherapy with a light-emitting diode (LED) is used in medicine due to its potential bio-stimulatory effects on the human body. However, controversy still exists regarding the efficacy of low-level laser therapy (LLLT) and phototherapy with LED. This in vivo study aimed to quantitatively and qualitatively assess the newly formed bone following LED phototherapy of the human maxillary sinuses.

This randomized clinical trial (concurrent parallel) was conducted on 44 patients in two groups (n=22) at the Implant Department of Tehran University of Medical Sciences. Randomization was done by a random sequence generator program. The inclusion criteria were absence of chronic sinusitis and chronic bone marrow conditions, no history of surgery at the site, absence of diabetes mellitus, no history of chemotherapy or radiotherapy, maxillary premolar edentulism, and signing informed consent forms. Group A underwent LED phototherapy with 620 ± 2 nm wavelength for 20 minutes daily for a total of 21 days after sinus lift surgery. Group B served as the control group and did not receive phototherapy. After 6 months, the grafted sites were re-opened for implant placement, and bone biopsy samples were obtained using a trephine bur. The samples were stained with hematoxylin and eosin and inspected under a light microscope. The results were statistically analyzed using the Mann-Whitney U test. Both the surgeon and pathologist were blinded to the group allocation of patients.

Forty tissue specimens were analyzed. Insignificant differences existed between the two groups in terms of the degree of inflammation, bone quality, and maturity of collagen. Histological analyses revealed no significant difference in the mineralized areas of bone between the two groups (P>0.05).

The results indicated that LED phototherapy cannot significantly enhance osteogenesis after sinus lift surgery. No side effects were observed in the experimental group.

Bone morphogenetic proteins (BMPs) and wingless (Wnt) signaling molecules and their antagonists, such as sclerostin and noggin, have been identified to have different effects on bone metabolism. This research intended to evaluate the transcript levels of CTNNB1 (catenin beta 1protein), SOST (sclerostin protein), BMP4 (Bone Morphogenetic Protein 4 protein), and NOG (noggin protein) bone metabolism-related genes in peripheral blood mononuclear cells (PBMCs) from condylar hyperplasia (CH) patients in comparison to rheumatoid arthritis (RA), ankylosing spondylitis (AS), and healthy individuals. PBMCs were separated from blood samples of 10 patients with CH, AS, RA, and 10 healthy controls. SYBR Green real-time polymerase chain reaction (PCR) was used for quantitative analysis of CTNNB1, SOST, BMP4, and NOG messenger RNAs (mRNAs). The expression of CTNNB1 was significantly upregulated in CH and AS patients compared with healthy individuals and RA patients. The difference of SOST expression was not significant between all groups. The BMP4 expression was significantly downregulated in AS, CH, and RA patients compared with healthy controls. The NOG expression was downregulated in RA, AS, and CH groups, however, it was only significant in CH and RA patients compared with controls.CH and AS patients were distinguished from RA by the upregulatedCTNNB1 expression. These results demonstrated that CTNNB1, BMP4, and NOG, but not SOST, may contribute to the pathogenesis of CH, AS, and RA.

Desmoplastic fibroma (DF) is a rare benign but aggressive fibrous lesion with an unknown etiology. It has an affinity for the mandible. DF has a high rate of recurrence after surgical resection. In this study, we report the therapeutic management of a recurrence of DF in the lower jaw in a 2‑year‑old boy. He responded well to second surgical intervention with wide resection and immediate reconstruction with plate. The purpose of this case report is to emphasize the particularity of the case, treatment modalities, and differential diagnosis in DF.

Pain control by local anesthesia plays a critical role in success of most dental treatments. Due to the unpleasant pain experience related to the use ofthe conventional syringe injection, some computerized techniques have been developed for local anesthetic injection. This study aimed to compare the pain score following infiltration anesthesia of the maxillary premolar teeth administered by the conventional syringe and automatic.
This single-bind randomized clinical trial was performed on 35 patients whose average age was 38. Requiring bilateral extraction of maxillary premolars. The patients’ dental anxiety was scored and they received infiltration anesthesia with the iCT injection SE (Dentium, South Korea) at one side and conventional syringe at the contralateral side. The pain level was recorded during needle insertion, anesthetic delivery and 5 hours after the injection using visual analog scale (VAS) and the face rating scale (FRS). The data were subjected to Wilcoxon signed-rank test.
Significant differences were found between the automatic and conventional method sregarding pain scores duringneedle insertion (P Both FRS and VAS in iCT injection showed that frequency of severe pain during needle insertion and anesthetic delivery was noticeably lower than that in conventional injection method but findings revealed that there was no significant difference between these two technics after 5 hours of injection.

Reconstruction of a facial defect is a complex modality either surgically or prosthetically, depending on the site, size, etiology, severity, age, and the patient’s expectation. Loss of an auricle, in the presence of an auditory canal, affects hearing, because the auricle gathers sound and directs it into the canal. The auricle acts as a resonator to slightly amplify lower frequency sounds and helps to localize sounds, especially in conjunction with the other ear. Osseointegrated implants have an important role in prosthetic reconstruction of patients with craniofacial defects. The main indications of this treatment plan are lack of local tissue for autogenous reconstruction, previous reconstruction failure and selection of this technique by the patient. This paper presents a clinical case and advantages of the osseointegrated implant technique for retention of auricular prostheses.

This case report presents a 16-year-old boy with bilateral temporomandibular joint (TMJ) bony ankylosis due to trauma. The patient had undergone several unsuccessful therapeutic surgeries and was experiencing reduced mouth opening, difficulty in eating and speaking, poor oral hygiene, snoring, and depression. Bilateral gap arthroplasty and distraction osteogenesis (DO) were performed. After the surgery, we were able to move the osteodistractors forward and prevent the upward and backward movement of the proximal mandibular segment with the use of our custom-made Sh-device, which allowed bone growth and soft-tissue matching. The mandibular deficiency was treated, and the patient's sleep quality significantly improved after three months. The physical, orthodontic and speech therapies were continued. The facial asymmetry, difficulty in sleeping, eating and speaking, and low self-esteem were completely resolved. At the 8-year follow-up, the patient's condition was satisfactory. The Sh-device can be used as a contemporary treatment modality for TMJ ankylosis.

It is estimated that one-third of the people with refractory epilepsy suffer from obstructive sleep apnea (OSA). In a patient presenting with OSA symptoms and epilepsy, removing a portion of the soft palate (uvulopalatoplasty) can be considered the treatment of choice for eliminating the OSA and decreasing the seizures.Here, we report the results of our surgical approach by which the patient’s problems completely resolved, and we observed no symptoms of OSA or epilepsy after the surgery. After 10 years of follow-up, the patient is seizure-free and does not need any antiepileptic drugs.

Subcondylar fractures are common in the maxillofacial region following direct trauma to the mandibular ramus. The literature is replete with articles written on the treatment of subcondylar fractures, encompassing a plethora of various surgical approaches; however, the best treatment procedure has remained controversial. Such fractures are either treated by open reduction with internal fixation or closed reduction with maxillomandibular fixation. In this article, we describe a new surgical method for treatment of subcondylar fractures.

Obstructive sleep apnea (OSA) can lead to various cardiovascular disorders (CVD) such as hypertension. There is no documented data about this relationship among the Iranian population. The aim of this study was to obtain comprehensive information about the severity of OSA as a cause of CVD and its relationship with other important risk factors.
In this cross sectional study, we studied patients with OSA and apnea/hypopnea index of 5 or more. The data were collected from the patients’ polysomnography report and medical files. Data analysis was done with SPSS version 18.
The majority of patients were males (71.9%). Among the studied individuals, 26.5% showed at least one sign of CVD, and hypertension was the most common condition (74.5%). Multiple regression analysis showed that the odds ratios for one unit increase in BMI and one year increase in age were 1.13 and 1.12, respectively (P In our study, BMI and age had the strongest relationship with CVD. Thus, public health care providers should implement weight control strategies and improve diagnostic and treatment procedures for the elderly patients.

The aim of this study was to compare the neck and temporomandibular joint range of motion and muscle endurance in patients with temporomandibular disorders, referring to the dental school of tehran university of medical science and healthy individuals.
A total of 30 healthy men as control and 30 patients aged 20-40 years with temporomandibular joint disorders (TMD) were selected as patients. Range of motion in flexion and extension of the head and neck and mouth opening was measured and masticatory muscle endurance as well as the neck extensor muscles was measured and averaged values for each patient group were compared with the control group.
Head and neck flexion range of motion and endurance of neck extensor muscles in patients with temporomandibular joint disorders (TMD) was lower than healthy controls. (P The results of this study showed that disorders of temporomandibular joint can change extensor muscle endurance and range of motion in neck. Pay attention to neck problems can be effective in improving patients with disorders of temporomandibular joint.

Fractures of the orbital floor, which are caused by various mechanisms, result in the herniation of periorbital tissue into the paranasal sinuses and its subsequent complications. Early diagnosis using various techniques and reduction of fractures are necessary to preserve ocular function and esthetic. Use of an endoscope has been associated with some advantages, including a decrease in the number of external incisions and soft tissue manipulations. The aim of the present study was to evaluate complications of reducing fractures of the orbital floor and the infra-orbital rim with the use of an endoscope and conventional techniques.
A total of 40 patients with fractures of the orbital floor were included in this clinical trial. The subjects were equally divided into two groups (n = 20). In Group 1, the complications of treatment with an endoscopic view were evaluated in addition to comparison of the sensitivity of endoscope and 3-mm computed tomography (CT) slices with the gold standard. In Group 2, complications of treatment with the conventional technique were compared with those in Group 1. T-test, chi-squared and Fisher’s exact tests, ANOVA and Tukey test for multiple comparisons were used for statistical analyses with SPSS statistical software.
There were no statistically significant differences between the two groups regarding age and gender. The sensitivity of the endoscope-assisted surgery in comparison to the gold standard was estimated to be 70% with a sensitivity of 85% in comparison to 3-mm CT scan slices. There was a significant difference between the two groups regarding complications, including edema, lower eyelid scars (P = 0.024), indicating superiority of the endoscope-assisted technique.
The present study showed the importance of the CT scan as a diagnostic technique. In addition, the efficacy of the endoscopic technique in decreasing complications and improving the quality of orbital floor fracture treatment outcomes was confirmed.

When dental implants are applied in partially edentulous patients, there is the risk of placing the implants in close proximity or in direct contact with the adjacent roots. In this situation assurance of pulp vitality of the adjacent tooth is neessary. The current study aimed to assess pulp response of the tooth after root proximity with dental implant.Patients and After investigating 2800 records of patients, 31 implants in 29 patients were included in this study. A parallel peri-apical radiography was taken and pulp vitality tests (cold, heat and electrical pulp tests) were conducted for each patient. Among the 31 assessed implants and the adjacent intact teeth, 13 implants had direct contact and 18 implants had proximity of less than 1 mm with the adjacent root. All of the teeth had positive (normal) pulp response to all tests. The most prevalent areas for proximity of implant-tooth were upper first premolar implants and upper canine teeth. The most approximation area was apical third of root of the teeth. Based on the clinical and radiographic examinations, implant-tooth approximation (less than 1 mm or direct contact) is not related to pulp vitality of the tooth. Further studies with larger sample sizes are necessary to confirm the results of the study.

The trigeminocardiac reflex (TCR) refers to the sudden development of bradycardia as well as asystole along with arterial hypotension associated with any manipulation of sensory branches of the trigeminal nerve. Clinically, the TCR has been reported to occur during craniofacial surgery. It is crucial to learn about this sudden physiological response during maxillofacial surgery that is likely to happen with any craniofacial surgical procedures.
In this clinical study 44 volunteers without any systemically compromising conditions were divided into 2 groups. The first group underwent Le Fort I osteotomy and the second mandibular osteotomy. Mean arterial blood pressure and pulse rate (MABP1, PR1) values were recorded before down fracture (DF) of maxilla and Sagittal Splitting (SS) of mandible, during DF and SS (MABP2, PR2), and after DF and SS (MABP3, PR3). The data were analyzed using repeated measure ANOVA tests (p = 0.05).
In Le Fort I group, PR1 and PR3 were significantly higher than PR2 (P It is concluded that TCR is triggered by the stimulation of V2 but V3 branch stimulation does not cause such reflex.

Cancer immunotherapy attempts to stimulate the immune system to reject and destroy tumors and is one of the cancer treatment strategies. Recently, interluekin36 (IL36) has been used as immunotherapeutic agents in cancer gene therapy. Present study investigated that the IL36 gene therapy effects on the regression of tumor masses in mouse model. Aim of this study is determination of the gene therapy effects by IL36 in the regression of tumor masses in mouse model. To study the therapeutic efficacy of this cytokine, WEHI-164 tumor cells were transected with mIL36 plasmids. ELISA test was used to check cytokine production by transected cells. To establish fibro sarcoma mouse model, Tumoral transfected cells were injected subcutaneously to inoculate tumor in BALB/C mice. Tumor volumes were measured by caliper. Mice were sacrificed and tumors were extracted. The expression of IL36 and IFN-γ was studied with Real-time PCR and immunoblotting. The expression of Ki-67 (a tumor proliferation marker) in tumor masses was studied by immunohistochemistry staining. In this study we had 2 groups which are treated with IL-36 and Untreated with IL-36 as a blank. The group treated with IL36 indicated decrease of tumor mass volume (p<0.001). The results of western blotting and real-time PCR showed the IL36 expression increased in the group treated with IL36 (with relative expression of 1.9). Immunohistochemistry staining indicated that the Ki-67expression has been reduced in the group interfered with IL36. IL36 gene therapy has therapeutic effects on the regression of tumor masses in fibro sarcoma mouse model.

Introducation: The long-term outcome and clinical results of gaparthroplasty used for the treatment of condylar ankylosis of the mandible in children with application of postoperative activator appliances and costochondral rib graft are evaluated and compared. The purpose of this study was to compare the effect of gap arthroplasty and costochondral graft methods on reankylosis, a mount of mouth opening and growth. A non-randomized, retrospective clinical study of l0 cases (5-12 years old) of condylar ankylosis of the mandible, surgically treated during a 10 year period from 2002 to 2012 was performed. Four patients were treated by condylectomy and interpositional flap, whereas six were treated by condylectomy and immediate costachondral rib grafts. The first group underwent long-term postoperative therapy using removable activator appliances. Casts, radiographs, photographs, and computed tomography (CT) were used post surgically to evaluate rib graft, condylar growth and function, occlusion, facial, and condylar symmetry. Data were analyzed by SPSS 16 statistical software using Mann-Whitney, Paired T-test and Chi-square tests. Children with long-standing condylar ankylosis of the mandible treated by condylectomy and interpositional flap showed more favorably when activators were used post-surgically. Gaparthroplasty with functional activator post-operatively can be considering for TMJ ankylosis.

Osteon is an alloplastic material containing 70% hydroxyapatite and 30% β-TCP. Calcitonin, a hormone produced by the thyroid gland, not only prevents bone resorption by reducing both the number and the activity of osteoclasts, but also stimulates bone formation. Considering the favorable effects of calcitonin on bone formation, we hypothesized that the addition of calcitonin to Osteon would result in better bone regeneration. To test this hypothesis, full-thickness bone defects were created bilaterally in the femoral condyles of 12 New Zealand white rabbits. The defect was filled with Osteon on one side (the control group); while on the other side, the defect was filled with a combination of Osteon and calcitonin (the experimental group). These findings showed that the number of osteoblasts and the degree of calcification in the experimental group were significantly higher than the control group (P = 0.05). On the basis of these findings, it is plausible to suggest that the addition of calcitonin to hydroxyapatite and β-TCP as alloplastic materials could contribute to a greater degree of osteogenesis.

Nanobacteria (calcifying nanoparticles, nanobes) are one of the most controversial issues in contemporary biology. Studies show accumulating evidence on association of nanobacteria with pathologic calcifications such as kidney stone, arterial plaque, calcification of coronary arteries, and cardiac valves calculus. The Hypothesis: Nanobacteria can tolerate harsh conditions extremely well. The apatite mineral layer around the organism and slow metabolism is likely to be the reason for the resistance of nanobacteria. They showed a wide resistance to the several disinfecting and sterilizating chemicals as well as autoclaving, ultraviolet light, microwaves, heating and drying treatments. Hence, it seems logic to postulate that hazardous diseases can be easily transmitted via nanobacterial contamination of medical and dental equipment. Evaluation of the Hypothesis: It is not enough to claim an agent not living according to the standard view on living creatures, as irrelevant to biological safety of cell cultures, or to human and animal health. Although the nature of prions is still under debate and prions are classified as nonliving, they exist and cause diseases, and thus form a serious risk for animal and human health. The risk was recognized only after enormous economical losses. It appears that nanobacteria situation is rather similar, except the fact that nanobacteria appear to cause or contribute to common hazardous diseases of the mankind. Hence, world-widely well-known organizations such as the Centers for Disease Control and Prevention, the Occupational Safety and Health Administration, and the World Health Organization should pay more attention to transmission of hazardous diseases via nanobacterial contamination of medical and dental equipment.

Supernumerary tooth is a rare event, which is usually found coincidentally in radiographic examination. The prevalence of this event is 1-3% with different prevalence for primary and permanent dentition. Supernumerary teeth may cause various clinical problems including: delayed or failure of eruption, displacement or rotation of permanent teeth and cyst formation. The purpose of this study was to present the case of a 9-year-old boy who had a large dentigerous cyst around his primary mandibular left premolar that was enucleated with the tooth. A year after this enucleation, we have observed a supernumerary tooth in mesial of canine. It is a reasonable question that “can the supernumerary tooth formation relate to the dentigerous cyst around impacted tooth?” Therefore, it is necessary to perform more pathological investigation in this aspect to answer this question.