javad yazdani

Adenotonsillectomy is one of the most commonly performed surgical procedures in children. Although this surgery is technically easy, it can run a high risk of serious complications, such as laryngeal spasm, laryngitis, bleeding, pain, and nausea. The present study  aimed to assess the effect of preemptive dexamethasone on pediatric post tonsillectomy pain.

This triple-blinded clinical trial study involved a total number of  70 children within the age range of  3-15 years. They were candidates for adenotonsillectomy and were randomly assigned to two groups. One hour before the surgery, one group received intravenous dexamethasone (0.1 mg/kg) and the other group received distilled water intravenously. Patients' pain at 1, 4, 10, and 24 hours after the surgery, initiation of soft-diet feeding and the prevalence of nausea and vomiting were evaluated in both groups. Data were analyzed in SPSS software (version 16).

The total number of patients was 70 (35 in each group). Both groups were homogenous in terms of age and gender. In the intervention group, the mean score of pain in the first and fourth hours and the mean initiation time of soft- diet feeding were significantly lower, as compared to those of the control group (P <0.05). The mean score of the pain in the intervention group at hours 1,4,10, and 24 after tonsillectomy were obtained at 8.40, 5.74, 4.28, and 2.28, respectively. On the other hand, in the control group, the above mentioned mean scores were measured at 9.40, 6.80, 4.51, and 2.7 respectively (P<0.05). Nonetheless, it is noteworthy that no significant difference was observed between the two groups regarding the incidence of nausea and vomiting.

As evidenced by the obtained results, preemptive dexamethasone reduces the post tonsillectomy pain in the first four hours after pediatric adenotonsillectomy. Moreover, it was revealed that it accelerates the initiation of soft-diet feeding without exerting any effect on nausea and vomiting.

Among the different stages of the criminal process, the stages of trial and execution of punishment are very important because at the trial stage, the final decision was made on the person's criminality, and the previous actions of the criminal justice system were effective at the stage of the execution of the sentence, and the sentence is implemented. A look at legislative and judicial policy suggests that various professionals assist the criminal justice system in carrying out these tasks, among which the most important are legal doctors. The legal practitioners, through the criminal process, fulfill a fair trial and, while removing the ambiguity of the specialized issues at the trial stage, also facilitate the execution of the penalties. Therefore, the purpose of this study is to investigate the aspects of legal medicine intervention in the process of trial and execution of punishment. In fact, this research seeks to answer the question of how the doctors' participation in the trial and execution of punishment affects the criminal process. The method of doing research is descriptive-analytic and the collection of data and information is also scientific documents. A summary of the research reveals that forensic medicine has intervened in different stages of the trial and execution of punishment. At the trial stage, according to the type of punishment, the degree of medical intervention differs, that is, in the Qesas, forensic medicine theory has a large role in the judicial decision on the implementation or non-execution of punishment, in Diyat, the judge takes into account the amount of Diyea forensic medical theory, in Hodood the theory of forensic medicine doctrine has played an important role in proving or rejecting accusations, and in Taezirat, forensics medicine theories form an important part of the personality case. In the enforcement phase, forensics medicine sometimes contributes to the practice of punishment, sometimes prevents the practice of punishment and sometimes also provides health care.

Langerhans cell histiocytosis (LCH) is characterized by the congregation of proliferating langerhans cells (LC). Langerhans cells are a part of dendritic cell system of primary immune response that is responsible for presenting antigen to lymphocytes. Being a rare disease, the total incidence of LCH is reported to be 1 in 2 million people. LCH mainly affects children and young adults, with a slight male predilection. LCH is clinically divided into three groups namely Letter-Siwe disease (multiple multi organ affecting LCH at very young age), Hand-Schuler-Christian disease (LCH of bone involvement exophthalmos and diabetes insipidus), and Eosinophilic granuloma (LCH of bone, solitary or multiple). The extent of involvement influences the treatment planning. In this retrospective study, we survey five patients with eosinophilic granuloma in jaws (bony LCH). The diagnosis was confirmed by tissue biopsy and histopathologic examination. Surgery and curettage of the lesions were carried out under general or local anesthesia. After surgery, the patients were examined clinically every 6 month in the first year and then once in a year. The overall outcome was excellent. According to the results, it can be concluded that surgical curettage of localized eosinophilic granuloma is an appropriate and sufficient treatment.

Temporomandibular joint dysfunction (TMD) is a term that describes problems in the masticatory system, including the temporomandibular joint, the dento-muscular system and the supporting bones. Injection of botulinum toxin, as a noninvasive technique, might be useful in decreasing symptoms such as muscular spasm, dystonia, migraine headaches and TMD. Therefore, the aim of the present study was to evaluate the effect of injection of botulinum toxin on decreasing the symptoms and signs of masticatory muscles in patients with TMD. A total of 61 patients were consecutively included in the present study in 2016‒2017. All the subjects received a 50-unit injection of Dysport botulinum toxin in the masseter muscles using an extraoral injection technique. The results of the injection were evaluated in terms of pain severity using VAS, clinical evaluations of the joint click through palpation and by determining the inter-incisal distance. The patients underwent follow-up examinations at 1-week, 3-month and 6-month intervals after injection. Data were analyzed with appropriate statistical tests. Comparison of pain severity and articular clicks at different intervals showed decreases in these parameters over time, with significant differences between the time intervals (P<0.05). Comparison of mouth opening at different intervals showed increases in mouth opening over time. The results of the present study showed that injection of botulinum toxin can be used in patients with TMD as a non-invasive treatment modality.

Bisphosphonates are commonly used in the management of skeletal complications such as metastatic bone disease, hypercalcemia of malignancy and osteoporosis. However, these chemicals may have an adverse side effect called BON (Bisphosphonate-associated osteonecrosis). The objective of this study was to assess the awareness among dentists in Tabriz, Iran about the bisphosphonate-related Osteonecrosis of the Jaw (BRONJ). In this descriptive, cross-sectional study a total of 270 dentists were involved to determine their knowledge about the BRONJ. The questionnaire was already validated by ten faculty members and university researchers. The average knowledge scores of participating dentists about BRONJ was 8.47± 2.52. The lowest score was 2 and the highest score was 12.There was no significant relationship between knowledge scores with age, university of graduation and the duration of clinical work experience. Women and recent graduates were found to have statistically significant more knowledge. The dentists working at Tabriz city have good knowledge regarding the BRONJ.

The activities of the criminal justice system began with the commission of the crime and tries to social order is restored and the victim is entitled to the right with the transition from the stages of exposure of a crime, prosecution, investigation, trial and execution of the sentence. Throughout the steps above, the steps taken in the exposure of a crime, prosecution, primarily investigation have a significant role in discovering the truth. The realization of this goal is outside of the jurisdiction of the judicial authorities, and various experts, including doctors, help them. The question arises is that: the presence of doctors in the process of discovery, prosecution and preliminary investigations will affect the criminal process? Through the establishment and management of NGOs in the field of patients, they can participate in the detection of crimes against the patients. They can also independently inform prosecutors about crimes against patients and help initiate a criminal justice system intervention. In addition, the results of medical examinations on the records of the suspects' illnesses constitute an important part of the person's case file and help the judiciary to issue appropriate sentences. Additionally, doctors, according to their oath, are obliged to provide services to all individuals. Therefore, if the accused needs medical assistance and the judicial authority asks them, they will commit themselves to executing the order of the judiciary. Ultimately, the views of doctors can play an important role in discovering the truth and possibly leading to a reduction or deterioration of criminal responsibility. This article attempts to analyze the most important effects of the role of doctors in the pre-trial stages (exposure of a crime, prosecution and preliminary investigations) with using a descriptive and analytical method and based on the legal articles. Please cite this article as: Moghaddasi MB, Yazdani J. The Role of Doctors in the Pre-Trial. Iran J Med Law 2019; 13(48): 65-90.

The ideal position of the plates and the need for additional plates are discussed continuously. In mandible, the tensile forces at the fracture line should be neutralized with a tension band. This study evaluated the role of the mandibular arch bar as a tension band eliminating the need for an upper miniplate (tension band plate) in cases of parasymphysis fractures. In this randomized control trial, a total of 90 patients with mandibular parasymphysis fractures underwent treatment in two groups. Group A was treated with one titanium miniplate along with Erich’s arch bar. In Group B, two titanium miniplates were placed across the fracture site along with Erich’s arch bar. Then, the complications and duration of the operation time were compared between two groups. The results were considered statistically significant when the P < 0.05. No significant difference was observed between the groups regarding postoperative complication rate. 1 month after surgery in Group A, number of patients with sensory impairment (17%) was significantly lower than Group B (37%) (P = 0.029). Furthermore, the operation time of Group A was significantly shorter than Group B (P < 0.001). In the presence of arch bar, placing one miniplate instead of the routine technique of placing two, do not increase complication rates. Furthermore, it reduces the operation time and costs and results in a better neurosensory recovery outcome in short time.

Today the penal intervention in family domain is becoming common in spite of some contradictory views. The advocates believe that the government's to Intervention must be controlled , and penalties should be used as the last resort Penal intervention, taken from criminalization basis, not only confines citizen’s freedom but also it is contrary to the principles so its implementation needs to be justified. In this regard, the four principles including making harm, building legal patriarchy, moralism and perfectionisicm, all which already exist in criminalization basis, have been raised to justify criminalization. Although, it should be pointed that the principle “making harm” has the most impact on family criminalization laws rather than other above principles. This paper tries to analyze the instances of Penal intervention in family domain using the descriptive and analytical method, while expressing the principles of criminalization. Hence, after expressing an introduction to the necessity penal intervention the principles, as well as relevant examples, will be mentioned accordingly.

In recent years, there has been a significant increase in the incidence of injuries and the relevant morbidity and mortality in Iran. The present study was undertaken to determine the etiology, type, and treatment modalities applied to zygomatic fractures and investigate the correlation of postoperative complications with the treatment modality used in patients referring to Imam Reza hospital.

The target population consisted of all the patients with zygomatic bone fractures referring to the oral and maxillofacial surgery service of Imam Reza hospital (2011 - 2012). Demographic data, the reason for trauma, the trauma date, the location and the type of fracture, and the clinical symptoms of fracture were recorded in checklists. The surgery was undertaken and the surgical procedure, the type of the therapeutic intervention and its complications, the type of the plate used, and the place it was used for fixation also were recorded in the checklists. Data were analyzed with descriptive statistics and chi-squared test using SPSS 21.

Of 165 patients with zygomatic fractures, 80% were male and 20% were female with a mean age of 32.81 years. Motor vehicle accidents were the most important cause of zygomatic fractures (64.8%), and the infraorbital nerve paresthesia was the most frequent symptom (62.4%). Paresthesia was the most frequent complication remaining after surgery in three follow-up visits (38%). The most commonly used open surgical procedures were eyebrow (53.9%), subciliary (46, 27.8%), and vestibular (46, 27.8%) surgeries, respectively.

Male patients, with amean age of 32 years, exhibited the highest rate of zygomatic fractures. Themost commonly used open surgical procedure was eyebrow surgery. Paresthesia of the infraorbital nerve was the most prevalent postoperative complication but these complications had no relationship with the surgical techniques used.

Dental implants are utilized with an ever-increasing rate. One of the causes of abutment screw loosening has been identified as inadequate preload. The objective behind this study was to compare the maximum hand-generated torque for tightening abutment screws by professors and postgraduate dental students using a digital torquemeter with 0.1 N/cm precision. In a laboratory study conducted in Dental Implant Department of Faculty of Dentistry, Tabriz University of Medical Sciences, the maximum hand-generated torque for tightening abutment screws by professors and postgraduate dental students was investigated, using a digital torquemeter with 0.1 N/cm precision. The participants consisted of 36 (41.9%) females and 50 (58.1%) males, totaling 86 participants, of whom 45 (46.87%) and 41 (53.13%) were university professors and postgraduate dental students, respectively. The mean age of the participants was 33.4±10.2 years with an age range of 25‒60 years; 50 (58.1%) participants were in the 25‒34-year, 23 (26.7%) in the 35‒47-year, and 13 (15.1%) in the 48‒60-year age range. The mean age of professors and postgraduate dental students was 41±8.3 and 25.1±3.3 years, respectively. The means of maximum torques generated by female and male professors were 14.3±3 and 20.8±4.2, respectively. The means of maximum torques generated by female and male postgraduate dental students were 14.7±3.4 and 18.7±4.3, respectively. Statistical analyses showed no significant differences between the mean maximum torques generated by professors and postgraduate dental students (P=0.051). In the present study, the mean maximum torque generated by professors was higher than that generated by postgraduate dental students. However, the difference was not statistically significant. The mean maximum torque generated by male subjects was significantly higher. No interaction was seen between the studied groups and sex. However, there was a statistically significant difference between the mean maximum torques generated in different age ranges; i.e., the maximum torque generated in the 25‒34-year age range was lower than that in the other two age groups. Finally, the effect of age range on the mean maximum torque was similar in both groups.

Inattention to the principles of writing prescriptions might give rise to ineffective or hazardous treatment and inflict injuries to the patient. The aim of this study was to evaluate the last-year dental students’ skill in writing prescription at the Tabriz Faculty of Dentistry in2016-2017.
In this cross-sectional study, all last-year dental students (92 students) at the Tabriz Faculty of Dentistry were asked to write separate prescription for 3 patients. The level of compliance with the principles of writing prescriptions was evaluated based on the WHO checklist, which consists of the following items: patient’s name, gender and age; date of prescription; Rx symbol; the form and name of the drug; the dose of the medication; the number of the drugs to be filled; administration interval; the strength of the drug; route of administration;the signature and seal of the physician; and the refill order. Each correct item was given a positive score and each incorrect item received no score (score range: 0-45).
10.9%, 43.5% and 45.6% of the students exhibited high, moderate and low skill.The mean score was 27.75 (SD 8.75) of a total possible score of 45. There were no significant differences between male and female students (P = 0.7, CI = -4.5 to 3.2, effect size = -0.035).
Overall, final-year dental students’ skill in writing prescriptions was at a moderate level and no student fully observed all the principles for the correct method of writing prescriptions.

Supporting form all community members is one of the most important duties of governments. However, some groups, including patients, need to special attention because of their vulnerability. Governments use a variety of tools to do this assignment. The use of punishment and criminalization of behaviors that impede this task or violates the rights of individuals is one of the most important tools. It should be used in limited cases and only as the last resort, and the use cases also need to be justified, because it is contrary to principle. Hence, various principles have been developed to justify it. Harm principle, legal patriarchy, moralism and legal perfectionism are the most important of these principles. Searching Iran's penal code shows that it is possible to trace each of these principles to the crime of different criminal behavior. This is also true for cases of criminalization in support of patients. The findings of this paper shows that the principle of harm has the most impact on Iran's criminal law in protecting patients. Similarly, examples of crime in support of patients were found in the framework of the principles of legal moralism and legal perfectionism. On the other hand, there were no criminal offenses based on the legal paternal principle. This article tries to extract and analyze the laws based on these principles and in order to protect the patients from the collection of criminal laws, using the descriptive and analytical method, while expressing the principles and principles of crime.

One of the main factors influencing students’ learning is learning style that tends to be flexible thus facilitating the learning process by adapting to a given teaching method. The aim of this study was to identify the learning styles of dental students at Shahid Beheshti University of Medical Sciences.

The population of this descriptive, cross-sectional study included all junior and senior dental students at International Branch of Shahid Beheshti University of Medical Sciences during 2016-17. Subjects were selected by means of complete enumeration sampling and standard VARK questionnaire (version 7.8) was used to collect data. Data were analyzed using descriptive and inferential statistics.

Of the 93 students, 72% were female and 28% were male. Their average age was 25.09 years and their mean GPA of their previous semester was 15.5. The results showed that 86% of the students used a single style with auditory style as the dominant style. Kinesthetic and auditory styles were the most frequent styles among the male and female students respectively. Double style technique was the most frequent multiple learning style. Moreover, no significant relationship was found between demographic variables (p≤0.05).

It is recommended to determine students’ learning styles in the freshman year and especially after finishing the basic sciences course. This will help teachers adapt their teaching styles to students’ learning styles which in turn will improve the effectiveness of training courses.

Temporomandibular joint disorders (TMDs) usually present with symptoms and signs such as pain, mandibular movement, dysfunction, or joint sounds. Botulinum toxin type A (BTX-A) is a biologic toxin which inhibits skeletal muscle through hindering the production of acetylcholine in the nerve endings. This toxin is used for the treatment of hyperactivity of lateral pterygoid muscle and TMD symptoms. This comprehensive review aimed to evaluate the effect of BTX-A injections in the lateral pterygoid muscle on treatment of TMDs symptoms. In this study, online databases including Scopus, Medline, Ebsco, Cochrane, EMBASE, and Google scholar were searched for the keywords “pterygoid muscle” and “Onabotulinumtoxin A”.
Twenty-four articles were eligible to be enrolled in the study. In 4 interventional studies and 20 descriptive studies, BTX-A was used for the treatment of TMDs. The dosage and number of injections were different in each study; however, the injection methods were relatively similar. Regardless of the type, number of injections, and dosage, injection of BTX-A in lateral pterygoid seems effective in reducing the click sound and other TMJ-related muscle disorders such as pain, hyperactivity, and dysfunction.

Background. Osteoporosis is a systemic skeletal disease characterized by a decrease in bone strength with an increase in the risk of fractures. This study aimed at evaluating the ability to predict osteoporosis and osteopenia based on radiographic density values obtained from CBCT imaging technique.
Methods. CBCT images of 108 patients were prepared by using NewTom VGI (QR, Verona, Italy). Then the patients were assigned to osteoporosis, osteopenia and healthy group, using the T-score derived from the DEXA technique. Finally, RD of the lateral mass of C1 on the left and right sides and body and dens of the C2 were measured. RD values were compared between the three groups by one-way ANOVA, followed by an appropriate post hoc test.
Results. The results of the comparisons of RD values at the first and second cervical vertebrae in the three groups showed that all the values had statistically significant differences (PConclusion. Based on the findings of this study, it is possible to predict the osteoporosis status of the patient through the RD related to the body of C2 and the left lateral mass of C1 more accurately than the other areas.

Background. One of the treatment methods for facial fractures is close reduction technique, but treatment with intermaxillary fixation (IMF) interferes with normal nutrition, and malnutrition can affect patient’s recovery. Anthropometric measurements such as skinfold thickness and body mass index (BMI) are universal indexes for diagnosing malnutrition. So in this study we pointed out how treatment with IMF changed the anthropometric indexes.
Methods. In this study 60 patients were treated with 4weeks of IMF, skinfold thickness and BMI of these patients were measured and compared before and after the treatment.
Results. Patients’ weight, BMI and skinfold thickness decreased during the IMF period, and this decrease was statistically significant (pConclusion. Although no severe and acute malnutrition was seen among our patients; but IMF led to mild to moderate malnutrition in some cases, which makes using nutrition supplements considerable in these situations.

The inferior alveolar canal must be constantly examined as an important anatomical landmark in the study of lower jaw, particularly posterior body and mandibular ramus sites, in dental and surgical procedures. In the present study, the effect of two pathological lesions, ameloblastomas and keratocystic odontogenic tumour, on canal displacement were investigated.
In total, 26 patients with lesions referred to Tabriz Imam Reza Teaching Hospital were studied in two equal groups (13 patients with a histopathologic ameloblastoma diagnosis and 13 with a histopathologic odontogenic keratocyst diagnosis) after confirming the initial incisional biopsy and pathologic report, the CBCT of the lesions larger than 3 cm mesiodistaly and those involving the posterior body and ramus of mandible, entered the study. Two maxillofacial surgeons with an oral and maxillofacial radiologist examined three points of CBCT imaging to determine the position of the mandibular canal to the lesions from the buccal and lingual aspects.
The results of statistical analysis showed that in ameloblastoma, inferior alveolar canal has been displaced buccally in ramus region (84.6%) but in distally region, displacement was less buccally (41.6%). In KOT it has been no significant difference in displacement of inferior alveolar canal between proximal and distal region of the lesion observed. Finally chi-squared test showed no statistically significant difference between two lesions.
The results of the statistical analysis showed that there was no relationship between these types of lesions and the inferior alveolar canal displacement.

Since lately¡ it was believed that only big enterprises could own a “brand”¡ but by emerging the idea of “micro-brand” this conception changed )Scott Gross¡ 2001(. The term »Micro-brand« is defined as a structure apposite to small and medium businesses¡ designers and independent producers. This draws attention to the importance of launching businesses training courses. However¡ in curriculum of industrial design in universities of Iran¡ such courses have not been included. Furthermore¡ crowdfunding platforms such as Kickstarter designed to raise funds for mass-producing the designs¡ for Iranian students has little benefit as publishing an electronic journal for innovative products. This article reviews a model provided in the United States for training the methods of launching personal businesses to the students of industrial design. Later on¡ focusing on “fundraising” through crowdfunding¡ it considers the analysis and study of the domestic facilities and potentials; moreover¡ it attempts to provide solutions for design schools in Iran in the direction of training entrepreneur students.

Postoperative pain from open reduction and internal fixation of mandibular fracture is a serious issue. Amantadine is an N-methyl-D-aspartic acid or N-methyl-D-aspartate (NMDA) receptor antagonist that can be effective against postoperative pain..
The present study examined the efficacy of amantadine in alleviating the postoperative pain of mandibular fracture surgery..
Patients and In this double-blind study, 60 patients (ASA physical status I–II) were randomly divided into two groups. The mean ages of the participants were 31.2 ± 13.1 years and 32.3 ± 18.1 years, respectively. The male/female ratios were 24/6 and 26/4, respectively, in the case and control groups. Randomization was based on a single sequence of random assignments using computer-generated random numbers. Group I was given oral amantadine 100 mg 1 hour before surgery, and group II received a placebo at the identical time. Through PCA pumps, patients received a bolus dose of morphine at 0.02 mg/kg body weight, to a maximum of 1.5 mg. PCA pumps were set at 6 minutes lockout intervals and a maximum dose of 0.15 mg/kg/h, to a maximum of 10 mg/h. Pain was assessed using a visual analog scale (VAS) at 0, 2, 4, 6, 12, and 24 hours and 1, 2, 3, 4, 5, and 6 months after surgery. The amounts of analgesic consumed were recorded for the first 24 hours, and for 6 months after surgery..
There were no significant differences between the two groups with respect to age, gender, nausea and vomiting, sleep quality, blood pressure, and heart rate. No significant differences were observed between the two groups in pain scores (P = 0.39) and analgesic consumption (P = 0.78)..
The results suggest that a single dose of preoperative oral amantadine did not reduce acute or chronic postoperative pain, nor analgesic consumption..

One of the treatment techniques for mandibular and midface fractures is intermaxillary fixation (IMF), but treatment with IMF interferes with normal nutrition, and malnutrition can affect the result of the treatment and patient’s recovery.
Paraclinical factors including lipid profile and protein profile indexes which are diagnostic for malnutrition were evaluated in this study to point out how treatment with IMF changes these indexes. In this study, 60 patients were treated with 4 weeks of IMF, the lipid profile and protein profile indexes for these patients were measured before and after the treatment.
The albumin (Alb) decreased during this period, but a slight increase was shown in the hemoglobin (Hb) level. All lipid profile indexes such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and total cholesterol (TC) decreased during this period but not statistically significant.
Treatment with IMF could cause a malnutrition situation although not severe, which makes using nutrition supplements considerable in these cases.

The infratemporal fossa is an anatomic space of great importance in the head. Abscesses of this space are rare but potentially life threatening. Regarding the proximity of some important anatomical features of the head, dealing with infratemporal space infection needs great consideration both in examination and surgical practice. In this case report, infratemporal space abscess formation following the removal of zygomatic arch suspension wire in a healthy, male, young patient and its treatment protocol are presented.

Backgrounds and Dry socket is a painful disabling condition almost following dental extractions. Given the high prevalence of this complication، many researchers have tried to find successful methods to prevent its occurrence. The purpose of this study is was to evaluate the effect of Gelatamp in prevention of dry socket. In this study 65 subjects with two impacted third molars in mandible were selected. Teeth were removed by conventional method and Gelatamp was inserted in one of the sockets randomly. All patients examined clinically four days after the surgery and obtained data were analyzed statistically. From total number of 57 subjects two subjects after Gelatamp application (22. 2 %) and seven subjects in the controls (77. 8 %) experienced dry socket. The difference between two groups was not significant (p = 0. 08). Gelatamp could be an effective strategy in the prevention of dry socket after mandibular impacted third molar removal.

Monocortical miniplate fixation is an accepted and reliable method for internal fixation of mandibular angle fractures. Although placement of a second miniplate may theoretically provide more stability; however, the clinical importance of this issue remains controversial.

The present study assessed the postoperative complications and outcomes associated with the fixation of mandibular angle fractures using 1 and 2 miniplates in patients with favorable mandibular angle fractures.

A prospective study of 87 patients (73 males, 14 females) with favorable mandibular angle fractures was done. In the first group, a 4-hole miniplate was placed at the superior border through an intraoral approach. In group 2, patients were treated with 2 miniplates, one placed at the superior border (similar to group 1) and the other on the lateral aspect of the angle at the inferior border through an intraoral and transcutaneous approach using a trocar. Postoperative complications including malocclusion, malunion and sensory disturbances associated with surgery, additional maxillomandibular fixation (MMF) by means of an arch bar and wires for a longer period (for delayed union) and infection were assessed in patients of both groups up to 12 months postoperatively. The data were analyzed using the chi-square test.

In the single miniplate group, 25 patients showed lip numbness associated with surgery (55.6%), 22 patients required additional use of MMF (48.9%) and 3 patients developed infections (6.7%). In the double miniplate group 20 patients showed lip numbness associated with surgery (47.6%), 18 patients required additional use of MMF (42.9%) and 1 patient developed infection (2.4%). None of the patients in either group showed malocclusion or malunion. No significant difference was observed between the groups regarding overall complication rate.

In this study, use of one miniplate or two miniplates for treatment of favorable mandibular angle fractures was associated with a similar incidence of complications. Thus, it seems that the use of two miniplates in this setting may not be warranted, nor cost-efficient.

Mucormycosis is a highly aggressive fungal infection which has the most aggressive behavior among all fungal infections. This infection typically affects immunocompromised patients and is rare in healthy individuals. Foreign bodies in open injuries may serve as the most common feature of mucormycosis infection in healthy patients. Early diagnosis is essential for successful treatment. Her, we report mucormycosis in a 52-year-old female without any systemic disease, with the history of an extraction of a maxillary first molar for about one month ago. Signs and symptoms included pain in the socket, swelling in maxillary alveolus with diffuse erythema, discharge in the socket, necrotic and exposed bone. In histopathological study, mucormycosis was reported. The patient was treated with debridement, fluconazole, nutritional support and hydration which resulted in patient’s recovery. Foreign bodies like dental calculus and delayed epithelialization in the socket may be considered as the predisposing factors in this case.

Impacted third molar surgeries are common in dental settings. Post-operation complications including pain and dry socket are also common. Reducing these complications is one of the necessities in oral surgeries. Although a few studies have found prophylactic metronidazole as an effective means of preventing dry socket, in most of these studies interventional factors have not been controlled properly. Therefore, the present study was aimed at evaluating the effect of metronidazole on prevention of pain and dry socket after controlling the interventional factors. A clinical trial was conducted in double-blinded manner on 42 patients with two mandibular impacted third molars. In each subject, both third molar teeth in mandible were selected, one as control. In case group, metronidazole gel (25%) was placed in the socket after tooth extraction. All operations were carried out by one oral surgeon under same circumstances. Demographic data, and pain and dry socket were evaluated by clinical examination and completing questionnaires 4 days after surgery. The interval between two surgeries was at least one month. The data were statistically analyzed by SPSS and Fisher’s exact test. Four days following surgery, 3 subjects in the case group (3.6%) and 5 subjects in the control group (6%) experienced dry socket. There was no statistically significant difference between the cases and controls (P=0.72). Metronidazole gel (25%) placement in the socket is not efficient in reducing complications after surgical removal of third molars.