Journal of Craniomaxillofacial Research
Volume:9 Issue: 2, Spring 2022

Restoring oral function with dental implants after maxillofacial defects improves aesthetics and provides adequate nutrition to improve patients’ quality of life significantly. One of the essential methods of repairing jawbone defects is bone grafting. Graft sources may be vascularized or nonsecularized. The present study aimed to review the survival rate of implants placed in vascularized and nonvascularized bone grafts for extensive jaw reconstructions in 2010 to 2021 articles.

This study is a narrative review study. In this study, research published in PubMed, Google Scholar, and Scapus databases has been reviewed by a review method and with a keyword search strategy.

2815 articles were found from the mentioned databases that after removing unrelated research (2713 cases) and duplicate researches (63 cases), 39 articles remained for final review. Then, those research that were presented in the scientific conference and were in the form of abstracts or did not have a correct statistical population, were excluded from the study (18 cases) and finally 21 articles were reviewed.

Bone jaw defects are a severe complication that affects many aspects of a person’s life. Our results showed that vascularized and nonvascularized grafts are used for mandibular and maxillary bone regeneration. Also, after maxillary reconstruction, implant survival in vascularized and nonvascularized grafts was more than 90% in the 17 cases of 21 studied articles. Also, the duration of follow-ups was from 3 months to 14 years. Interestingly, in patients with head and neck cancer whose jaws were reconstructed with bone grafts and implants were placed in them, the survival rate of implants under radiotherapy was lower than in patients without radiotherapy.

Pain is the most leading cause of visits to physicians and dentists. It is also a common symptom of diseases that can significantly undermine the quality of life and physical activities. This study aimed to review the existing literature for the causes of  temporomandibular disorders (TMD) from the genetic point of view.

Four international scientific databases including Google Scholar, Biomed Central, PubMed, and ProQuest plus two Iranian databases including Magiran and SID. Then all articles published between 1980 and 2019 were searched using the following keywords: facial pain, genetic factors and temporomandibular disorders (TMDs). A total of 900 articles were found that 36 were review articles.

Our review shows that genetic factors have an impact on the incidence and pathology of TMDs These factors include TSPAN9 polymorphism and the COMT gene.

There is growing evidence indicating that genetic factors play a key role in the pathology of temporomandibular disorders, however, the underlying mechanism of pain is still largely unknown

Maxillofacial fractures are one of the most common fractures in the body due to trauma. Maxillary fractures, especially Lefort fractures, are common fractures. The aim of this study is to evaluate the prevalence and etiology of Lefort fractures in patients referred to Shahid Rajaei Hospital during 2011 to 2021.

In this cross-sectional study, 2700 patients who referred to the maxillofacial surgery department of Shahid Rajaei Hospital in Shiraz between 2011 to 2021 due to trauma and fractures of the jaw and face were examined. 903 cases were related to patients with upper jaw fracture and were included in the study. The demographic information of the patients, including age, sex, cause of trauma, and also the type of fracture, were extracted from their records. The etiology of maxilla fracture was divided into three groups: vehicle accidents, violence and interpersonal conflict, and accidents during work and sports. Finally, in order to analyze the data, it was done through statistical tests.

65% of patients were male and 35% were female. The average age of people was 38.5 years. Lefort I fracture was reported in 25% of patients, Lefort II fracture in 31% and Lefort III fracture in 11% of patients. 46% of patients had fractured maxilla due to vehicle accidents, 26% of patients due to interpersonal violence, and 27% of patients due to accidents during work and sports.

The prevalence of Lefort fracture in men is significantly higher than in women. In our society, injuries caused by road accidents, especially car accidents, are the most common causes of Lefort fractures. The most common type of Lefort fracture is Lefort II fracture. Of course, the cause of injury has an important effect on the pattern of injury.

Orthodontic appliances increase the risk of dental caries and gum disease. Since it is rather difficult to maintain oral hygiene in patients with fixed orthodontic appliances due to the presence of brackets, bands, and arch wires, they should be persuaded to take care of their oral cavity. Therefore, the present study was conducted to evaluate the effect of an oral and dental health educational intervention using motivational interviewing in adolescents with fixed orthodontic appliances.

Thirty adolescents with fixed orthodontic appliances aged 12-16 years presenting to orthodontics departments of school of dentistry, Tehran University of Medical Sciences, received individual counselling, verbal guidelines, and training for correct brushing and flossing techniques by a senior student of dentistry during a 20-minute motivational interview. To evaluate the effect of the intervention, oral health behaviors including brushing, flossing, and consumption of sugary snacks were collected in a self-report manner. Moreover, plaque and gingival indexes were measured before and one-month post intervention. The SPSS software version 23 was used for data analysis.

Among oral health behaviors, optimal frequency of brushing increased after the intervention (p=0.002). The mean plaque index was 0.99±0.43 before and 0.37±0.16 after the intervention, indicating a significant difference (p<0.001). Moreover, the mean gingival index (average inflammation) was 0.99±0.56 before the intervention, which improved to 0.30±0.20 after the intervention (p<0.001).

Educational intervention based on motivational interviewing reduced dental plaques and gingival inflammation and increased the frequency of brushing in the short term among adolescents with fixed orthodontic appliances.

The oral and maxillofacial region is exposed to many harmful agents and can be affected by a wide range of reactive, infectious, cystic, precancerous, and neoplastic  lesions. This study aimed to determine the prevalence of oral and maxillofacial pathological  lesions in pathology laboratories in Zanjan.

This retrospective descriptive study was conducted in the period  2014-2020 by referring to the hospitals and laboratories with pathologists in Zanjan. Information  about patients with histopathological lesions of oral and maxillofacial region was extracted, and  studied in terms of age, gender, location and histopathological type of lesion. Finally, the collected  data were entered into SPSS software version 22 and statistically analyzed (P<0.05).

A total of 176 histopathological lesions were investigated. Of them, 120 cases (58%)  were female and 74 (42%) were male. The mean age of the patients was 39.4 years. The most prevalent  lesion was periapical cyst (14.8%). In terms of tissue involved, the most lesions were related  to soft tissue (67%) and in terms of anatomical location, the most lesions were gingival mucosal  lesions (35.2%).

The prevalence of pathological lesions was higher in females than in males. Soft  tissue lesions were more than hard tissue lesions. Gingival mucosal lesions were the most prevalent  and lesions of the floor of the mouth and nasal vestibule lesions were the least prevalent ones. Given  the histopathologic nature of lesions, periapical cyst was the most prevalent lesion.

Ameloblastoma is a benign neoplasm with origin from odontogenic epithelium. Unicystic ameloblastoma has clinical and radiographically features resemble to other odontogenic cysts but it has a typical ameloblastomatous epithelium lining the cyst cavity.

Case: 

In this case report study, we presented a 9-year-old girl who was referred to Oral and Maxillofacial Surgery of Isfahan Dental School for the management of a large swelling on the right posterior mandiblular region. The histopathologic examination of the specimen showed mural type of unicystic ameloblastoma. In the first step, the patient was treated by decompression of the lesion. Five month after it, shrinkage of the lesion was observed and in the second stage of surgery, curettage of the remaining lesion and extraction of tooth buds in the areas of lesion was performed. After two years, radiographic image showed new bone formation and complete healing of the lesion.

Choosing the best treatment for children with unicystic ameloblastoma requires more attention and all clinical and histopathological parameters should be considered. Conservative treatment for ameloblastoma leads to reduce complications after treatment and affect the patient’s quality of life.

Central giant cell granuloma (CGCG) is a relatively uncommon benign osseous lesion with sometimes aggressive nature. The nature of this lesion is unknown and although the exact cause is unclear, the three theories about possibility of its nature are: developmental anomaly, reactive lesion or benign neoplasm. Histologically by presence of multinucleated giant cells within a stroma of spindle-shaped mesenchymal and fibro vascular connective tissue along with containing of hemorrhagic areas is characterized. This case report presents the diagnosis and management of a CGCG in a 50 years-old man with biopsy and surgical treatments. The lesion involve the left side of mandibular. Diagnosis plan was designed based on the combination of pathology and imaging. Finally after en bloc resection of involved regions of mandible, a titanium plate prosthesis was used for the jaw reconstruction. Since some of CGCG lesions can be highly invasive and inclinically and radiographic features can mimic as malignancy lesions.