Journal of Craniomaxillofacial Research
Volume:1 Issue: 1, Winter-Spring 2014

Surgical removal of impacted third molars is amongst the most common surgical procedures performed by oral and maxillofacial surgeons. Every year many articles are published in different journals regarding different aspects in such surgeries. It is necessary to translate such vast amounts of data into simple and easily comprehensible sentences for the students of dentistry and oral surgery. This article is a modest and simple review of the recent literature and presents a number of tips, recommendations, and cautions intended to improve the quality of clinical practice in third molar surgery.

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.

Due to the increased prevalence of medically compromised patients who require dental treatments, it is a crucial task for dentists and dental specialists to prepare themselves for emergent professional situations. This study was performed to determine the prevalence of different medical problems among a population of patients admitted to a dental educational center. In this prospective study, the prevalence of medical problems in patients(n = 968) referred to the Department of Oral and Maxillofacial Surgery of the School of Dentistry of Tehran University of Medical Sciences, Iran, was investigated for 3 consecutive months. Among all patients, 397 were medically compromised patients. The mean age of the patients was 48 ± 0.15 and 51.4% were men. The results showed that 41% of the patients had at least one medical problem. The two most common diseases were hypertension (13.9%) and diabetes mellitus (6.3%), respectively. The majority of patients with medical problems were referred from private dental offices. The majority of patients (97%) had well-controlled systemic diseases that could be treated in a private office. This investigation showed the necessity of teaching the management of medically compromised patients in dental school curriculum and in continuous dental education programs.

Supplementation with minerals like calcium has been shown to be effective in preventing bone loss and increasing bone density. Thus, it can be assumed that if calcium supplementation is paired with bisphosphonates, greater benefit can be achieved. In this context, we decided to perform this animal study on ovariectomized rats to assess whether bisphosphonate supplemented with calcium can improve implant osseointegration compared to bisphosphonate and calcium alone. In this animal study, 40 ovariectomized rats were divided into 4 groups prior to implant insertion. The first group received 5 mg/kg intramuscular calcium gluconate 3 times per week for 4 weeks. The second group received 5 mg/kg intramuscular pamidronate 3 times per week for 4 weeks. The third group was administrated a combination of both intramuscular calcium gluconate and pamidronate. The control group received no medication. The rats were sacrificed and the contact surface ratio (CSR) was evaluated 8 weeks after implant insertion in tibial bone. The pamidronate receiving group had significantly better CSR than the Ca receiving and control groups (P < 0.001). Intravenous calcium did not improve CSR compared to the control group (P = 0.459). Short-term preoperative intravenous pamidronate can significantly improve bone to implant contact in post-menopausal animal models, whereas calcium supplementation has no beneficial effect.

The aim of this study is to define the trend of the orthodontists and the surgeons in the borderline Class III patients and assess their satisfaction after the surgery. The study population consisted of 31 patients (16 female and 15 male) with the average age of 21 years, whose final occlusion 2 months after the surgery was perfect. The amount of reverse overjet was less than 5 mm in all patients. Surgeons and orthodontists made their treatment plan separately and if there were any differences, the surgeon and orthodontist would discuss it and the patient would be treated by the best treatment plan. The patients’ satisfaction at least 5 months after orthognathic surgery was assessed quantitatively by means of a visual analogue scale (VAS) of 10 cm. Among 31 patients entered in this study, orthodontists suggested two-jaw surgery for 61% of patients while surgeons suggested two-jaw surgery for 45% of patients. In 35% of patients, the orthodontist’s treatment plans was different from the surgeon’s, but these differences were not significant (P = 0.23). This shows that the orthodontists’ and surgeons’ current trend in borderline Class III patients (reverse overjet less than 5 mm) is two-jaw surgery. At least 5 months after the surgery, the total satisfaction score for appearance was 5 (maximum 7 and minimum 2) and this can indicates that most of the patients see no changes in their appearance or their changes were not significant. Data analysis of this study indicated that there are no differences between orthodontists and surgeons trend in the treatment plan of the borderline patients, but both of them prefer two- jaw surgery (for 55% of patients) for borderline patients (discrepancy less than 5 mm).

Dental malpractice is the failure of a professional person to render appropriate services through reprehensible ignorance or negligence or through criminal intent, especially when injury or loss follows. Since dental implants have gained a special place in modern dentistry and this new treatment is a costly one, paying more attention to the prevention of malpractice is more important. In this study, we decided to survey the proportion of complaints of dental implant treatments and compare them to the total rate of dental claims in a period of 5 years. This was a retrospective cross-sectional study. Data was collected in Medical Council of Iran during 2006 to 2011 by the means of a checklist inquiring about the date of complaints, main complaint field, gender of doctor and complainant, degree (specialist/general) of the therapist, and the court decision. In regard to ethical issues, the name of dentist and complainants were not mentioned in any document. Data was analyzed using chi-squared test by SPSS. From the total 44 dental claims, 93% were for general practitioners and 86.5% of the accused dentists were male. Moreover, 33 complainants were female. In 57% of cases the court found the dentist guilty. The complaints of male dentist in the field of surgery had the greatest percentage (50%). The second field according to complainant frequency was implants and prosthodontics accounting for 27% of all dental claims. There was only 1 implant complaint submitted about a specialist, and all the others were from general dentists. There was no gender difference regarding dental implant complainants. According to study findings, implants and prosthodontics complaints are in the second rank of dental claims. Therefore, paying greater attention to the training process in universities and continuing training programs is necessary.

This case report describes a 59-year-old woman with a giant basal cell carcinoma on the face neglected for 11 years. Surgical resection of the lesion resulted in a 13 × 11 cm defect. Issues regarding the adequately safe surgical margins and the management of the resultant defect through modern wound dressing technologies are discussed.

In 1986 Altemir, for the first time, described submental intubation for maxillofacial cases. A problem with the technique is that the edges of the tube may damage the anatomic tissues of the mouth floor. To avoid such damages, a modification of this technique using nasal speculum is presented here. Moreover, with this technique blood and detached tissues cannot enter into the endotracheal tube while passing through submental tissues.