ABSTRACT
Statement of the Problem: Refractory nocturnal enuresis possesses a heavy psychosocial burden for the affected child. Only a 15% spontaneous annual cure rate is reported
Purpose: This patient-level meta-analysis aimed to evaluate the efficacy of rapid palatal expansion to treat nocturnal enuresis among children
Materials and Method: A sensitive search of electronic databases of PubMed [since 1966], SCOPUS [containing EMBASE, since 1980], Cochrane Central Register of Controlled Trials, CINAHL and EBSCO till Jan 2014 was performed. A set of regular terms was used for searching in data banks except for PubMed, for which medical subject headings [MeSH] keywords were used. Children aged at least six years old at the time of recruitment of either gender who underwent rapid palatal expansion and had attempted any type of pharmacotherapy prior to orthodontic intervention were included
Results: Six non-randomized clinical trials were found relevant, of which five studies had no control group. Eighty children were investigated with the mean age of 118 [28.12] months ranged from 74 to 185 months. The median time to become completely dry was 2.87 months [confidence interval [CI] 95% 2.07-2.93 months]. After one year, the average rate of becoming complete dry was 31%. The presence of posterior cross bite [relative risk [RR]: 0.31, CI 95%: 0.12-0.79] and signs of upper respiratory obstruction during sleep [RR: 5.1, CI 95%: 1.44-18.04] significantly decreased and increased the chance of improvement, respectively. Meanwhile, the other predictors did not significantly predict the outcome after simultaneous adjustment in Cox regression model
Conclusion: Rapid palatal expansion may be considered when other treatment modalities have failed. The 31% rate of cure is promising when compared to the spontaneous cure rate. Though, high-level evidence from the rigorous randomized controlled trials is scarce [Level of evidence: C]
ABSTRACT
Statement of the Problem: The presence of impacted third molars in the jaws is a common finding in the routine dental examination of patients. Concerning the odontogenic components of the dental follicle, it can be the origin of different types of odontogenic cysts and tumors
Purpose: The aim of this study was to find feasible radiographic criteria to help differentiate between normal and pathological dental follicles
Materials and Method: 134 asymptomatic impacted third molars were recruited in this study. Then, based on the radiographic measurements, the ratio between the diameter of the dental follicle and the mesiodistal width of the tooth crown was calculated. After surgical removal of impacted third molars, the related dental follicles were evaluated histopathologically. Statistical analyses were performed by adopting chi-square test, t-test, receiver oprating characteristic [ROC] curve, and logistic regression using SPSS-19 software
Results: The mean ratio of the dental follicle's diameter to the mesiodistal width, in the normal and cystic follicle group was 1.18 +/- 0.07 and 1.18 +/- 0.08, respectively. There was no statistically significant difference between this ratio and the histopathological evaluation. Based on the logistic regression analysis, only the age >20 years and inflammation had predictive value in identifying cystic changes in dental follicle
Conclusion: According to the findings of the current study, the ratio of dental follicle diameter to the mesiodistal width of the teeth cannot not be employed as a diagnostic index to differentiate between normal and pathological dental follicle
ABSTRACT
Odontogenic keratocyst is a developmental odontogenic cyst. It is to be considered for histopathological features and clinical behavior. It has aggressive behavior and tendency to recurrence and it has been named benign cystic neoplasm. OKCs have different radiographic appearance such as unilocular to multilocular radiolucency. In some cases, they have been observed in the interradicular area but in rare cases they can be found in periapical radiolucency in apex of non-vital teeth that may be mistaken with lesions of endodontic origin and cause mistreatment. A 33 year old male patient came to clinic because of swelling in the anterior region of mandible that was repaired with endodontic treatment. In the histological diagnosis of radiolucent lesion, inflamed odontogenic keratocyst was reported. Diagnosis based on clinical finding may risky because it can lead to inappropriate treatment. In most of the cases, microscopic examination of all material surgically removed is necessary for diagnosis. This is especially recommended when treatment of lesion is not successful with routine treatment