[New method for treatment of intrabony vascular malformation of the mandible]

Vascular malformations are presented at birth. Some %35 of vascular malformations occurs in bone. Intrabony hemangioma may also occur and probably is indicative of either venous or arteriovenous malformations. The aim of this report was to assess previous studies and also presenting a patient with intrabony vascular malformation. A twenty - year old man with an extensive multi-locular radiolucent lesion at the right side of mandible with bone destruction, buccal and lingual cortex expansion, malocclusion, teeth displacement, facial asymmetry, and bleeding after tooth extraction or biopsy was referred for control of bleeding. Intra - osseous hemangioma was diagnosed by clinical and para - clinical [panoramic - computerized tomography - angiography] examinations. Following access to external carotid artery by a vascular surgeon and retraction of buccal and lingual soft tissues, the right side of mandible was resected [from middle portion of ramus to left central incisor]. After complete curettage of lesion and inter - maxillary fixation, the mandibular bone was fixed at its exact location by using three plates and ten screws for six weeks. The advantages of this method are: The use of patient's bone for mandibular reconstruction bypasses the process of bone harvesting from another site [iliac - calvarium], Shorter time of surgery and general anesthesia and lower morbidity rate, Intra - orally approach leaves no scar on the skin

Evaluating mortality rate caused by electrolyte abnormalities in hospitalized patients

Adjustment of composition of body fluids and electrolytes is one of the most important aspects of patients care. Sodium and Potassium are the most important body cations, the improper adjustment of them will cause sever disorders in neuromuscular, gastrointestinal, respiratory and cardiovascular systems. Acute renal failure indicated by increase in creatinine and nitrogen urea, brings an accumulation of fluids, salts and metabolites of nitrogen in body. This study intends to assess the status of electrolyte abnormalities and mortality rates of the patients hospitalized in ICU wards in our country. This is a descriptive and retrospective study on the records of 378 patients hospitalized in ICU. A questionnaire was prepared and the data were entered in SPSS system. They were statistically analyzed by using chi-square and fisher's Exact test methods. Out of 378 patients hospitalized in ICU, over 2/3 of them were male and over half of them were>45 years old. Frequency distribution of electrolyte abnormalities was as follows: Hyponatremia 59% hypernatremia 23% hypokalemia 37% hyperkalemia 28%, 35% and 21% of patients had respectively BUN and creatinine more than the normal range. 26% of patients hospitalized in ICU had nonsurgical problems and 74% of the patients had surgical problems. Average time of hospitalization in ICU was 85 days and mortality rate was 35%. The most common electrolyte abnormality was related to variation in serum sodium levels in the form of hyponatremia. And the highest prevalence electrolyte abnormality in dead patients was hyponatremia. This study proves that the prevalence of electrolyte abnormalities is directly related to mortality and increase in hospitalization period and those having undergone surgical operations during hospitalization in ICU, manifested more abnormalities

[ epidemiology of mid facial fractures at two hospitals in Qazvin [1995-2005]]

Qazvin [Iran] during 1995-2005. This was a descriptive cross-sectional study in which the demographic and other existing information including age, sex, job, site and cause of fracture, place of living, season, fracture-associated signs and symptoms, type of radiography, and the treatment methods were collected and analyzed statistically using SPSS. The data obtained from 3257 cases showed that the prevalence of fracture in men was higher than that of females. Most fractures occurred in 10-19 year age group. The nasal bone was the most commonly fractured bone [97%] followed by zygomatic fracture [3%] and fractures of maxilla [2/4%] and orbital [2/1%]. Fall [31/9%] and traffic accidents [23/3%] were found to be the two major causes of fractures. Regardless of nasal bone fractures, the most common cause of midfacial fractures was traffic accident [39/2%]. The type of radiography requested was mostly lateral nasal. The majority of fractures [30/8%] occurred in summer and mostly [22/9%] among students. Pain, bleeding, tenderness, and swelling were demonstrated to be the most frequent signs and symptoms. High prevalence of nasal fracture could be due to the prominency of this bone compared with other midfacial bones. Our findings in consistent with similar studies, support the view that the pattern of midfacial fractures vary from one country to another. Strict following of traffic and safety rules by drivers is of prime essentiality in reduction of such events

[Maxillary sinusitis in patients referred to Qazvin Qods hospital [2003-2004]]

Sinusitis is the inflammation of mucous membrane of maxillary sinus. The prevalence of maxillary sinusitis varies from one society to another based on the etiology. Sinusitis occurs secondary to dental origin in 10% of patients. Maxillary sinusitis can arise when the sinus membrane is violated following extraction of teeth, facial trauma, and maxillary osteotomies. To determine the frequency of maxillary sinusitis in patients referred to Qods Hospital in Qazvin [2003-2005]. This was a descriptive cross-sectional study in which the demographic information including age, sex, symptoms, sinus involvement and the type of treatment were obtained and analyzed using SPSS statistical software. The results showed that the frequency of maxillary sinusitis was 86.95% [40 patients]. Of 46 patients, 60.9% [28] were males and 39.1% [18] females. The male/female ratio was 1.5 to 1. The mean age of patients was 10.3 +/- 10.5 years with an age range of 2-56. The right maxillary sinus was the one frequently involved compared to other sinuses [27 cases, 58.69%]. The left maxillary sinus in 3 cases [6.5%], both right and left maxillary sinuses in 10 cases [21.74%], and the frontal sinus in 5 cases [10.86%] were involved. In one patient, no sinus involvement was observed. Antibiotic therapy was given to 89.1% [41] of patients and in 10.9% [5] of cases a combination of medical therapy and surgery established. Fever, postnasal discharge, cough, pain were observed as the most common symptoms in 56.5, 47.8, 43.55, and 43.5% of patients, respectively. Considering the high frequency of maxillary sinusitis [86.95%] found in our study, the destructive outcomes of maxillary sinusitis and the treatment costs could be lowered if attempts are made to promote the knowledge of dentists and also establishing a logical relationship between ENT specialists and the dentists

prevalence and risk factors of dry socket in dental surgery clients following tooth extraction at Qazvin Faculty of Dentistry

Dry socket is one of the complications occurs following tooth extraction. The prevalence of such condition is reported to be highly different ranging from 0.5-68.4%. The etiology and pathogenesis are not clearly known but many related predisposing factors have been discussed. To evaluate the prevalence and risk factors of dry socket after tooth extraction. This cross-sectional study was carried out at the department of oral and maxillofacial surgery in Qazvin university of medical sciences [Jan 2002 to Jan 2003]. Out of 1402 patients, those having their teeth extracted and returned with dry socket were chosen. Characteristics such as, age, sex, site of extraction, extracted tooth, trauma during extraction, periapical lesion, oral hygiene, smoking, systemic diseases, and OCP in women [oral contraceptive pill] were determined. Over the one-year period of study, 1402 teeth were extracted and in the meantime, 12 patients returned with dry socket. Our results showed that the incidence of dry socket was 0.85% and the ratio of females to males was 2.5 to 1. Dry socket in mandible was two times higher than maxillae [1.12% versus 0.57%]. Mandibular third molars were more often involved than other areas. Periapical lesion, trauma, poor oral hygiene and OCP increased the incidence of dry socket. Prevalence of dry socket after tooth extraction in Qazvin oral and maxillofacial surgery clinic was not higher than other centers. Seemingly, application of atraumatic techniques, aseptic procedures, ability of surgeon, oral hygiene and so on can lead to a lower prevalence of dry socket

Diagnosis of central giant cell granuloma using fine needle aspiration biopsy

Easiness, accuracy, reliability and usefulness of fine needle aspiration biopsy [FNAB] have been frequently verified. This procedure is routinely used to diagnose the tumors of thyroid and parotid glands in head and neck areas. To investigate the diagnostic value of FNAB in central giant cell granuloma [CGCG] of the jaws. 16 cases out of the patients referred to surgery department of dental faculty were chosen based on radiolucent lesion in which a CGCG as a differential diagnosis was suspected. In each case the perforation and aspiration of lesion was performed using an 18 gauge syringe. Sampling was carried out in triplicate e.g., three syringes and three different points. The aspirated samples were smeared on slides, fixed with Patofix and sent to pathology department to be examined histologically. In four samples from a total of 16 specimens obtained by FNAB, the pathology report was indicative of the presence of giant cells as well as bleeding, inflammation, lymphocytes and polymorphonuclear cells. Histopathological studies on postoperative specimens confirmed the presence of CGCG in three samples out of four. The results showed a sensitivity of 100% and a specificity of 75% for giant cell granuloma of the jaws using FNAB method. Based on data found in our study, the application of FNAB technique, if performed precisely, in combination with clinical and radiographic findings will effectively help in diagnosis of CGCG. This will cause a reduction in expenses, size of stress and physical damage to patients and also prevent seeding of lesion