The efficacy of low-level diode laser versus laser acupuncture for the treatment of myofascial pain dysfunction syndrome (MPDS)

Background@#Myofascial pain dysfunction syndrome (MPDS) is the most common type of temporomandibular disorder. This study compared the efficacies of low-level diode laser therapy (LLLT) and laser acupuncture therapy (LAT) in the treatment of MPDS. @*Methods@#This double-blind randomized controlled clinical trial included 24 patients with MPDS who were randomly divided into two equally sized groups. Patients in the LLLT group received 12 sessions of low-level diode laser irradiation applied to the trigger points of the masticatory muscles during 1 month. The same protocol was also used in the LAT group according to the specific trigger points. We measured pain intensity and maximum mouth opening in both groups at baseline, during treatment, and 2 months after treatment completion. @*Results@#The pain intensities decreased from 6.58±1.31 to 0.33±0.65 and from 7.08 ± 1.37 to 0 in the LLLT and LAT groups, respectively. The maximum mouth openings increased from 32.25 ± 8.78 mm to 42.58 ± 4.75 mm and from 33 ± 6.57 mm to 45.67 ± 3.86 mm in the LLLT and LAT groups, respectively. Pain intensity (P = 0.839) and level of maximum mouth opening (P = 0.790) did not differ significantly between the groups. @*Conclusion@#Our results showed similar efficacy between LLLT and LAT in the treatment of MPDS signs and symptoms.

Bone loss-related factors in tissue and bone level dental implants: a systematic review of clinical trials

Dental implants are popular for dental rehabilitation after tooth loss. The goal of this systematic review was to assess bone changes around bone-level and tissue-level implants and the possible causes. Electronic searches of PubMed, Google Scholar, Scopus, and Web of Science, and a hand search limited to English language clinical trials were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines up to September 2020. Studies that stated the type of implants used, and that reported bone-level changes after insertion met the inclusion criteria. The risk of bias was also evaluated. A total of 38 studies were included. Eighteen studies only used bone-level implants, 10 utilized tissuelevel designs and 10 observed bone-level changes in both types of implants. Based on bias assessments, evaluating the risk of bias was not applicable in most studies. There are vast differences in methodologies, follow-ups, and multifactorial characteristics of bone loss around implants, which makes direct comparison impossible. Therefore, further well-structured studies are needed.

Bone loss-related factors in tissue and bone level dental implants: a systematic review of clinical trials

Dental implants are popular for dental rehabilitation after tooth loss. The goal of this systematic review was to assess bone changes around bone-level and tissue-level implants and the possible causes. Electronic searches of PubMed, Google Scholar, Scopus, and Web of Science, and a hand search limited to English language clinical trials were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines up to September 2020. Studies that stated the type of implants used, and that reported bone-level changes after insertion met the inclusion criteria. The risk of bias was also evaluated. A total of 38 studies were included. Eighteen studies only used bone-level implants, 10 utilized tissuelevel designs and 10 observed bone-level changes in both types of implants. Based on bias assessments, evaluating the risk of bias was not applicable in most studies. There are vast differences in methodologies, follow-ups, and multifactorial characteristics of bone loss around implants, which makes direct comparison impossible. Therefore, further well-structured studies are needed.

Common conditions associated with displacement of the inferior alveolar nerve canal: A radiographic diagnostic aid

PURPOSE: This study reviewed the common conditions associated with displacement of inferior alveolar nerve canal. MATERIALS AND METHODS: General search engines and specialized databases including Google Scholar, Pub Med, Pub Med Central, Science Direct, and Scopus were used to find relevant studies by using keywords such as “mandibular canal”, “alveolar canal”, “inferior alveolar nerve canal”, “inferior dental canal”, “inferior mandibular canal” and “displacement”. RESULTS: About 120 articles were found, of which approximately 70 were broadly relevant to the topic. We ultimately included 37 articles that were closely related to the topic of interest. When the data were compiled, the following 8 lesions were found to have a relationship with displacement of mandibular canal: radicular/residual cysts, dentigerous cyst, odontogenic keratocyst, aneurysmal bone cyst, ameloblastoma, central giant cell granuloma, fibrous dysplasis, and cementossifying fibroma. CONCLUSION: When clinicians encounter a lesion associated with displaced mandibular canal, they should first consider these entities in the differential diagnosis. This review would help dentists make more accurate diagnoses and develop better treatment plans according to patients' radiographs.

Common conditions associated with mandibular canal widening: A literature review

PURPOSE: The aim of this study was to review the common conditions associated with mandibular canal widening. MATERIALS AND METHODS: General search engines and specialized databases including Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus were used to find relevant studies by using the following keywords: “mandibular canal,” “alveolar canal,” “inferior alveolar nerve canal,” “inferior dental canal,” “inferior mandibular canal,” “widening,” “enlargement,” “distension,” “expansion,” and “dilation.” RESULTS: In total, 130 articles were found, of which 80 were broadly relevant to the topic. We ultimately included 38 articles that were closely related to the topic of interest. When the data were compiled, the following 7 lesions were found to have a relationship with mandibular canal widening: non-Hodgkin lymphoma, osteosarcoma, schwannoma, neurofibroma, vascular malformation/hemangioma, multiple endocrine neoplasia syndromes, and perineural spreading or invasion. CONCLUSION: When clinicians encounter a lesion associated with mandibular canal widening, they should immediately consider these entities in the differential diagnosis. Doing so will help dentists make more accurate diagnoses and develop better treatment plans based on patients' radiographs.

Low level laser therapy versus pharmacotherapy in improving myofascial pain disorder syndrome

Introduction: Temporomandibular disorders [TMD] lead to masticatory muscle pain, jaw movement disability and limitation in mouth opening. Pain is the chief complaint in 90% of the TMD patients which leads to disability and severe socioeconomic costs. The purpose of this study was to evaluate the therapeutic effects of low level laser therapy [LLLT] compared to pharmacotherapy with NSAIDs [naproxen] in myofascial pain disorder syndrome [MPDS]

Methods: In this randomized controlled clinical trial, 40 MPDS patients were divided into two groups. One group received naproxen 500 mg bid for 3 weeks as treatment modality and also had placebo laser sessions. The other group received active laser [diode 810 nm CW] as treatment and placebo drug. Pain intensity was measured by visual analogue scale [VAS] and maximum painless mouth opening was also measured as a functional index every session and at 2 months follow up. Data was collected and analyzed with SPSS software. Independent t test was used to analyze the data. A P<0.05 was considered significant

Results: Low level laser caused significant reduction in pain intensity [P<0.05] and a significant increase in mouth opening. In naproxen group neither pain intensity nor maximum mouth opening had significant improvement. Pain relief, in subjective VAS was observed in third session in LLLT group, but did not occur in naproxen group. Maximum mouth opening increased significantly in laser group compared to the naproxen group from the eighth session

Conclusion: Treatment with LLLT caused a significant improvement in mouth opening and pain intensity in patients with MPDS. Similar improvement was not observed in naproxen group

38- year demographic study of central and peripheral giant cell granulomas of the gaws

Objective: the purpose of this study was to retrospectively analyze the demographic characteristics of patients with central peripheral giant cell granulomas [CGCGs] / [PGCGs] an Iranian population

Methods: in this 38-year retrospective study, the data were obtained from records of 1019 patients with CGCG and PGCG of the jaws referred to the Department of Oral and Maxillofacial, Pathology, Mashhad University of Medical Sciences, Iran between 1972 and 2010. Information regarding age distribution, gender, location of the lesion and clinical signs and symptoms was documented

Results: a total of 1019 patients were affected by giant cell granuloma lesions [GCGLs] including 435 CGCGs and 584 PGCGs. The mean age was 28.91 +/- 18.16. PGCGs and CGCGs had a peak of occurrence in the first and second decade of life respectively. A female predominance was shown in CGCG cases [57.70%], whereas PGCGs were more frequent in males [50.85%]. Five hundred and ninety eight cases of all giant cell lesions [58.7 %] occurred in the mandible. Posterior mandible was the most frequent site for both Lesions. The second most common site for PGCG was posterior maxilla [21%], whereas anterior mandible was involved in CGCG [19.45%]. The majority of patients were asymptomatic. Patient's age, location [mandible/maxilla] and bleeding were the influential variables on the type of the lesion

Conclusion: although the CGCGs share some histopathologic similarities with PGCGs, differences in demographic features may be observed in different populations

Jaw lesions associated with impacted tooth: A radiographic diagnostic guide

This review article aimed to introduce a category of jaw lesions associated with impacted tooth. General search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks were used to find relevant studies using keywords such as "jaw lesion", "jaw disease", "impacted tooth", and "unerupted tooth". More than 250 articles were found, of which approximately 80 were broadly relevant to the topic. We ultimately included 47 articles that were closely related to the topic of interest. When the relevant data were compiled, the following 10 lesions were identified as having a relationship with impacted tooth: dentigerous cysts, calcifying odontogenic cysts, unicystic (mural) ameloblastomas, ameloblastomas, ameloblastic fibromas, adenomatoid odontogenic tumors, keratocystic odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibro-odontomas, and odontomas. When clinicians encounter a lesion associated with an impacted tooth, they should first consider these entities in the differential diagnosis. This will help dental practitioners make more accurate diagnoses and develop better treatment plans based on patients' radiographs.

Review of common conditions associated with periodontal ligament widening

PURPOSE: The aim of this article is to review a group of lesions associated with periodontal ligament (PDL) widening. MATERIALS AND METHODS: An electronic search was performed using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as “periodontium”, “periodontal ligament”, “periodontal ligament space”, “widened periodontal ligament”, and “periodontal ligament widening”. RESULTS: Out of nearly 200 articles, about 60 were broadly relevant to the topic. Ultimately, 47 articles closely related to the topic of interest were reviewed. When the relevant data were compiled, the following 10 entities were identified: occlusal/orthodontic trauma, periodontal disease/periodontitis, pulpo-periapical lesions, osteosarcoma, chondrosarcoma, non-Hodgkin lymphoma, progressive systemic sclerosis, radiation-induced bone defect, bisphosphonate-related osteonecrosis, and osteomyelitis. CONCLUSION: Although PDL widening may be encountered by many dentists during their routine daily procedures, the clinician should consider some serious related conditions as well.

How Do Family Caregivers of Older People Give Up Caregiving?

Population aging has social, economic and political consequences. Most family caregivers prefer to care for their family member older person with chronic disease at home. Despite traditional culture within Iranian families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this affects the old person and his/her family. The aim of this study was to explain how Iranian family cargivers give up caring their older person with chronic condition at home. A grounded theory approach was used to conduct the study. The study setting included four nursing homes under the auspices of Iran Welfare Organization. Fourteen participants were recruited through purposive sampling. Data were collected from December 2010 to March 2011 by Semi-structured interviews lasting about 17 to 95 minutes [average 52 minutes]. Constant comparative analysis was used to analyze the data. Three main categories appeared at the end of the analysis: [going out of the road of usual life], [challenge of meeting older person, family and caregivers care needs], and [the appearance of inconstancy in the family]. They explained exclusively how family caregivers of old people give up caregiving. Health care providers are recommended to become familiar with challenges of family caregivers in taking care of older person with chronic disease at home, and then organize their supportive and consulting actions according to family situations in order to improve the life quality of older person and family caregivers

Radiolucent rim as a possible diagnostic aid for differentiating jaw lesions

In this study, we formulate a new proposal that complements previous classifications in order to assist dental practitioners in performing a differential diagnosis based on patients' radiographs. We used general search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks to find relevant studies by using keywords such as "jaw disease," "jaw lesions," "radiolucent rim," "radiolucent border," and "radiolucent halo." More than 200 articles were found, of which 70 were broadly relevant to the topic. We ultimately included 50 articles that were closely related to the topic of interest. When the relevant data were compiled, the following eight lesions were identified as having a radiolucent rim: periapical cemento-osseous dysplasia, focal cemento-osseous dysplasia, florid cemento-osseous dysplasia, cemento-ossifying fibroma, osteoid osteoma, osteoblastoma, odontoma, and cementoblastoma. We propose a novel subcategory, jaw lesions with a radiolucent rim, which includes eight entities. The implementation of this new category can help improve the diagnoses that dental practitioners make based on patients' radiographs.

Tongue squamous cell carcinoma in a patient with systemic sclerosis: a case report

Objective: Systemic sclerosis [SS] is a chronic autoimmune disease of connective tissue, which involves skin and internal organs, and results in collagen deposition and fibroblasts activation. Studies have reported a higher risk of malignancy in patients with progressive systemic sclerosis [PSS].The aim of this study is to report a case of tongue squamous cell carcinoma [SCC] in a patient with PSS

Case: A 46-year-old woman with SS presented to the Department of Oral Medicine of Shahid Beheshti University of Medical Sciences Dental School with chief complaint of an ulcer on her tongue. During intraoral examination, an asymptomatic ulcer measuring 2.0×1.5 cm was discovered on the right lateral border of the tongue. Incisional biopsy under local anesthesia was performed and histopathological report confirmed presence of squamous cell carcinoma. After further evaluation, surgery was performed, followed by three sessions of brachytherapy and six sessions of chemotherapy. After 26 months of follow-up, there was no evidence of recurrence

Conclusion: Periodic screening examinations are necessary to discover possible malignancies in primary stages in patients with SS

Position of impacted mandibular third molar in different skeletal facial types: First radiographic evaluation in a group of Iranian patients

PURPOSE: This study was performed to evaluate the position of impacted mandibular third molars in different skeletal facial types among a group of Iranian patients. MATERIALS AND METHODS: A total of 400 mandibular third molars in 200 subjects with different types of facial growth were radiographically investigated for their positions according to their types of facial growth on the basis of the beta angle. The subjects were divided into three groups (class I, II, and III) according to ANB angle, representing the anteroposterior relationship of the maxilla to the mandible. Meanwhile, the subjects were also divided into three groups (long, normal, and short face) according to the angle between the stella-nasion and mandibular plane (SNGoGn angle). ANOVA was used for statistical analysis. RESULTS: The mean beta angle showed no significant difference among class I, II, and III malocclusions (df=2, F=0.669, p=0.513). The same results were also found in short, normal, and long faces (df=1.842, F=2, p=0.160). The mesioangular position was the most frequent one in almost all of the facial growth patterns. Distoangular and horizontal positions of impaction were not found in the subjects with class III and normal faces. In the long facial growth pattern, the frequency of vertical and distoangular positions were not different. CONCLUSION: In almost all of the skeletal facial types, the mesioangular impaction of the mandibular third molar was the most prevalent position, followed by the horizontal position. In addition, beta angle showed no significant difference in different types of facial growth.

Prevalence and characteristics of pneumatized articular tubercle: First large series in Iranian people

PURPOSE: This study was performed to determine the prevalence and characteristics of pneumatized articular tubercle or eminence among a defined group of Iranian people. MATERIALS AND METHODS: Digital panoramic radiographs of 1694 patients in the Department of Oral and Maxillofacial Radiology, Hamadan Dental School, Iran were evaluated retrospectively to detect the above lesion. Finally, 1563 radiographs were selected according to inclusion criteria. Then, a review was done of 10 large case series found using a MEDLINE search of the literature. Chi-squared test was used to analyze the differences in variables such as age, gender, laterality, and locularity in our case series. RESULTS: The average age of our samples was 32.6+/-7.63 years. Pneumatized articular tubercle was found in 98 cases, representing a prevalence of 6.2% with a mean age of 22.8+/-7.9 and a range of 8 to 60 years. Sixty-four (65.3%) pneumatized articular tubercles were unilateral, with 30 lesions on the right and 34 on the left side. Bilateral lesions were found in 34 (34.7%) patients. 52 (53.06%) of the pneumatized articular tubercles were of the unilocular type and 46 (46.94%) were multilocular. The results showed no statistically significant differences regarding age (p=0.454), gender (p=0.634), laterality (p=0.252), or locularity (p=0.807) among the samples. CONCLUSION: Among ten large case series from other countries, the prevalence of pneumatized articular tubercle (6.2%) in Iranian patients was higher than that of all eight of the case series that used the same detection method as the present study of panoramic radiography.

rare crestal branch of inferior alveolar nerve: case report

Sectional imaging modalities are accurate techniques for the identification and localization of the mandibular canal anatomy and variations. The aim of this study was to evaluate the mandibular nerve accessory branches. Existence of these variations may cause some difficulties in anesthesia and also in surgical procedures such as implant planning. The authors report a rare crestal branching of right mandibular canal in a 49 year old male observed in cone beam computed tomography image. Although this anatomical variation is rare, it should be kept in mind

Effect of vitamin C on salivary total antioxidant capacity in smokers

This study was designed to elucidate the effect of ascorbic acid on salivary total antioxidant capacity in smokers. In this single blind crossover clinical trial, the whole unstimulated saliva of 30 smokers, who were randomly divided into two groups, was collected. In the first phase after the saliva collection, one group of patients took 500 mg of vitamin C powder, for 3 weeks. Then, saliva of all patients was collected. After a one-week wash-out period, vitamin C was given to the other group. The collection of saliva was done after 3 weeks. Total antioxidant capacity was measured. Statistic evaluation was performed by Repeated Measured ANOVA, Independent sample t-test and Covariate test. The mean of total antioxidant capacity with and without using vitamin C was 0.511 +/- 0.155 [U/mL] and 0.555 +/- 0.171 [U/mL], respectively. This variability was not significant [p = 0.605]. Oxidative stress from cigarette smoke was not decreased significantly with using vitamin C

[In vitro evaluation of antibacterial effect of myrtus extract with different concentrations on some oral bacteria]

Microorganisms are the main etiologic factors of periodontal diseases and dental caries. Recently, the use of herbal medications has been considered as an alternative method in elimination of oral microbial agents. Therefore, the aim of this study was to determine the antibacterial effects of Myrtus extract on some common oral bacteria. This experimental trial study was performed on nine strains of some oral bacteria. Each strain was cultured in blood agar and Muler-Hintone media. Paper disks 6mm in diameter containing different concentrations of Myrtus extract were placed on the selected media and then inhibition zone [IZ] was measured after 24 hours. Data analysis was carried out using ANOVA and Tukey HSD test. The results of this study showed that, there were no statistically significant differences in IZ between S.Salivarius and S. epidermis in different Myrtus concentrations. The widest IZ was presented in concentration of 2.5% for S.Sanguis, S.Mutans and diphteroid and in concentration of 1% for lactobacillus and in concentration of 1% and 2.5% for S.aureus and finally, in concentration of 2.5% for P.aeruginosa. The narrowest IZ was presented in concentration of 5% for Laetobaeillus. The highest sensitivity to Myrtus extract was observed in concentration of 2.5% and the lowest sensitivity in concentrations of 0.5% and 5%.Myrtus extract had different effects in different concentrations and on different bacteria in this study. The widest IZ [16 milimeter] was presented in concentration of 2.5% for P. aeruginosa and the narrowest IZ [6mm] was presented in concentration of 5% for Lactobacillus

[Evaluation of serum albumin level in chronic periodontitis]

Periodontal disease has been implicated as a risk factor for systemic diseases. There was a association between periodontal disease and serum albumin level in recent studies. The aim of this study was to evaluate the serum albumin concentration as a prognostic marker of the periodontal disease. In this cross-sectional study, 64 patients with chronic periodontitis, aged 20-50 years and 64 healthy control subjects with same age were selected. Dental and systemic stata were assessed for all subjects. Blood samples [2cc] were collected and COBASMIRA method was used to determine serum albumin level. The data were analyzed by One-Way ANOVA, Chi- square and t-tests. The mean serum albumin concentration was 5.05 +/- 2.7 gr/dl in chronic periodontitis and 4.40 +/- 0.39gr/dl in control group and the difference was significant [P=0.000]. Also there was a significant difference in albumin level between mild and moderate periodontitis [P=0.000]. Mean concentration of serum albumin level in periodontitis [mild, moderate, sever] was higher than control group