Does maxillomandibular fixation affect skeletal stability following mandibular advancement? A single-blind clinical trial / 대한악안면성형재건외과학회지

Background@#The stability of the results remains a significant concern in orthognathic surgeries. This study aimed to assess the amount of relapse following mandibular advancement with/without maxillomandibular fixation (MMF). @*Materials and methods@#A single-blind clinical trial was conducted on patients with mandibular retrognathism who underwent BSSO for mandibular advancement and Lefort I maxillary superior repositioning. Patients were randomly divided into two groups of treatment (MMF) and control (no MMF). In the treatment group, MMF was performed for 2 weeks; meanwhile, MMF was not performed in the control group, and only guiding elastics were applied postoperatively. Lateral cephalograms were obtained preoperatively (T1), immediately after surgery (T2), and at 1 year postoperatively (T3). The distance from points A and B to the X and Y plane were measured to identify the amount of vertical and horizontal relapse in 1 year as a primary outcome. An independent t-test was applied in order to find differences in outcomes between the control and treatment groups. @*Results@#Fifty-eight patients were evaluated in two groups (28 patients in the MMF group and 30 in the no-MMF group). The magnitude of mandibular advancement following BSSO was 7.68±1.39 mm and 7.53±1.28, respectively, without significant difference among the groups (p= 0.68). The mean sagittal and vertical changes (relapse) at point B were significantly different between the two groups at 1-year follow-up after the osteotomy (p=0.001 and p=0.05, respectively). @*Conclusion@#According to the results of this study, patients with short-term MMF following BSSO for mandibular advancement benefit from significantly greater skeletal stability in the sagittal and vertical dimensions.

Comparison of postoperative paresthesia after sagittal split osteotomy among different fixation methods: a one year follow-up study

OBJECTIVES: Postoperative paresthesia is a common complication after sagittal split osteotomy (SSO). This study aimed to compare paresthesia among different fixation methods one year postoperative. MATERIALS AND METHODS: This prospective cohort study assessed subjects in four groups: class II with miniplate fixation (Group 1), class II with three-screw fixation (Group 2), class III with miniplate fixation (Group 3), and class III with three-screw fixation (Group 4). Paresthesia was evaluated one year postoperative based on a 0-10 visual analogue scale. Pearson correlation was used to evaluate associations of age and mandibular movement with paresthesia. ANOVA was used to compare paresthesia among groups. RESULTS: A total of 80 subjects were enrolled, with 20 subjects in each of the four groups. The Pearson correlation test demonstrated a significant correlation between mandibular movement and paresthesia (P=0.001). Comparison of paresthesia among the groups showed significant differences among groups 1 and 2, 2 and 3, and 3 and 4 (P<0.05). CONCLUSION: The three-screw fixation method led to more paresthesia one year postoperative compared with miniplate fixation. In addition, the magnitude of mandibular movement had a positive correlation with paresthesia.

Comparison of postoperative paresthesia after sagittal split osteotomy among different fixation methods: a one year follow-up study

OBJECTIVES@#Postoperative paresthesia is a common complication after sagittal split osteotomy (SSO). This study aimed to compare paresthesia among different fixation methods one year postoperative.@*MATERIALS AND METHODS@#This prospective cohort study assessed subjects in four groups: class II with miniplate fixation (Group 1), class II with three-screw fixation (Group 2), class III with miniplate fixation (Group 3), and class III with three-screw fixation (Group 4). Paresthesia was evaluated one year postoperative based on a 0-10 visual analogue scale. Pearson correlation was used to evaluate associations of age and mandibular movement with paresthesia. ANOVA was used to compare paresthesia among groups.@*RESULTS@#A total of 80 subjects were enrolled, with 20 subjects in each of the four groups. The Pearson correlation test demonstrated a significant correlation between mandibular movement and paresthesia (P=0.001). Comparison of paresthesia among the groups showed significant differences among groups 1 and 2, 2 and 3, and 3 and 4 (P<0.05).@*CONCLUSION@#The three-screw fixation method led to more paresthesia one year postoperative compared with miniplate fixation. In addition, the magnitude of mandibular movement had a positive correlation with paresthesia.

Relationship between religion and school students' road behavior in southern Iran / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Unsafe behaviors are an important cause of accidents in adolescent age groups. This study was designed to examine the behaviors of adolescent pedestrians in southern Iran.</p><p><b>METHODS</b>This is a descriptive analytical cross-sectional study. The study population consisted of high school students in Shiraz, capital city of Fars Province, Iran. Five hundred and sixteen students were selected by multi-stage sampling. Data were collected by the use of three questionnaires, which included Persian copies of adolescent road user behavior questionnaire (ARBQ), Duke University Religious Index (DUREL), as well as the context and independent variables questionnaire.</p><p><b>RESULTS</b>The results showed that a decrease in dangerous behaviors on the road resulted in an increase in respondents' intrinsic religiosity. Also, engagement in unsafe crossing behavior in the road decreased with increasing respondents' intrinsic religiosity. Another finding showed that female students were less involved in dangerous play and planned protective behaviors on the road.</p><p><b>CONCLUSION</b>Findings clearly indicate that intrinsic religiosity has a significant role in reducing the risky road behaviors of students. Hence, religion may improve road safety in school students' road behavior in Iran.</p>

Burden of traffic accidents among pedestrians of Fars province, southern Iran; estimate of years of life lost in a sample of Iranian population from 2009 to 2013 / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Traffic injuries are among the leading causes of mortality and morbidity worldwide. Pedestrians have been considered as a high-risk group among road users, especially in middle- or low-income communities. This study attempted to determine the burden of pedestrians' fatalities in Fars, the southern province of Iran using years of life lost (YLL) approach.</p><p><b>METHODS</b>The data used in this study were retrieved from Fars Forensic Medicine Organization database on pedestrian traffic accidents. The YLL from 2009 to 2013 was estimated using the method presented by World Health organization. Some epidemiological characteristics of pedestrians' fatalities were analyzed by SPSS.</p><p><b>RESULTS</b>Although YLL among 1000 male pedestrians decreased from 2.5 in 2009 to 1.5 in 2013, it increased from 0.9 to 2.1 among 1000 females during the same period. Higher proportion of death was found in female, illiterate, and married pedestrians (p < 0.001). In addition, mortality was higher in pedestrians living the cities, during daytime, at home, and in hospitals (p < 0.001).</p><p><b>CONCLUSION</b>Consistent with the global trends, burden of pedestrian accidents in Fars was also exceptionally high. Considering the national and cultural aspects of different countries, improving the safety of pedestrians demands a multi-dimensional approach with interventional factors concerning policies, rules, pedestrians, motor vehicles and environmental conditions taken into consideration.</p>

Association of gastrointestinal functional disorders and migraine headache: a population base study

Background: Migraine is one of the prevalent headaches. Many of patients with migraine, complain of gastrointestinal symptoms. There is limited studies on relation of gastrointestinal symptoms and migraine headache at population level

Methods: In this population-based study, 1038 subjects older than 15 year from a rural area in Fars province, south of Iran. were investigated for functional gastrointestinal disorders. By cluster random sampling, 160 of these persons invited to receive endoscopy along with histopathology samples of upper gastrointestinal tract. Data were analyzed using Pearson chi-square and Fisher exact

Results: Mean age of participations were 34.3 years with female to male of 3:1. The prevalence of migraine, irritable bowel syndrome [IBS], reflux, and dyspepsia were 24.6%, 17.7%, 17.4%, and 32.1%, respectively. There were significant relationship between migraine and functional gastrointestinal diseases [odds ratio of association for migraine with IBS, reflux, and dyspepsia were 3.43, 1.68, and 1.68 with p-value < 0.001 for all]. In endoscopic findings, only presence of hiatal hernia was associated significantly with migraine [p = 0.011]. No histopathologic findings in antral or duodenal biopsies were associated with migraine

Conclusion: In this population based study we found significant association between migraines and gastrointestinal functional disorders including IBS, reflux and dyspepsia. This may have implication in better management of patients with migraine headache

risk factors in early failure of dental implants: a retrospective study

Statement of the Problem: Despite the low failure rate of dental implants, recognition of the risk factors can enhance the predictability of failure. Purpose: The aim of this study was to evaluate the risk factors for early implant failure

Materials and Method: This retrospective cohort study was conducted on two groups of patients, the patients with a failed implant before loading and those without a failed implant. Age, gender, implant type, implant surface, implant length, bone type, type of surgery [one- or two-stage] and immediate [fresh socket] or delayed placement of implant were the variables to be assessed in this study

Results: Out of the 1,093 evaluated implants, 73 cases [6.68%] failed in early stages. The two groups were significantly different in terms of implant surface, fresh socket placement, prophylactic use of antibiotics, and bone density [p< 0.05]. Age, gender, implant height, implant type [cylindrical or tapered] and one-stage or two-stage placement were not significantly different between the two groups [p> 0.05]

Conclusion: It seems that prophylactic antibiotic therapy, implant surface, bone density and placement in fresh extraction socket may contribute to dental implant failure

Skeletal stability following mandibular advancement: is it influenced by the magnitude of advancement or changes of the mandibular plane angle?

OBJECTIVES: The aim of this study was to investigate the effects of advancement magnitude and changes in mandibular plane angle on the stability of mandibular advancement. MATERIALS AND METHODS: This retrospective cohort study evaluated the postoperative stability of mandibular advancement in class II skeletal subjects who underwent bilateral sagittal split osteotomy. Radiographs taken preoperatively, immediately postoperatively and 1 year postoperatively were traced and analyzed using linear and angular measurements. To determine horizontal and vertical relapse, an X-Y coordinate system was established in which the X-axis was constructed by rotating S-N downward by 7° (approximation of the Frankfort horizontal plane) and the Y-axis was defined as a line perpendicular to the X-axis and passing through the point Sella. For certain reference points including point A, point B, pogonion and menton, the perpendicular distance between each point and both axes was determined and cephalometric variables were recorded as X and Y coordinates. RESULTS: Twenty-five subjects were studied. A significant correlation between the amount of mandibular advancement and relapse in the B point (vertical and horizontal) and the pogonion point was observed (vertical and horizontal, P<0.001). Evaluation of data demonstrated a positive correlation between the mandibular plane angle (SN/ML) change and vertical relapse in the B point (P<0.05). A simple regression model demonstrated that 74% of horizontal relapse and 42.3% of vertical relapse in the B point was related to the amount of mandibular advancement. The receiver operating characteristic test showed that 8.5 mm mandibular advancement is related to a relapse rate of 1 mm or more in the pogonion, vertically or horizontally. CONCLUSION: The magnitude of mandibular advancement is a stronger surgical predictor for horizontal rather than vertical relapse at the B point. Changes in mandibular plane angle (SN/ML) during surgery affect vertical, but not horizontal relapse at the B point.

Outcome of neoadjuvant chemotherapy on local recurrence and distant metastasis of oral squamous cell carcinoma: a retrospective study

Statement of the Problem: Neoadjuvant chemotherapy [NCH] is controversial in the treatment of oral squamous cell carcinoma [OSCC]

Purpose: The aim of this study was to evaluate the efficacy of NCH on OSCC prognosis

Materials and Method: In this retrospective cohort study, 94 patients were studied in two groups. The patients in group 1 received NCH before the surgery, and those in group 2 underwent resection without any chemotherapy prior to surgery. The employed NCH agents consisted of cisplatin in combination with 5-fluorouracil in two treatment courses. Tumor size, lymph node involvement, age, and follow-up time were considered as variable factors of the study. Local recurrence [LR] and distant metastasis [DM] were outcomes of the study

Results: Comparison of LR and DM in various tumor sizes demonstrated no significant difference between the two groups [p> 0.05]. Analysis of the data did not show any statistically significant difference between the groups for LR in subjects with N0, N1 and N2. Each one-year increase in age was associated with 10% increase in the hazard ratio [HR] [HR distance metastasis Y/N = 1.10, p= 0.05]. In the same analysis, when considering LR as a dependent factor, LR risk in N2 was 3 times more than in N1 [p= 0.02]. LR risk in N3 was 5 times more than in N1 [HR local recurrence [p= 0.006]

Conclusion: Based on our results, neoadjuvant chemotherapy with combination of cisplatin and 5-fluorouracil may not improve prognosis of OSCC. However, further studies are suggested to assess other neoadjuvant chemotherapy protocols in OSCC patients

Denture stomatitis and candida albicans in iranian population: a systematic review andmeta-analysis

Statement of the Problem: Denture stomatitis is the common form of oral candidiasis, which is seen in the form of diffused inflammation in the areas covered by dentures. Many primary studies report the prevalence of denture stomatitis and candida albicans among patients in the Iranian population; therefore, using meta-analysis is valuable for health policy makers

Purpose: The purpose of the present study is to determine the prevalence of denture stomatitis and candida albicans in Iran

Materials and Method: Using relevant keywords, national and international databases were searched. After limiting the search strategy and deleting the duplicates, the remaining papers were screened by examining the title and abstract. In order to increase the sensitivity of search reference lists of papers were examined. Finally the index of heterogeneity between studies was defined using Cochran test [Q] and Isquared [I2]. According to heterogeneity, the random effects model was used to estimate the prevalence of denture stomatitis and candida albicans in Iran

Result: The prevalence of denture stomatitis in 12 studies, and the prevalence of candida albicans in patients with denture stomatitis have been reported in 6 studies. The number of sample under investigated and its age range among primary studies included meta- analysis was 2271 individuals and 32.7 till 87.5 years respectively. The prevalence of denture stomatitis in preliminary studies imported to a meta-analysis varied from 1.9% to 54.6%, and its rate in Iran using the meta-analysis was estimated 28.9 % [CI 95%: 18.2-39.6]. Also the overall prevalence of candida albicans in patients with denture stomatitis in Iran was estimated 60.6% [CI 95%:50.1-71.2]

Conclusion: This study showed that the prevalence of denture stomatitis and candida albicans among patient infected denture stomatitis is relatively significant in Iran

Evaluation of condylar position after orthognathic surgery for treatment of class ii vertical maxillary excess and mandibular deficiency by using cone-beam computed tomography

Statement of the Problem: In orthognathic surgeries, proper condylar position is one of the most important factors in postoperative stability. Knowing the condylar movement after orthognathic surgery can help preventing postoperative instabilities

Purpose: The aim of this study was to evaluate the condylar positional changes after Le Fort I maxillary superior repositioning along with mandibular advancement by using cone beam computed tomography [CBCT]

Materials and Method: This cross-sectional study was conducted on 22 subjects who had class II skeletal malocclusion along with vertical maxillary excess. Subjects underwent maxillary superior repositioning [Le Fort I osteotomy] along with mandibular advancement. The CBCT images were taken a couple of days before the surgery [T0], and one month [T1] and 9 months [T2] after the surgery. The condyles positions were determined from the most superior point of the condyle to three distances including the deepest point of the glenoid fossa, the most anteriorinferior point of the articular eminence, and the most superior point of the external auditory meatus in the sagittal plane

Results: The mean mandibular advancement was 4.33 +/- 2.1 mm and the mean maxillary superior repositioning was 4.66 +/- 0.3 mm. The condyles displaced inferiorly, anteriorly, and laterally between T0 and T1. They were repositioned approximately in the initial position in T2. No correlation was observed between the mandibular and maxillary movement and the condylar positions

Conclusion: The condyles displaced in the inferior-anterior-lateral position one month after the bilateral sagittal split osteotomy for mandibular advancement in combination with the maxillary Le Fort I superior repositioning. It seems that the condyles adapted approximately in their initial position nine months after the surgeries

Prevalence and risk factors of alcohol and substance abuse among motorcycle drivers in Fars province, Iran / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>The aim of this present study is to investigate the prevalence of alcohol and substance abuse (ASA) and its relationship with other risky driving behaviors among motorcycle drivers.</p><p><b>METHODS</b>This is a cross sectional study which is performed at Shiraz city of Iran. Data from motorcycle drivers were collected using a standard questionnaire in eight major streets at different times of the day. The data includes consumption of alcohol and other substances two hours before driving and some of the risky behaviors during driving.</p><p><b>RESULTS</b>A total of 414 drivers with a mean ± SD age of (27.0 ± 9.3) years participated in the study. Alcohol or substance consumptions two hours before driving was significantly associated with risky driving behaviors such as using mobile phone during driving, poor maneuvering, and driving over the speed limit (both p < 0.001). It was also associated with carelessness about safety such as driving with technical defects (p < 0.001) and not wearing a crash helmet (p=0.008).</p><p><b>CONCLUSION</b>Screening for alcohol and substance consumption among motorcycle drivers is an efficient way to identify drivers that are at a greater risk for road traffic accidents.</p>

causal factors associated with the loving care of the mothers of children with multiple disabilities

Families with disabled children need more psycho-social considerations. Motherhood care of the children with multiple disabilities is difficult. Due to its importance, the aim of this study was to investigate the causal factors affecting loving care of mothers of children with multiple disabilities. The study used a cross-sectional method in which 75 mothers of exceptional children with multiple disabilities [physical and mental] in elementary schools in Shiraz, Iran. The data were collected through questionnaires which, besides demographical factors, evaluated the relationship between mothers' loving care of children with multiple disabilities and four other variables including purpose in life, life satisfaction, religious attitude, and sense of coherence. Mann-Whitney U was used for comparison between mothers' loving care and other variables. Results revealed that demographic variables did not have a significant relationship with loving care. In the case of social variables, there was a significant relationship between mothers' loving care and purpose in life [P<0.001], religious attitude [P<0.001], and life satisfaction [P=0.01]. Motherhood care of disabled children is a unique phenomenon which is due to attachment of mother-child situation. Nevertheless, these mothers are vulnerable and marginalized people who need more attention and social supports provided by related governmental institutions and also NGOs actors

Herpes zoster induced osteomyelitis in the immunocompromised patients: a 10-year multicenter study

Statement of the Problem: Alveolar bone necrosis induced by Herpes zoster infection is considered as a rare manifestation of osteomyelitis and few case reports are presented in the literature

Purpose: The aim of this study was to evaluate mandibular osteomyelitis caused by herpes zoster in the immunocompromised patients with histopathologically documented osteomyelitis in the mandible and herpes zoster infection

Materials and Method: 30 patients were recruited in this cross-sectional study. 19 patients were completely edentulous, 4 patients were partially edentulous and 7 with complete dentition. In all cases, specimens were analyzed using a conventional polymerase chain reaction [PCR] test for varicella zoster virus

Results: 16 patients underwent dialysis, 9 patients received chemotherapy treatments and 5 patients had transplantation [four kidneys and one liver]. Histopathological assessment demonstrated a nonspecific bone necrosis exhibiting an eosinophilic, homogeneous non-vital bone tissue with peripheral resorption surrounded by reactive connective tissue. PCR test was positive in 21 cases

Conclusion: This study demonstrated that the frequency of osteomyelitis induced by herpes zoster could be more than the records provided by previous studies. Histopathological findings might be nonspecific in such patients. PCR test was not positive for all HZ induced osteomyelitis patients