Two-dimensional and volumetric airway changes after bimaxillary surgery for class III malocclusion

OBJECTIVES: Any change in maxilla and mandible position can alter the upper airway, and any decrease in the upper airway can cause sleep disorders. Thus, it is necessary to assess airway changes after repositioning of the maxilla and mandible during orthognathic surgery. The purpose of this study was to evaluate linear and volumetric changes in the upper airway after bimaxillary surgery to correct class III malocclusion via cone-beam computed tomography (CBCT) and to identify correlations between linear and volumetric changes. MATERIALS AND METHODS: This was a prospective cohort study. CBCTs from 10 class III patients were evaluated before surgery and three months after. The Wilcoxon one-sample test was used to evaluate the differences in measurements before and after surgery. Spearman's rank correlation coefficient was used to test the correlation between linear and volumetric changes. RESULTS: The results show that the nasopharyngeal space increased significantly, and that this increase correlated with degree of maxillary advancement. No significant changes were found in volumes before and after surgery. A correlation was found between linear and volumetric oropharyngeal changes. CONCLUSION: Bimaxillary surgical correction of class III malocclusion did not cause statistically significant changes in the posterior airway space.

Assessment of the anterior loop of the inferior alveolar nerve via cone-beam computed tomography

OBJECTIVES: The aim of this study was to evaluate different anatomical variants of the anterior loop of the inferior alveolar nerve (IAN) via cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images of 71 patients (36 males and 35 females) were evaluated. We used the classification described by Solar for IAN evaluation. In this classification, three different types of IAN loops were introduced prior to emerging from the mental foramen. We classified patients according to this system and introduced a new, fourth type. RESULTS: Type I was seen in 15 sites (10.6%), type II in 39 sites (27.5%), and type III in 50 sites (35.2%). We found a new type in 38 sites (26.8%) that constituted a fourth type. CONCLUSION: We found that type III was the most common variant. In the fourth type, the IAN was not detectable because the main nerve was adjacent to the cortical plate and the incisive branch was thinner than the main branch and alongside it. In this type, more care is needed for surgeries including inferior alveolar and mental nerve transposition.

Glandular odontogenic cyst of the posterior maxilla

The glandular odontogenic cyst is an uncommon developmental odontogenic cyst described as a distinct entity by Gardner et al. in 1988. The Glandular odontogenic cyst occurs more commonly in middle-aged people and has a predilection for the mandible. Only histopathological examinations allow for certain diagnosis of the cyst. The increased recurrence rate can be due to its multilocularity and incomplete removal of the lining following conservative treatment. This article presents a case of glandular odontogenic cyst in a 28-year-old male patient in the posterior region of the maxilla, which is quite rare

influence of experimental spinal cord injury on carbamazepine pharmacokinetics

Previous studies have demonstrated that pharmacokinetic behavior of several drugs such as paracetamol, theophylline, and aminoglycosides are significantly altered in patients with spinal cord injury. So far, no study on pharmacokinetics of carbamazepine has been performed in patients or experimental models with spinal cord injury. The present study was designed to find the influence of experimental spinal cord injury on carbamazepine pharmacokinetics. Among 12 male albino rabbits, 6 were subjected to spinal cord injury at the 8th thoracic level by knife severance method and 6 rabbits underwent laminectomy alone [sham-lesioned control group]. All received a single oral dose of carbamazepine [20 mg/kg] 24 hours after the injury. Blood samplings were done at predetermined times to 96 hours after drug administration. Carbamazepine concentration in serum samples was determined by high-performance liquid chromatography. Pharmacokinetic parameters including maximum concentration, time to reach maximum concentration, half-life, and area under the curve0 - 24 were directly determined from the concentration-time curve. Area under the concentration against time curve 24-infinity was calculated from the real data. Maximum concentration was appeared at 2.8 hours after administration in sham-lesioned control group at a concentration of 2.3 micro g/mL, whereas in spinal cord injury group it was appeared at 4.4 hours at a concentration of 2.7 micro g/mL. In spinal cord-injured group, area under the curve and half-life were increased from 29.1 micro g/mL.hr to 38.7 micro g/mL.hr and from 7.7 hr to 14.1 hr as compared with the sham-lesioned control group, respectively. Statistical analyses of data showed that spinal cord injury does not induce significant changes in carbamazepine pharmacokinetics. We concluded that pharmacokinetic behavior of carbamazepine was not significantly changed by spinal cord injury, although its subtle pharmacokinetic changes could be resulted from alteration in gastrointestinal tract motility, blood perfusion, or metabolism