Quality of Life in Adolescents and Young Adults with Cleft Lip and Palate with and Without Speech Therapy During COVID-19.

OBJECTIVE: Cleft-related speech concerns can affect the quality of life (QOL) in patients with cleft lip and palate (CLP). During the coronavirus disease 2019 (COVID-19), in-person speech therapy (ST) was restricted due to fear of getting infected. This study aimed to compare QOL in patients with CLP with and without ST during the pandemic. DESIGN: Cross-sectional Study. SETTING: CLP team at Tehran University of Medical Sciences (TUMS). PATIENTS/PARTICIPANTS: Thirty-six CLP subjects with a mean age of 17.33 ± 4 years participated in two groups, including with and without ST. Fifteen subjects had cleft palate only (CPO) and others had CLP. INTERVENTIONS: ST group received at least 10 ST sessions, and group without ST didn't receive ST during COVID-19. MAIN OUTCOME MEASURE(S): A virtual link of demographic and QOL adolescent cleft (QoLAdoCleft) questionnaires were sent to fill out. Results were extracted and transferred to SPSS. RESULTS: Total and subscales' scores of QoLAdoCleft were lower in ST group than without ST but differences between them weren't statistically significant (P > .05). Furthermore, according to cleft type, there weren't any statistically significant differences in total, physical, and social subscales of QoLAdoCleft (P > .05); however, psychological subscale in CLP had a higher significant score than CPO (P < .05). CONCLUSIONS: QOL was weak in all patients with CLP, and receiving/not receiving ST couldn't make noticeable differences between them. It seems; COVID-19 pandemic can have an adverse effect on these results. Also, subjects with CLP had weaker psychological than CPO due to negative psychosocial feedback related to Orofacial deformities received from society.

Ameloblastic Fibro-Odontoma.

Introduction: Ameloblastic fibro-odontoma (AFO) is a benign odontogentic tumor without an aggressive behavior, unlike the similar ameloblastic fibroma. Case Presentation: A 9-year-old boy, with tooth eruption failure, underwent enucleation and curettage of a well-defined variable radiolucent and radio-opaque right mandible lesion. There was odontogenic epithelium with peripheral palisading in a loose myxoid stroma as well as a disorganized component of dentin, enamel, and cementum, features of an AFO. Conclusion: AFO is an odontogenic mixed tumor of epithelium and mesenchyme.

Educational content of professional ethics in postgraduate dental education.

PURPOSE: Inclusion of proper educational content with respect to professional ethics in dental curricula is an important step to achieve objectives of ethics education especially in postgraduate programs when the time and opportunities for explicit instruction of ethics are limited. This study aimed to find and discuss the topics of ethics and professionalism for dental postgraduate programs. METHODS: A modified Delphi survey of experts' opinions with three rounds was conducted to establish a consensus on the need to teach professional ethics topics. The topics were identified through a literature review and according to the opinion of the experts. Items scored as highly important by over 80% of the participants in each round of the survey were considered educational needs. RESULTS: A total of 154 ethical issues were identified and classified into 29 topical categories to design the initial questionnaire. A consensus was developed on 24 ethics and professionalism topics for inclusion in the professional ethics curriculum for all dental postgraduate programs. CONCLUSIONS: Based on the results of this study, the same educational content in professional ethics is needed for all dental residency programs in all specialties. Most of the topics on which experts reached a consensus to be included in the ethics educational content were related to ethical and professional standards of conduct.

A rare case of maxillary osteoblastoma in a 10-month-old infant.

Osteoblastoma (OSB) is an uncommon (3% of benign and 1% of all) primary bone neoplasm with extremely rare occurrence in head and neck, especially the maxillary bone region. OSB of the jaw mainly involves the mandible bone. We report a 10-month-old male who was admitted to the hospital because of a mass in the right maxillary jaw region. Clinicoradiopathologic features of the patient have been described. The histological examinations revealed OSB of the maxillary bone. Total surgical resection of the tumor was performed with 10 months of follow-up and there is no evidence of recurrence. To the best of our knowledge, it is the first report of maxillary OSB in an infant.

Desmoplastic fibroma of the lower jaw in a 2-year-old patient; report of a rare case.

Desmoplastic fibroma (DF) is a rare benign but aggressive fibrous lesion with an unknown etiology. It has an affinity for the mandible. DF has a high rate of recurrence after surgical resection. In this study, we report the therapeutic management of a recurrence of DF in the lower jaw in a 2-year-old boy. He responded well to second surgical intervention with wide resection and immediate reconstruction with plate. The purpose of this case report is to emphasize the particularity of the case, treatment modalities, and differential diagnosis in DF.

Patient with Crouzon Syndrome Treated with Modified Le Fort III Osteotomy without Previous Orthodontic Treatment: Case Report and a Review of the Literature.

Crouzon syndrome is the most common type of craniofacial dysostosis anomaly which presents a great challenge for clinicians since birth. Multiple synostoses in the sutures of the cranial base in this syndrome result in the hypoplasia of the midface, shallow orbits, a short nasal dorsum, maxillary hypoplasia, and, in severe cases, obstruction of the upper airways. Apart from esthetic and functional problems, these patients suffer from various psychological problems which mandate correction of midface deformities at younger ages. The aim of this report is to describe the case of a 26-year-old female patient with Crouzon syndrome displaying severe midface hypoplasia and proptosis with no history of orthodontic treatment, who was treated with modified Le Fort III osteotomy with a coronal and intraoral approach without periocular incisions.

Benign Cementoblastoma Involving Deciduous and Permanent Mandibular Molars: A Case Report.

Cementoblastomas are rare benign odontogenic tumors. Diagnosis of these lesions must be made by an association of clinical, radiographic, and histopathological findings. Cementoblastomas rarely occur in both primary and permanent dentitions. We describe the sixth case of cementoblastoma in the literature with the involvement of both deciduous and permanent teeth. The aim of this case report is to present the clinicoradiopathologic features of a cementoblastoma in a 4.5-year-old boy with an unusual recurrence. The first clinical and radiographic features appeared on the deciduous mandibular second molar. The second lesion occurred 1 year after treatment at 5.5 years old, involving the permanent mandibular first molar, and a subsequent lesion was seen at age 8 years in the edentulous region of the extracted mandibular first molar. After the last surgery, there was no recurrence of the lesion at 6 months' follow-up. Follow-ups of patients with cementoblastomas are highly recommended for an early detection of recurrences.

Effects of oral clonidine premedication on hemodynamic status in bimaxillary orthognathic surgery: A double-blind randomized clinical trial.

PURPOSE: Controlled hypotension during a surgical procedure is a way to decrease blood pressure and subsequently to improve the field of operation. Clonidine is an antihypertensive agent used for induced hypotension. Correction of maxillomandibular discrepancies may necessitate performing osteotomy on both jaws in many cases. Bimaxillary orthognathic surgery is a procedure that is associated with significant blood loss. MATERIAL AND METHODS: A total of 30 participants who were candidates for double-jaw orthognathic surgery were classified into two groups with equal numbers. In one group, 300 µg oral clonidine premedication was administered 90 min before the operation, and in the other group a placebo with the same condition as in the first group. Mean arterial pressure (MAP) and heart rate at 10 min intervals, operation time, blood loss, and surgeon satisfaction were measured. RESULTS: A total of 10 men and 5 women with a mean age of 22.9 ± 2.9 years in the study group and 13 men and 2 women with a mean age of 22.1 ± 2.1 years in the control group were evaluated. The MAP was significantly lower in the clonidine group (P < 0.001). Intraoperative bleeding was 508.67 ± 46.2 mL in the placebo group and 287.33 ± 72.06 mL in the clonidine group, and the difference was statistically significant (P < 0.05). Significant differences were observed in operation time (P < 0.05) and surgeon satisfaction (P < 0.001). CONCLUSION: The authors of this study suggest clonidine premedication in bimaxillary orthognathic surgery. Hemodynamic stability, bleeding control, decrease of operative time, and enhancement of surgical results are advantages of this method.

Effect of low-concentration povidone iodine on postoperative complications after third molar surgery: a pilot split-mouth study.

PURPOSE: Povidone iodine is used primarily as an antiseptic to decrease surgical site infection. Its hemostatic and antiedematous properties in oral surgery also have been investigated recently. PATIENTS AND METHODS: A randomized controlled clinical trial was performed in 30 patients undergoing mandibular third molar removal in a split-mouth design. In the study group, a povidone iodine solution with a concentration of 0.5 mg/mL was used as the coolant and irrigant solution, whereas normal saline was used in the control group. Swelling (orotragus and mentotragus distances), trismus (maximum interincisal opening), and pain (visual analog scale score) were evaluated on postoperative days 2 and 7. RESULTS: In the study group, a significant decrease in swelling and trismus was observed at the 2 postoperative visits (P = .00) compared with the control group. The decrease of pain in the study group was not statistically significant at either postoperative visit (P > .05). More patients (63%) were subjectively satisfied with the side treated with povidone iodine. CONCLUSION: Povidone iodine irrigation is an inexpensive and safe method to lessen the postoperative sequelae of third molar surgery.

Clinical outcome with half-dose depot triptorelin is the same as reduced-dose daily buserelin in a long protocol of controlled ovarian stimulation for ICSI/embryo transfer: a randomized double-blind clinical trial (NCT00461916).

BACKGROUND: Traditional doses of depot GnRH agonist may be excessive for ovarian stimulation. We compared half-dose depot triptorelin (Group I) with reduced-dose daily buserelin (Group II) in a long protocol ICSI/embryo transfer through a double-blind randomized clinical trial. METHODS: Controlled ovarian stimulation (COS) was started by a pretreatment with oral contraceptives for 21 days. Then, 182 patients were randomized into two groups of 91. Group I received 1.87 mg triptorelin depot i.m. followed by daily s.c. injections of saline. Group II (reduced-dose protocol) received a bolus injection of i.m. saline followed by daily s.c. injections of 0.5 mg buserelin, which was then reduced to 0.25 mg at the start of human menopausal gonadotrophin stimulation. When transvaginal ultrasound showed at least two follicles of 16-20 mm diameter, HCG was given and ICSI was performed 40-42 h later. RESULTS: No significant differences were seen in the mean (SD) number of follicles at HCG administration, as our primary outcome [10.3 (4.4) in Group I versus 11.1 (4.2) in Group II, P = 0.180, mean difference = 0.86, 95% confidence interval 0.39-2.11]. The other early results of COS, clinical and ongoing pregnancy rates, or early pregnancy loss were also not significantly different between the groups. Group I endured longer stimulation period [11.2 (1.8) days versus 10.6 (1.9), P = 0.030]. CONCLUSIONS: Clinical outcomes were not significantly different between Group I and Group II.