Effect of buccal fat autotransplantation on improving the alveolar socket bone regeneration: An in-vivo study.

Background: There are various materials used for socket preservation following dental extraction. The aim of the present animal study was to histologically investigate the efficacy of buccal fat autotransplantation on alveolar bone regeneration following dental extraction. Study design: In this prospective, double-blind laboratory experiment with a split-mouth design, 16 mandibular second premolar teeth in eight beagle dogs were extracted, and half of the extraction sockets were randomly filled using buccal fat autotransplantation. Other samples were left untouched to heal normally by the formed blood clot. Buccal fat autotransplantation was the primary predictor variable, and the type and amount of newly formed bone were the primary outcome variables. Assessment methods were the H & E coloring technique and histomorphometric evaluation. The significance level was set at 0.05, and data was subjected to Chi-Square and Wilcoxon signed-rank tests using SAS statistical software version 9.4. Results: From the total number of 16 samples in 8 dogs, 50% of the samples in the intervention group represented inflammation with lower intensity compared to 33% in the control group; however, this difference was not considered statistically significant (Chi-Square test, P-value = 0.55). Wilcoxon test results showed no statistically significant difference between the two groups regarding the mean amount of total bone formation (Z = 0.00, P-value = 1.00). Conclusion: It was inferred from the outcomes of the present study that when compared to the normal healing of the socket, buccal fat autotransplantation did not represent with superior outcome concerning the socket bone regeneration.

Effect of the absorption rate of suture material on oral mucosal scar formation: A triple-blind randomized controlled trial.

Introduction: Extensive oral mucosal scar formation following LeFort-I osteotomy can pose patients with several scar-related complications in case of function as well as cosmesis. The present study aimed to evaluate the effect of the absorption rate of Vicryl Rapide and Vicryl on oral mucosal scar formation. Material and methods: In a triple-blind randomized controlled trial study, Vicryl and Vicryl Rapide were used randomly for wound closure on the left and right sides of the LeFort-I incision line. Three maxillofacial surgeons evaluated mucosal scars on each side two and four months post-surgically using Mucosal Scarring Index (MSI). Results: The differences in the total scores of MSI between the Vicryl and Vicryl Rapide groups were not significant, neither in the anterior nor in the posterior areas (Paired t-test, df = 25, CI = 95 %, P-value >0.05). Conclusion: The results of the present study demonstrated that Vicryl Rapide is comparable to Vicryl suture material regarding the mucosal scar formation following LeFort-I osteotomy surgery; therefore, it could be considered for such oral surgical procedures.

Histopathological assessment of the preventive effect of leukocyte-platelet-rich fibrin on bisphosphonate-related osteonecrosis of the jaw following dental extraction: An animal study.

Background: Leukocyte- and platelet-rich fibrin (L-PRF) could be considered a preventive measure in Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ). The present experiment aimed to assess the preventive effects of L-PRF on osteonecrosis of the jaw in rats. Methods: In this interventional animal study with a split-mouth design, 28 rats were randomly allocated to saline (negative control), bisphosphonate (positive control), and Bis + L-PRF (case) groups. Bilateral extraction of maxillary molar teeth was performed followed by random application of L-PRF to one of the extraction sockets treated with Zoledronic acid for four weeks. Clinical occurrence of BRONJ and histopathologic evaluations were done, and data were subjected to the Kruskal-Wallis test, Mann-Whitney U test and exact Fisher test performed using SPSS 25. The significance level was set at 0.05. Results: The application of L-PRF resulted in a 41.67% reduction in osteonecrosis centers and the number of osteoclast cells. Also, Kruskal Wallis test results showed a significant difference among the three groups regarding the frequency distribution of inflammation severity. However, no significant difference was detected regarding the frequency distribution of the blood vessels (Kruskal Wallis test, P-value = 0.649). Conclusion: It could be inferred that possible preventive effects on the clinical occurrence of osteonecrosis could be expected from the application of L-PRF.

The effect of micro-osteoperforation on root resorption, pulp vitality, and biological changes of teeth subjected to orthodontic tooth movement: A systematic review study.

Background: These days minimally invasive micro-osteoperforation (MOPs) has accelerated orthodontic tooth movement (OTM). However, there are some conflicting reports about their various impacts; hence, the present systematic review study aimed to evaluate the effect of MOP on root resorption, pulp vitality, and the biological changes of teeth subjected to OTM. Materials and Methods: Search in electronic databases of English literature including PubMed, Scopus, Web of sciences, Cochrane, and Google scholar as well as a manual search was performed from 2013 to 2022. Most of the studies included in this article were randomized controlled trials. Results: From the total number of 321 found articles, 31 duplicated and 268 irrelevant articles were excluded regarding the defined inclusion and exclusion criteria. Consequently, 22 articles were subjected to the quality assessment process, and finally, 18 articles were selected for the review phase. Root resorption during tooth movement using the MOP approach was reported only in one study. Besides, except for two animal studies, all of the relevant included articles showed that MOPs significantly increased the expression of some inflammatory biomarkers known to recruit osteoclast precursors and increase the number of osteoclast cells. On the other hand, two animal studies showed no differences in osteoclast counts by using MOPs in comparison to their control groups, which was consequently the result of biologic variability between animal and human and also probably the small sample sizes of these two studies. Conclusion: In this systematic review, according to the adverse effects of MOP on root resorption, one study showed higher levels of root resorption among patients undergoing MOP. However, this outcome was due to the different methods used to evaluate the effect of MOPs on root resorption. Moreover, a high certainty of evidence supports that MOP causes biological changes and an elevation in cytokines, chemokines, and other biomarkers that stimulates osteoclasts differentiation which in turn accelerate OTM. There was no change in pulp vitality status based on available evidence.

Evaluation of the effect of green tea extract on postoperative pain management following surgical removal of impacted mandibular third molar.

Background: Pain following surgical removal of impacted molars has remained a principal concern among practitioners. Since green tea has anti-inflammatory and anti-bacterial properties, the current study aimed to evaluate the efficacy of green tea extract local application in controlling postoperative pain following surgical extraction of the impacted mandibular third molar teeth. Materials and Methods: In a double-blinded randomized controlled trial study with a split-mouth design, 32 patients underwent bilateral removal of impacted third molars in a 2-month time interval; afterward, the sterile gauzes impregnated with green tea extract and saline were applied randomly to the surgical sites. Postoperative pain was evaluated 6, 12, 24, and 48 h after surgery using a questionnaire based on the Visual Analog Scale (VAS) and the number of analgesics used after surgery. Data were subjected to exact and Chi-square tests with the significance level set at 0.05. Results: There was a decrease in the mean scores of the VAS and the mean number of analgesic consumptions in the first 2 days after surgery. Chi-square test results showed a significant reduction in the VAS scores after applying the green tea extract only 6 and 12 h after surgery (P < 0.05). Moreover, the number of analgesic consumptions was significantly lower in the green tea group compared to the control group. Conclusion: Green tea extract may be an appropriate and safe choice for postoperative pain control after surgical extraction of the impacted mandibular third molar teeth.

Evaluation of Blood Levels of Omentin-1 and Orexin-A in Adults with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.

Background and objective: Obstructive sleep apnea (OSA) can be related to changes in the levels of adipokines and neuropeptides, which in turn may affect the energy balance components of neuronal cells. Herein, a systematic review and meta-analysis checked the changes in serum/plasma levels of omentin-1 (OM-1: an adipokine) and orexin-A (OXA: a neuropeptide) in adults (age > 18 years old) with OSA (aOSA) compared to controls. Materials and methods: Four databases (Cochrane Library, PubMed, Web of Science, and Scopus) were systematically searched until 14 November 2022, without any restrictions. The Joanna Briggs Institute (JBI) critical appraisal checklist adapted for case−control studies was used to assess the quality of the papers. The effect sizes were extracted using the Review Manager 5.3 software for the blood levels of OM-1 and OXA in aOSA compared with controls. Results: Thirteen articles, with six studies for OM-1 levels and eight for OXA levels, were included. The pooled standardized mean differences were −0.85 (95% confidence interval (CI): −2.19, 0.48; p = 0.21; I2 = 98%) and −0.20 (95%CI: −1.16, 0.76; p = 0.68; I2 = 96%) for OM-1 and OXA levels, respectively. Among the studies reporting OM-1, five were high and one was moderate quality. Among the studies reporting OXA, six were moderate, one was high, and one was low quality. Based on the trial sequential analysis, more participants are needed to confirm the pooled results of the analyses of blood levels of OM-1 and OXA. In addition, the radial plot showed outliers as significant factors for high heterogeneity. Conclusions: The main findings indicated a lack of association between the blood levels of OM-1 and OXA and OSA risk. Therefore, OM-1 and OXA did not appear to be suitable biomarkers for the diagnosis and development of OSA.

Effect of Dexmedetomidine Added to Lidocaine Cartridge on the Level of Patient Sedation, Cooperation, and Patient and Surgeon Satisfaction during Mandibular Third-Molar Extraction Surgery: A Randomized Double-Blind Controlled Trial.

Background: Various methods have been introduced for anxiety control during third-molar extraction surgery. Dexmedetomidine (DEX) is known to have analgesic, anxiolytic, and sympatholytic properties with minimal adverse effects. This study aimed to evaluate the impact of the local injection of the combination of DEX and Lidocaine on patients' anxiety and the surgeon's satisfaction during third-molar extraction surgery. Methods: A total number of 26 healthy volunteers with symmetrical bilateral impacted mandibular third-molar teeth indicated for surgical removal were included in this double-blind randomized controlled trial. A single experienced surgeon performed two surgical extraction procedures within at least four-week time intervals using anesthetic cartridges containing "DEX + LIDO" or "LIDO alone" used randomly on each side for each patient. The Visual Analog Scale and the SDFQ index were used to evaluate patients' anxiety and surgeon satisfaction during the procedure. Results: SDFQ reports showed that patients in the "DEX" group were 1.5 times more relaxed than those in the "LIDO alone" group. As a result, the level of sedation was considered statistically significant between the two groups (Wilcoxon test, P value <0.019). Wilcoxon test results also showed significant differences between the two groups regarding patients' overall cooperation in terms of interfering movement and verbal presentation of discomfort (P value <0.05); however, this difference was not considered significant regarding nonverbal signs of discomfort (P value >0.05). Moreover, both the surgeon and the patients reported a significantly higher satisfaction rate in the DEX group (paired T-test, df = 25, P value <0.05). Conclusions: It was inferred from the outcomes of the present study that the application of DEX added to the LIDO local anesthesia cartridge could significantly benefit anxious patients with previous unpleasant dental treatment experiences. Trial Registration. This trial is registered with the clinical trial registration number: IRCT20200406046966N.

Midface advancement in an adult patient with Crouzon syndrome: Modified LeFort III + LeFort I osteotomy accompanied by genioplasty and nasal dorsum augmentation.

Crouzon syndrome is an autosomal dominant trait, leading to midface deficiency, undeveloped orbits, short nasal dorsum, and exophthalmos as the typical clinical features. Early correction of craniofacial problems can improve patients' quality of life, but many of these patients with Crouzon syndrome are seeking treatment in older ages when they are missed for multidisciplinary management and distraction technique in proper timing. Modified LeFort III osteotomy is one of the treatment options that can be used for proper resolution in adult patients. The present case report study aims to describe a patient with midface deficiency due to the Crouzon syndrome who has undergone a combination of modified LeFort III osteotomy with the periocular approach and LeFort I osteotomy, nasal dorsum augmentation accompanied by genioplasty, wholly as a single surgical procedure which has been shown that can result in highly satisfactory outcomes for both patient and surgeon.

Evaluation of the CBCT imaging accuracy in the volumetric assessment of unilateral alveolar cleft.

INTRODUCTION: Appropriate radiographic evaluation is a fundamental step for determining the topography of the defect before the surgical intervention for alveolar bone grafting. Evaluation of cleft volume by CBCT has been done in dry skull samples in previous studies and it was recommended as an effective tool in the volumetric evaluation of the bone defect prior to the surgery. The purpose of this study was to evaluate the accuracy of preoperative clinical use of CBCT2 imaging in determining the alveolar cleft volume. MATERIAL AND METHODS: We performed a clinical study. 20 patients with unilateral alveolar cleft underwent preoperative radiographic evaluation using CBCT scan. Volumetric measurement was performed by an oral and maxillofacial radiologist using 0.5, 1, and 2 mm slices and an oral and maxillofacial surgeon using 2 mm slices. After the closure of the nasal floor and palatal mucosa, the alveolar defect was clinically measured with putty impression material. Descriptive and bivariate statistics were computed and the p-value was set at 0.05. RESULTS: This study showed that there is a statistically significant difference between CBCT-estimated and clinical volumes of the alveolar cleft (paired T-test, p-value < 0.05). CONCLUSION: Considering the significant difference between clinical and CBCT-estimated volumes of the alveolar cleft, CBCT imaging is not considered an accurate tool for pre-operative volumetric assessment of the alveolar cleft.