Cone-Beam Computed Tomographic Assessment of Anatomical Variations of the Interforaminal Region in a Selected Iranian Population

Objectives This study assessed the anatomical variations of the mental foramen (MF) and presence and length of the anterior loop and the incisive canal in a selected Iranian population using cone-beam computed tomography (CBCT). Methods This descriptive, cross-sectional study evaluated CBCT scans of 256 patients (123 males, 133 females) over 18 years of age. The CBCT multiplanar reformatted panoramic images (10-mm thickness) were used to assess the anatomical position of the MF and presence/absence and length of the anterior loop. The cross-sectional images were used to assess the presence/absence and length of the incisive canal. The anatomical variations were compared in the right and left sides and between males and females using dependent and independent t-test. SPSS version 21was used for statistical analysis. Results The most common position of MF was adjacent to the apex of the second premolar, noted in 41.4% of the patients. The second common position of MF was between the apices of the first and second premolars (30.1% of the patients). The anterior loop was present in 44.3% of the patients. The mean length of the anterior loop and the incisive canal was 2.64 mm and 7.15 mm, respectively. No significant difference was noted between males and females or right and left sides in any variable (P>0.05). Conclusion Anatomical variations of the anaterior mandible indicate the significance of 3D imaging to prevent nerve traumatization by proper treatment planning

Dimensional Distortion of Four Types of Intracanal Posts on CBCT Scans with Different Fields of View and Resolutions

Objectives This study assessed the dimensional distortion of four types of intracanal posts on cone-beam computed tomography (CBCT) scans with two different fields of view (FOV) in high and standard resolution modes. Methods This in vitro study evaluated 40 extracted single-rooted maxillary central incisors that underwent root canal treatment. The teeth were randomly assigned to 4 groups (n=10) for placement of non-tapered brass, silver, titanium and stainless steel (SS) intracanal posts. The diameter of the posts was measured at two reference points by a digital caliper (gold standard). The teeth underwent CBCT with 8 x 8 and 8 x 12 cm FOV with high and standard resolution modes. The post diameters were measured on axial CBCT images at the same reference points and compared with the gold standard. Data were analyzed by ANOVA, and paired and independent sample t-test. Results Significant differences were noted between the radiographic diameter of the posts and their actual size (P<0.05). Titanium posts (40.25%) showed minimum percentage of dimensional distortion followed by brass (54%), silver (62.5%) and SS (70.17%) posts. High-resolution images with 8 x 8 cm FOV yielded minimum dimensional distortion (40.6%) followed by high-resolution images with 8 x 12 cm FOV (45.75%), standard-resolution images with 8 x 8 cm FOV (68.75%), and standard-resolution images with 8 x 12 cm FOV (72.1%). Conclusion All metal posts showed significant dimensional distortion on CBCT scans, irrespective of the FOV size and resolution mode. SS posts yielded maximum, and titanium posts showed minimum dimensional distortion

Bone Tissue Engineering: A Literature Review

Introduction: Classic bone tissue engineering involves use of osteogenic cells, growth factors, and bone scaffolds to generate a graft material to replace the gold standard which is autogenous bone graft. Several modifications have been applied to the classic approach but none of them can fully regenerate bone defects. The current study reviewes the literatures in applications of bone tissue engineering both in vivo and in vitro. Materials and Methods: An electronic search in MEDLINE was conducted and both in vivo and in vitro studies were included using bone scaffolds with or without osteogenic growth factors or stem cells. In vitro studies which did not investigate cell-scaffold interactions and in vivo studies which did not measure new bone formation were excluded. Results: Of 86 studies, 38 concerned in vitro and 48 in vivo studies. These studies were divided into six groups based on scaffold which they used: Synthetic, natural, polymers (non-ceramics), composites (polymer+ceramic), metal-based and nano-scaffolds. The results of the studies were compared in a qualitative manner. In vitro studies were mostly conducted on polymers, while relatively more animal and clinical studies were performed on ceramics. The most commonly used scaffolds, stem cells and growth factor were synthetic ceramics, bone marrow stem cells and bone morphgenic protein 2, respectively. Conclusion: Determination of the most successful approach was not possible due to the presence of several variable and variances in analyzing methods and data report. However, studies which used all three components of BTE, including scaffolds, growth factors and stem cells, showed good results both in vitro and in vivo

Seizure, Deafness, and Renal Failure: A Case of Barakat Syndrome

Etiologic diagnosis of seizure requires proper consideration of apparently unrelated clinical features of the patient. Here, we report the case of a patient of status epilepticus with moderate-to-severe bilateral sensorineural deafness. Investigations showed extensive intracranial calcification, hypoparathyroidism and unilateral renal agenesis. The features were consistent with Barakat syndrome, a rare developmental disorder associated with mutations in the GATA3 gene. To the best of our knowledge, this is the first reported case of Barakat syndrome from India

Comparison of Fluoride Uptake into Tooth Enamel Using Four Different Fluoride Varnishes

Objectives The efficacy of fluoride varnish in preventing dental caries has been well documented. The objective of this study was to compare the impact of four different fluoride varnish brands containing 5% sodium fluoride on the sound enamel of permanent teeth. Methods In this experimental study, 40 sound human premolar teeth were randomly assigned to four groups (Fluorilaq®, FluoroDose®, Preventa®, Kimia®; N=10). Each tooth was sectioned into buccal and lingual halves, corresponding to the control and the experimental subgroups, respectively. In the experimental halves, a semi-circular shaped area of the enamel was treated with the designated fluoride varnish. All specimens underwent Acid Etch Enamel Biopsy. Fluoride and Calcium concentrations were measured using a Potentiometer and Inductively Coupled Plasma optical emission spectrometer, respectively. The collected data were analyzed using paired t-test and one-way ANOVA at P<0.05. Results There was a significant difference between the enamel fluoride content of experimental and control halves in all groups (P<0.05). Preventa® Fluoride varnish caused the highest Fluoride uptake, followed by FluoroDose®, Fluorilaq®, and Kimia®. All pair comparisons were statistically significant (P<0.05), except for Preventa® vs. FluoroDose® (P=0.36). Conclusion Since all examined Fluoride varnishes increased the Fluoride content of the tooth enamel, they potentially qualify for caries prevention. Furthermore, Preventa® could be considered a good domestic alternative for other brands investigated in this research, in terms of enamel fluoride uptake

Efficacy of orlistat in the treatment of patients with non-alcoholic fatty liver

Background: Nonalcoholic fatty liver disease (NAFLD) is a reversible condition of fat accumulation that is associated with liver inflammation and can disrupt the normal activity of the liver. People with a diagnosis of NAFLD have a higher risk of all- cause mortality than the general population. The purpose of the present study was to determine, the efficacy of orlistat in the treatment of patients with NAFLD.Methods: This semi-experimental study was performed on 45 fatty liver patients of the gastroenterology clinic of Imam Khomeini Hospital in Ardabil city in April 2016 to April 2017. Data was collected by a checklist which included demographic and clinical data such as age, sex, body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), cholesterol and result of ultrasound before and after orlistat consumption.Results: The mean decrease in the variables examined was as follows: weight 8.3 kg, BMI 3.5 kg/m2, ALT 31.6 U/l, AST 18.1 U/l, cholesterol 15.5 mg/dl and TG 33.1 mg/dl. All of the upper indexes were decreased significantly following received drug.Conclusions: Orlistat therapy was associated with significant decreases in ALT, AST, TG and cholesterol level. Orlistat is effective in weight loss, body mass index reduction and can be used to treat non-alcoholic fatty liver disease

Using Diode Laser for Soft Tissue Incision of Oral Cavity

INTRODUCTION: The purpose of this case report is to analyze the results of vestibuleplasty around an over-denture based on dental implants to determine the evidence on the effectiveness of laser-assisted surgery and soft tissue management in implant dentistry.CASE REPORT: The patient in this case report was a 57 year- old male who was completely edentulous, with a mandibular over denture based on 4 standard implants suffering from pain on chewing, and a general discomfort, especially in anterior segment. He received a standard gingival augmentation surgery which failed to create sufficient vestibular depth. A laser-assisted vestibuloplasty was done to make the environment suitable for making a new overdenture.CONCLUSIONS: There were clinically significant improvements in vestibular depth and peri implant soft tissue situation by laser. Also, bleeding during surgery was well controlled; the patient’s discomfort and pain were less than the first operation done with gingival graft. Based on our clinical data and review of the literature, an evidence-based approach to the use of lasers for the management of soft tissue in oral surgery is necessary. Simply, there is insufficient evidence to suggest that any specific wavelength of laser is superior to the traditional modalities of therapy. However, improved hemostasis and patient’s satisfaction can be considered as advantages of adjunctive laser therapy in some clinical situations like vestibuloplasty

Renal cell carcinoma : factors of importance for follow-up and survival

Background: Renal cell carcinoma (RCC) is most lethal of the urological cancers, with more than 40% dying of the disease. About 30% of the patients have metastases at initial diagnosis and up to 40% undergoing nephrectomy for localized RCC develop metastasis. A follow-up protocol based on accurate prognostic variables allows identification of low and high risk patients and selection of those most likely to benefit from adjuvant therapy. I have studied a number of prognostic patient-related factors, including tumour stage and grade, angiogenetic factors and tumour markers, in order to improve follow-up guideline as well as to try to predict prognosis and clinical outcome for individual patients. Material and Methods: The studies are based on patients treated for RCC between 1982 and 2002. All patients eligible for surgery with or without metastasis were treated with nephrectomy and were followed according to a scheduled follow-up programme. Serum samples were collected after obtained informed consent. Multiple clinicopathological, laboratory variables and preoperative radiological examinations were analyzed. Results: Study I- After nephrectomy in 187 patients with non-metastatic RCC, 30% developed metastases during the follow-up. The risk for metastases was greater for more advanced stage and was adjusted by size and DNA ploidy. The median time to the diagnosis of metastases was 14.5 months. Metastases occurred in 43% of the patients within one year, within 2 years in 70% and 80% in 3 years. Patients with tumours less than 5 cm and diploid pT1>5cm and pT2 tumours survived longer than those with larger and aneuploid tumours. The 5-years survival rate for pT1, pT2, pT3 tumours were 95%, 87%, and 37% respectively. In pT3 tumours DNA ploidy had no relation to survival time. Study II and IV- The median survival time for patients with metastatic RCC was 7 months. Cytoreductive nephrectomy was associated with longer survival time. Factors including performance status (PS), number of metastatic sites, erythrocyte sedimentation rate (ESR), calcium in serum, vein invasion, capsule invasion had independent prognostic value with Cox multivariate analysis. Study III- The incidence of adrenal tumour involvement was 5.3 %, unaffected of RCC type, tumour location or side. Gender (male) and locally advanced tumours (pT3 > 5cm) were factors predicting adrenal involvement. The presence of adrenal involvement was a significant adverse prognostic variable, indicating a significantly shorter survival in patients both with and without distant metastases. Conclusion: Optimal follow-up guidelines are important from both medical and economic perspectives. The risk for progression depends mainly on stage, which in combination with other prognostic factors may allow more individualized and cost effective follow-up, in some cases by avoiding unnecessary examinations in a third of the patients. Cytoreductive nephrectomy in patients with good PS, metastases limited to one organ, low ESR, normal calcium and no vein invasion were factors associated to long survival time. Soluble angiogenic factors in serum gave no prognostic information. Ipsilateral adrenalectomy in conjunction with radical nephrectomy should be performed if an adrenal lesion cannot be cleared of suspicion during preoperative work up. Ipsilateral adrenal involvement is a highly adverse prognostic factor and should be staged as M1a in the TNM staging system

The Effect of Pentoxifylline in Reducing Proteinuria in Patients with Diabetic Nephropathy Treated with ACEI or ARB

Background & objectives: Diabetes mellitus belongs to a group of common metabolic disorders characterized by hyperglycemia phenotypes. Diabetes mellitus causes secondary pathophysiological disorders in multiple organs of the body such as nephropathy, which causes many problems for patients and the health care system. In this study, the effect of pentoxifylline, a nonselective phosphodiesterase inhibitor, on reducing urinary protein excretion in diabetic patients was assessed. Methods: In this clinical trial, 72 diabetic patients with proteinuria who were admitted to the endocrine and nephrology clinic were selected and divided into two groups. Checklists, including demographic data, etc. were completed. In group (A), Angiotensin-converting enzyme inhibitors (ACEI) or Angiotensin II receptor blockers (ARBs) were prescribed to reduce proteinuria, and in another group (B), in addition to ACEI or ARB drugs, pentoxifylline was prescribed. In the end, the results in both groups were compared in terms of further reduction of proteinuria. Results: Most of the studied patients were male. There was a significant correlation between proteinuria (mean urinary protein excretion in 24 hours) and the effect of pentoxifylline on reducing proteinuria in patients with type II diabetes. Also, there was not a significant difference in systolic and diastolic blood pressure changes and HbA1c between the two groups at the beginning and end of the study. Conclusion: Pentoxifylline, independent of lowering blood pressure or reducing the improvement of metabolic control, can significantly decrease proteinuria and protein excretio