Repair of Wide Cleft Palate by Bilateral Buccal Fat Pad: A Preliminary Study

Introduction: This study aimed to prospectively assess the effectiveness of the use of the bilateral buccal fat pad (BFP) for wide cleft palate reconstruction and its effect on transverse palatal growth and fistula formation. Methods and Materials: Buccal fat pad was utilized for treatment of wide palatal cleft patients managed by at Department of Oral and Maxillofacial Surgery of Ahvaz Jundishapur University of medical sciences. Also, an electronic search of articles was performed in Medline and PubMed database from January 1990 to May 2015 to review the literature and summarize the utilization of BFP graft in reconstruction of palatal defects. Results: Ten wide palatal cleft patients were enrolled in this study from 2009 to 2015. Age ranged from 1.5 to 18 years with a mean of 6 in all cases and 2.4 in growing patients. The exposed BFP fully epithelialized within 4 weeks. No palatal fistula type III or IV was observed in follow-up. Palatal transverse growth was not adversely affected in seven growing patients in the follow-up time. Conclusion: The results of this study may suggest application of pedicled BFPs to support and fill nasal layer, raw bone, dead space between oral and nasal layer and hypoplastic muscles to prevent fistula formation and severe scar contracture

Assessment of Low-Level Laser Therapy Effects After Extraction of Impacted Lower Third Molar Surgery

Introduction: The aim of this study was to assess the effect of low-level laser therapy (LLLT) on pain, swelling and maximum mouth opening in patients undergoing third molar surgery.Methods: A prospective, randomized double-blind study was undertaken on 44 patients at the Dental School, Ahvaz Jundishapur University of Medical Sciences, in 2015. A low-level laser was randomly applied on one of the two sides after surgery of 15 patients. The experimental side received 18 J/cm2 of energy density, wavelength of 980 nm, and output power of 1.8 W. On the control side, a hand-piece was applied intra-orally, but laser was not activated. In addition, in order to evaluate trismus, 13 patients were treated by unilateral laser therapy and 16 patients did not receive laser therapy at all. The laser was administered intraorally on two points of vestibular and lingual sides at 1 cm from the surgery site, and extraorally at the emergence of the masseter muscle, immediately after surgery, and repeated 24 hours later. The pain, swelling and maximum mouth opening (MMO) were compared between the two groups at 24 hours and a week after surgery.Results: The mean score of pain 24 hours after surgery in the laser therapy group (2.3 ± 3.5) was significantly lower than the mean score of pain in the drug therapy (4.19 ± 3.09) (P = 0.036). Moreover, the mean score of pain at one week after surgery in the laser therapy group (0.13 ± 2.33) was significantly lower than the drug therapy group (1.43 ± 2.45) (P = 0.046). The amount of swelling according to different measurements did not significantly differ between the two groups neither at 24 hours nor at 1 week after surgery.Conclusion: Our findings showed that LLLT was useful in reducing pain and could slightly reduce swelling compared to drug therapy in impacted third molar surgery

Customized Lateral Nasal Osteotomy Guide: Three-Dimensional Printer Assisted Fabrication

Lateral osteotomy is a necessity in several rhinoplasty cases. However, it can be challenging for inexperienced surgeons to perform external osteotomy due to difficulties such as lack of control, inconsistent results and technical complications. The present article presents a simplified approach for external lateral nasal osteotomy by using a customized lateral nasal osteotomy guide fabricated with three-dimensional printer. This technique may assist novice surgeons to perform external lateral nasal osteotomy more safely and with reduced operation time and consistent outcomes

Long and Short-term Metformin Consumption as a Potential Therapy to Prevent Complications of COVID-19

Purpose: The aim of the study is to evaluate the effect of metformin in complication improvement of hospitalized patients with COVID-19. Methods: This was a randomized clinical trial that involved 189 patients with confirmed COVID-19 infection. Patients in the intervention group received metformin-500 mg twice daily. Patients who received metformin before admission were excluded from the control group. Patients who were discharged before taking at least 2000 mg of metformin were excluded from the study. Primary outcomes were vital signs, need for ICU admission, need for intubation, and mortality. Results: Data showed that patients with diabetes with previous metformin in their regimen had lower percentages of ICU admission and death in comparison with patients without diabetes (11.3% vs. 26.1% (P=0.014) and 4.9% vs. 23.9% (P≤0.001), respectively). Admission time characteristics were the same for both groups except for diabetes and hyperlipidemia, which were significantly different between the two groups. Observations of naproxen consumption on endpoints, duration of hospitalization, and the levels of spO2 did not show any significant differences between the intervention and the control group. The adjusted OR for intubation in the intervention group versus the control group was 0.21 [95% CI, 0.04-0.99 (P=0.047)]. Conclusion: In this trial, metformin consumption had no effect on mortality and ICU admission rates in non-diabetic patients. However, metformin improved COVID-19 complications in diabetic patients who had been receiving metformin prior to COVID-19 infection, and it significantly lowered the intubation rates

Maxillomandibular fixation miniplate, alternative management for condylar fractures in complete/partial edentulous mandible

This study aimed to evaluate the feasibility, effectiveness, and reliability of using conventional miniplates to provide stable maxillomandibular fixation (MMF) for the management of condylar fracture(s) in complete/partial edentulous mandible. Eleven displaced condylar fractures (37.5% bilateral) in eight completely/partially edentulous adult males (mean age: 43.37) were immobilized with 2–3 conventional miniplates (across two jaws) and followed for three months. All cases showed stable mandibular immobilization during the MMF period. MMF-miniplates were removed after six weeks under local anesthesia. Satisfactory mouth opening was observed after MMF-miniplate removal. No cases of MMF-miniplate failure, significant postoperative complications, and emergency MMF-miniplate release were observed. Only one case showed local soft tissue inflammation at the MMF-miniplate entry site, which resolved after removal. In conclusion, MMF-miniplate is a feasible, effective, and reliable technique with satisfactory clinical outcomes. This technique can be easily and quickly used as an alternative treatment for open reduction of condylar fractures or as a temporary MMF in complete/partial edentulous mandible to reduce difficult, complex, and time-consuming perioperative procedures