Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents. Management of MRONJ has remained a controversial topic within the oral and maxillofacial surgery community. Materials and Methods: Articles from 2010 to 2020 were selected. We determined that all review studies evaluated the effectiveness of various MRONJ therapies to resolve the condition were eligible for this study. We determined that all review studies evaluated the effectiveness of various MRONJ therapies to resolve the condition were eligible for this study. Results: Antibiotic therapy such as penicillin-based antibiotics plus β-lactamase inhibitor or metronidazole could decrease disease progression and may prevent super infection of the bone. Surgery should be considered in all stages of MRONJ as it confirms the histology. Fluorescence-guided surgery is helpful for MRONJ cases under Denosumab and it is recommended to use low level laser and PDT as adjuvant treatment of MRONJ.Conclusion: It seems that conservative treatment, minimally traumatic extraction technique, removal of bone edges and mucosal wound closure may prevent the occurrence of MRONJ. Keywords: Mronj; Bronj; Treatment; Prevention.

Introduction: The purpose of this study is to determine the incidence of velopharyngeal insufficiency (VPI), fistulae and recurrence development in patients seen by the Isfahan Cleft Care Clinic and also determine the association of gender, age at repair, and cleft type with the incidence of each. Materials and Methods: In this retrospective study, 320 children who had undergone a primary cleft palate surgery and who had come to the cleft lip and palate clinic in Isfahan in 2010-2017 were studied based on the medical records and information about each patient. Then all patients were evaluated by standard speech assessment methods for severity of hypernasalitis and screened for clinical manifestations of fistula and recurrence. Results: According to the results of this study, the incidence of velopharyngeal insufficiency after initial repair was 78.1% and most of these patients had severe form. The results also showed that by increasing age at surgery also increased the intensity of velopharyngeal insufficiency, and the severity of this complication has nothing to do with gender. In the case of fistula and recurrence of cleft showed that, in patients who are undergoing the new procedure to be significantly less than other patients. Conclusion: According to the study, palatoplasty complications such as velopharyngeal insufficiency, fistula, and recurrence were less common in patients treated with microsurgery, Therefore, it can be concluded surgical repair of cleft palate should be performed before 12 months ages and in microsurgery methods. It seems that follow up of these patients after surgery for monitoring of speech complications is necessary. Keywords: Cleft palate; Velopharyngeal insufficiency; Fistula; Palatoplasty; Microsurgery.

Background and Objectives: Temporomandibular joint dysfunction (TMD) is known as a chronic pain in the ears manifested in the form of tinnitus, earache, hearingloss, vertigo, and other impairments. Although patients affected with this disorder undergo long-term treatments using various medicines without significant pain relief, medical care is still possible with a correct diagnosis. This study investigated the incidencerate of TMD in patients suffering from earache. Materials and Methods: This cross-sectional study investigate the incidence rate of TMD in patients with earache referring todental clinics affiliated to Tehran University of Medical Sciences (TUMS), Iran, including patients with over six months of earache or those having pain despite using medicines. The Diagnostic Criteria for TMD (DC/TMD) Axis I and II Protocol was used for examining TMD and stress, and also independent t-test and Chi-square test were employedto compare TMD patientsin terms of age and gender. Results: A total number of 100 individuals aged between 18 and 65 years, including 40 malesand 60 females were examined in this study. The incidence rate of TMD in patients with earache was also reported by 76.5%. Conclusion: The results indicated a high incidence rate of TMD in patients having earache. Accordingly, patients complaining about TMD required specialized earache evaluations by dentists and medics. Keywords: Temporomandibular joint dysfunction; Earache; Tinnitus.

Aim: As the patterns of impaction can affect the treatment plan of removing or remaining the impacted tooth, the difficulty of surgery, and the post-surgical complications, this survey aimed for assessment of the mandibular wisdom tooth impaction patterns in terms of angulation and depth in the north population of Iran. Materials and Methods: 196 Panoramic radiographs were gathered from patients attending to the department of oral and maxillofacial surgery of GUMS in 2018-2019. To perform this retrospective study the prevalence of impaction, angulation, and the level of the eruption were assessed. The data were analyzed by SPSS 16. Results: This study found that the most common pattern of impacted mandibular third molars was level B in terms of depth and mesioangular in terms of angulation. Conclusion: The current study notes the importance of determining the angulation and level of wisdom tooth in designing the pre-surgical treatment and in post-surgical complaints. Keywords: Impacted teeth; Panoramic radiography; Retrospective study; Third molar.

Background: Evaluating the quality of life of participant with normal facial features in the Kurdish society and quality of life assessment of patients with dentofacial deformities corrected by orthognathic surgery and comparing their satisfaction with those of patients with dentofacial deformities, the comparison is performed by applying the orthognathic quality of life questionnaire (OQLQ).Materials and Methods: Three groups of participants were interviewed, and orthognathic quality of life questionnaire (OQLQ) was used to assess generic health-related quality of life. They were asked to complete the Kurdish version of the 22-item orthognathic quality of life questionnaire (OQLQ) of SJ cunningham for the control, the deformity and the operated patient groups. Responses were compared using paired t-tests, with the significance level set to P<0.05. Results: The results showed that there is a strong impact of the dentofacial deformity on people in the society, and there is a significant difference between the QOL of normal people in comparison with people with dentofacial deformities P<0.05. In addition There were statistical differences in the satisfaction of four domains of the questionnaire (oral function, facial aesthetics, psychological, and social aspects), between QOL of patients that had correction of the deformity and the non-operated patients with same kind of deformities. This indicated that quality of life was significantly higher in patients operated on by orthognathic surgery (P<0.001). Results showed statistical differences between groups and suggested that people with no deformity (normal) and those subjected to orthognathic surgery have a better quality of life compared to those with a facial deformity and experiencing a QOL that is near normal. Conclusion: Dentofacial correction by orthognathic surgery seems to have a positive effect on the quality of life and it is an effective method in normalization of the social and psychological state.Keywords: Orthognathic surgery; Dentofacial deformities; Quality of life.

Ectodermal dysplasia is an inherited disorder with partial or complete anodontia. Early dental treatments are mandatory for improving child mastication, communication, and esthetic. There are various treatment approaches such as implant-retained prosthesis, fixed and removable denture which should be selected according to remained teeth, oral and facial parameters. This clinical study describes the prosthetic treatment of a child with ectodermal dysplasia with combination of complete overdenture and partial removable denture. Keywords: Ectodermal dysplasia; Hypodontia; Children; Removable prosthodontic deture; Overdenture.

The LeFort I osteotomy is a versatile and simple procedure used by oral and maxillofacial surgeons for correction of congenital, developmental, or acquired dentofacial deformities. This technique is widely used due to its low complication rate such as rare, life-threatening events, reliable long-term results, and a high level of patient satisfaction. This report presents a case of LeFort I osteotomy  resulting in an unusual complication of pulmonary thromboembolism. Keywords: LeFort I osteotomy; Complication; Pulmonary thromboembolism.

Dear Sir, COVID 19 is spreading rapidly throughout the whole world especially in United States of America and some European countries such as Italy, Spain, France, United Kingdom, Belgium, and Netherlands. More than 276,000 and 4 million people have been killed and infected, respectively. The author wants to mphasize the reasons of low COVID 19 detection and mortality rate in Pakistan. Pakistan came into being on 4 and 15 August 1947, respectively. Now let’s come to the point. Pakistan confirmed its first case on 26 bruary 2020. Till now on 7 May 2020, Pakistan confirmed a total of 24,073 cases, 564 deaths and 6,464 ecoveries. Pakistan has implemented a complete lock down for first three weeks and five weeks, respectively 1,2]. Extensive testing and effective lockdown are the main key points to stop covid 19 infection chain. One of he important reasons behind low COVID 19 detection is limited testing.That is why the low number of cases has been reported in Pakistan. Even the director general of World Health Organization Tedros Adhanom Ghebreyesus said ‘Without testing, it’s like moving blind folded. A minimum ratio of 10 per positive case was recommended by World Health Organization [3].