Craniofacial  anomalies  include  clefts,  synostoses,  atrophic  abnormalities,neoplasias etc. among which cleft lip and/or palate caused by abnormal facial development during gestation is one of the most prevalent congenital defects. Its overall occurrence is about 1:700 ranging from 0.02 to 4.04 in 1000 live births. There are different etiologic factors considering the cleft cause. In most cases the exact cause is unknown, but it is thought to be a combination of genetic (internal) and environmental (external) factors.A cleft lip and palate can have a profound psychological impact both on the parents  and  the  child.  It  affects  the  appearance of  the  face,  also  lead  to problems  with  feeding,  speech  and  language  and  hearing  –due  to  ear infections. Speech and aesthetic concerns seem to have been important factors affecting the health-related quality of life for children with oral clefts. It is obvious that cleft lip and palate can have a substantial impact on the health economics of countries in the developing world.The  multispecialty approach  to  the  care  of  children  with  clefts  is  highly recommended.  A  research  registry  can  be  of  invaluable  assistance  to physicians and researchers by providing an available panel of patient information that could assist in understanding the patients they are serving, utilization  of  health  care  services,  and  the  design  and  implementation of research studies to improve patient care.The Cleft Lip/Palate and Craniofacial Anomalies Registry may be functioning with a mission “to promote better understanding of cleft lip/palate and craniofacial anomalies and to improve patient care and health care planning. Data collection can provide better resources for future interventional studies. As it helps to have an accurate picture of the children’s number in need of treatment in a population. Recording the data of cleft patients and treatment teams and their workload is necessary for planning about providing training centers for members of treatment teams.

Introduction: Bisphosphonates are  widely used  for  various bone  diseases including osteoporosis and bone tumors. One of the complications associated with these pharmaceutical agents is bisphosphonate-related osteonecrosis of the jaw. This condition may be triggered by placement of dental implants. In turn,  osteonecrosis  of  the  jaw  may  cause  failure  in  osseointegration  of implants. Moreover, bisphosphonates can influence osseointegration of dental implants by alteration of bone turnover. The aim of this study was to review the published articles on osseointegration of dental implants in patients taking oral bisphosphonates.Material   and   Methods:   PubMed/Medline   database   was   searched   for published articles until 31 January 2014 using “osseointegration” and “bisphosphonate”   as   keywords.   Inclusion   criteria   were   human   studies including case  series,  retrospective studies  and  prospective  studies  on  the subject.  Exclusion  criteria  were  case  reports,  intravenous  bisphosphonate intake, and placement of implants in other parts of the body rather than jaws.Results: A total of 66 articles were evaluated at abstract level. Eventually 4 articles  were  chosen  including  nearly  1470  patients  taking  oral bisphosphonates. Failure in osseointegration of dental implants or its loss was observed in 23 patients. This shows failure in integration between bone and implant in approximately 1 out of 64 patients taking oral bisphosphonates. Accordingly impaired osseointegration was observed in 1.44% of patients with bisphosphonate intake.Conclusion: Although failure in osseointegration of dental implants in patients with bisphosphonate intake is unlikely, the risk of failure should be considered in treatment planning for these patients and utmost care should be employed to prevent possible complications.

Introduction: The incidence and etiology of maxillofacial fractures vary widely between different countries. Understanding the cause and pattern of these injuries can assist in establishing clinical and research priorities for more effective treatment and prevention of maxillofacial injuries. The study aimed to  evaluate  the  etiology  and  pattern  of  maxillofacial  fractures  in  trauma patients hospitalized in Shariati Hospital in Tehran, Iran.Materials and Methods: A prospective analysis of all maxillofacial fracture patients admitted to the Department of Oral and Maxillofacial Surgery was performed during a 12-month period from November 2010 to November 2011. Recorded data included age, sex, cause of trauma, and the pattern of maxillofacial fractures.Results: A total of 302 consecutive patients were included in the study, with a male to female ratio of 3.4:1. Most patients (41.3%) were in the third decade of  life  (20-29  year-old).  Motor  vehicle  accidents  (MVA)  were  the  most common cause of injury (50%), followed by interpersonal violence (30%). Mandible fracture was the most common fracture (41%), followed by midface fracture (34%). Fracture of the body of the mandible (24%) was the most common mandible fracture; and the most common midface fracture was zygomaticomaxillary fracture (32%).Conclusions: In most other epidemiologic studies of maxillofacial fractures, MVA was the main cause of injury; and mandible the most common site of fracture. However, the vagueness and imprecision in the classification and nomenclature of maxillofacial fractures has led to confusing results that are difficult to compare.

Introduction: We studied and measured facial parameters of 160 students,aged 22-24 years attended at Sahand University of Technology in Northwest of Iran.Material and Methods: In this paper, six linear and six angular facial parameters are measured. These parameters are measured in frontal and profile facial images. The measured values are the mean and standard deviation (SD) of distance between the two medial canthi, width of alar base, length of nose, width of  mouth,  length of  upper  lip,  length of  lower  lip,  interlabial gap, nasofrontal angle, nasofacial angle, nasomental angle, nasolabial angle, mentolabial angle, and throat angle. The mean (SD) of the above mentioned parameters were 33mm (3), 38mm (2), 49mm (2), 46mm (3), 16mm (3), 14mm (1), 4mm (0.75), 127° (3°), 31° (2°), 127° (3°), 112° (5°), 135° (3°), 124° (2°), respectively.Results: Most of the parameters we measured were comparable in men and women. When we compared our results with studies in South of Iran and elsewhere many differences were found and this shows that the measurement of  the  facial  parameters  in  different  races,  ethnic  groups,  and  regions  of country is necessary.Conclusion: Measurement of these parameters is vital in facial surgeries especially in aesthetic, maxillofacial, rhinoplasty and orthognathic surgeries.

Introduction:  The  trigeminocardiac  reflex  (TCR)  refers  to  the  sudden development of bradycardia as well as asystole along with arterial hypotension associated with any manipulation of sensory branches of the trigeminal nerve. Clinically, the TCR has been reported to occur during craniofacial surgery. It is crucial to learn about this sudden physiological response during maxillofacial surgery that is likely to happen with any craniofacial surgical procedures. Materials and Methods: In  this clinical study 44 volunteers without any systemically compromising conditions were divided into 2 groups. The first group underwent Le Fort I osteotomy and the second mandibular osteotomy. Mean  arterial  blood  pressure  and  pulse  rate  (MABP1,  PR1)  values  were recorded before down fracture (DF) of maxilla and Sagittal Splitting (SS) of mandible, during DF and SS (MABP2, PR2), and after DF and SS (MABP3, PR3). The data were analyzed using repeated measure ANOVA tests (p =0.05).Result: In Le Fort I group, PR1 and PR3 were significantly higher than PR2 (P< .001). MABP2 was significantly lower compared with MABP1 and MABP3 (P < .001). PR2 and MABP2 showed a mean decrease of 7.4% and 8.9%  compared  with  PR1  and  MABP1,  respectively.  In  second  group differences on MABP and PR was not statistically significant.Conclusion: It is concluded that TCR is triggered by the stimulation of V2 but V3 branch stimulation does not cause such reflex.

Introduction: Due to the increase in Le Fort surgeries and its effect on nose widening, it seems necessary to use an alternative method without this effect. The present research examined the effect of alar release on interalar changes in Le Fort I osteotomy.Materials and Methods: The study population included patients admitted to Bou-Ali Hospital in 2012-2013 undergoing Le Fort I osteotomy. The samples were 26, selected using simple random sampling method. Fourteen patients who underwent osteotomy with alar release were considered as experimental group and 12 who underwent conventional orthognathic surgery considered as control group. Then, the width of interalar was measured with actual size in photography.Results: The initial interalar width in experimental group was 4.1 mm; 12% wider  than  control  group  (p<0.000).  After  surgery,  the  interalar  width  in control  and  experimental groups  were  36.2  and  39.6mm  respectively  that revealed a significant difference (p<0.01). The interalar width in control group increased 1.45±2.25 which showed a significant difference (p<0.05). In experimental group the increase was 0.28±2.48 reporting a significant difference (p<0.4). The change of interalar width in control group was 0.62 mm; 74.7% more than experimental group and Man-Whitney U test reported this difference as significant. Nine patients (75%) in control and 7 patients (50%) in experimental group experienced improvement. The relative risk for patients received alar release, was 1.5 higher (RR-1.5) and attributable risk of not using alar release for interalar width increase 25% (A.R-25%). Chi-square test showed that this difference was not significant (p<0.3).Conclusion: Basically, using alar release would probably prevent increase of interalar width in Le Fort I osteotomy.

Introduction: Our study was designed to assess the effect of the submucosal injection of dexamethasone on postoperative discomfort after surgical removal of impacted mandibular third molars.Materials and methods: Twenty six patients with bilaterally bony impacted mandibular third molars were recruited to this split mouth study. On the study side, prior to surgery, 8 mg of dexamethasone was injected in buccal vestibule submucosally, while the control side received no steroid. Complications such as swelling, trismus and infection were evaluated postoperatively.Results: The results showed that the patients experienced significantly less swelling  (p=  0.001)  on  study  side  on  the  3rd   and  7th   postoperative  days compared to the control side. The amount of trismus was significantly less (p=0.001) after submucosal injection of dexamethasone on both time intervals.Conclusion: Perioperative submucosal injection of dexamethasone can significantly reduce postoperative swelling and trismus after surgical removal of the impacted teeth.

A palatal defect may result from surgical resection, and its consequences could include difficulty in speech and nasal regurgitation of food and liquids. An obturator combined to speech aid prosthesis can improve nasal emission during speech,  and  assist  in  preventing  nasal  regurgitation  of  food.  This  article presents a clinical report of the reconstruction of palatopharyngeal function by prosthetic obturator and speech aid.

The infratemporal fossa is an anatomic space of great importance in the head.Abscesses of this space re rare but potentially life threatening. Regarding the proximity of some important anatomical features of the head, dealing with infratemporal space infection needs great consideration both in examination and surgical practice.In  this  case  report,  infratempora  space  abscess  formation  following  the removal of zygomatic arch suspension wire in a healthy, male, young patient and its treatment protocol are presented.