Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 6 4 2020 05 16 138 142 Mahbube Sadat Hasheminasab Department of Oral & Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Mortazavi Department of Orthodontics, University of the Pacific, Arthur A, Dugoni School of Dentisry. Reza Sharifi Oral and Maxillofacial Surgery Department, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farzaneh Bolandparva Department of Oral & Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2020 01 12 2020 04 11 Introduction: In orthognathic surgery, maxillomandibular complex (MMC) refers to a  three-dimensional dento-osseous structure consisting of the surgically-mobilized part of the maxilla together with the distal segment (i.e., tooth bearing segment) of the mandible (either surgically  mobilized or not). In fact, MMC is the skeletal part of the lower face. The size, shape and position  of MMC play a major role in soft tissue esthetics of the lower face.  Materials and Methods: A comprehensive review of the current data regarding effects of  maxillomandibular complex rotation in sagittal plane, on “occlusal plane, TMJ, sleep apnea, paranasal  soft tissues, upper lip, chin, cervicomental soft tissues” was conducted.  Results: MMC rotation and translation could take place in any of the three planes of reference  including sagittal, coronal, and horizontal. Any kind of changes in the position of MMC could  have its own functional and esthetic consequences. In general, patients with convex facial profiles  require counter clockwise rotation while patients with concave profiles require clockwise rotation.  Conclusion: MMC not only has great impacts on facial esthetics, but also has significant functional  effects, for example in breathing and mastication. Alteration in the position of MMC is  possible by orthognathic surgery.  Keywords: Maxillomandibular complex (MMC); Orthognathic surgery; Consequences of maxillomandibular complex rotation. https://jcr.tums.ac.ir/index.php/jcr/article/view/306 https://jcr.tums.ac.ir/index.php/jcr/article/download/306/275

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 6 4 2020 05 16 143 150 Zahra Ghoncheh Department of Oral and Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran. Behrang Moghaddam Zadeh Department of Oral and Maxillofacial Radiologist, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Sahar Shaeri School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. 2020 01 13 2020 04 11 Objective: Comprehensive knowledge about the anatomy of the surgical site is an important  prerequisite for any surgical procedure. This study aimed to assess the prevalence, position and  anatomical characteristics of mandibular incisive canal (MIC), lingual foramen (LF) and anterior  loop of the mandibular canal (ALMC) in an Iranian population using cone beam computed tomography  (CBCT). Materials and Methods: This study was conducted on 103 patients who underwent CBCT  prior to implant placement. The CBCT scans of patients were evaluated by two observers to determine  the visibility and length of MIC, LF and ALMC. The buccolingual inclination of MIC at the  initiation point of canal and canal path were also studied.  Results: The prevalence of MIC, LF and ALMC was 90%, 76% and 84% on CBCT scans, respectively.  The mean length of MIC and ALMC was 7.5mm and 1.2mm, respectively and the mean  width of LF was 0.9mm. The MIC had a buccal inclination at the initiation point and approximated  the lingual plate as extended towards the midline. Analytical statistics including independent samples  t-test, paired samples t-test, ANOVA analyses were applied.  Conclusion: Considering the high prevalence of MIC, ALMC and LF and wide range of MIC  (1.2mm to 20mm) and ALMC (1mm to 9.9mm) length, CBCT is recommended for patients prior  to surgical procedures in the anterior mandible to determine the exact location of these anatomical  structures. Keywords: Mandible; Lingual frenum; Cone-beam computed tomography. https://jcr.tums.ac.ir/index.php/jcr/article/view/307 https://jcr.tums.ac.ir/index.php/jcr/article/download/307/276

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 6 4 2020 05 16 165 170 EN Masoud Fallahi Motlagh Azarbayjan Hospital, Urmia, Iran. Yousef Janbaz Oral & Maxillofacial Pathologist. Zahra Mirzaei Department of Oral & Maxillofacial Disease, Medical Sciences of Urmia University, Urmia, Iran. 2020 01 20 2020 04 11 Leiomyosarcoma (LMS) is an uncommon malignant spindle cell tumor of the head and neck region.  It is extremely rare in the oral cavity that arises from smooth muscle differentiation. It may  arise as primary, radiation-associated, or metastatic tumor. The clinical appearance of these tumors  can be deceptively benign and can be mistaken for non-malignant conditions. Here We present a  case with atypical leiomyoma of the mandible in a 40-year- old man who referred with complaint  of pain and swelling in his jaw. He underwent surgery and histology and immonohistochemestery  studies confirmed the diagnosis. After 6 months recurrence occurred. Histologic examination confirmed  leiomyosarcoma so he was managed with surgical excision followed by radiotherapy and  chemotherapy without any recurrence or metastasis after 2 years of follow-up.  Keywords: Leiomyosarcoma; Mandible; Spindle cell tumor. https://jcr.tums.ac.ir/index.php/jcr/article/view/308 https://jcr.tums.ac.ir/index.php/jcr/article/download/308/279

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 6 4 2020 05 16 151 157 Farnoosh Razmara Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Rezvaneh Ghazanfari Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran. Ghazal Shabankare School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran. 2020 03 02 2020 04 23 Introduction: Laser assisted uncovering of dental implants is one of the most interesting aspects  of lasers utilization. Compared to conventional scalpel technique, this method provides less  bleeding and pain and shorter healing period, leading to a better patient compliance. The objective  of this study is to contribute a comprehensive review on laser assisted second-stage of implant  surgery.  Materials and Methods: We searched Pubmed and Google Scholar databases using combined  keyword search or medical subject headings. Eight articles from 2009 to 2019 were identified  and assessed.  Results: Selected studies were categorized according to variables including amount of pain,  need for anesthesia, soft tissue healing, temperature rise and quality of impressions. All the reviewed  articles, measuring the amount of required anesthesia, agreed that laser-aided uncovering  of implants needs significantly less anesthesia compared to conventional scalpel technique.  Laser-assisted uncovering of their implants led to less pain. Ex-vivo studies measuring temperature  rise, suggested that application of a non-contact 445nm diode laser reduces the temperature  rise significantly. However, Er:YAG lasers proved to generate lower temperature rise. Diode lasers  showed no significant amelioration of soft tissue healing whilst Er:YAG and Er,Cr:YSGG lasers  revealed superior esthetic results and shorter healing period. Impressions can be taken 4-7 days  after the laser-assisted surgery with a satisfactory quality.  Conclusion: Laser-assisted uncovering of implants can be selected as an alternative over the  conventional scalpel technique. But, further studies are advisable.  Keywords: Laser assisted surgery; Dental implants; Uncovering; second-stage surgery. https://jcr.tums.ac.ir/index.php/jcr/article/view/311 https://jcr.tums.ac.ir/index.php/jcr/article/download/311/277

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 6 4 2020 05 16 171 174 Ata Garajei Department of Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran AND Department of Oral & Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Shirkhoda Department of Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Shohreh Akrami Department of Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Reza Amirzargar Department of Oral & Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Zoheir Mirzajani Department of Oral & Maxillofacial Surgery, School of Dentistry, Azerbaijan Medical University, Baku, Azerbaijan. 2020 02 12 2020 04 11 Head and neck oncologic resections leave complex defects which are challenging to reconstruct.  In head and neck region, aesthetic facial units should be considered and a thin, malleable, suitable  texture and color flap should be applied. Supraclavicular artery Island flap is fasciocutaneous flap,  that taken from skin on the shoulder and supraclavicular area that based on supra clavicular artery.  One of the advantages of the supraclavicular artery Island flap is the possibility of one-stage  reconstruction with minimal morbidity. The objective of our study were to describe our initial  experience using the supra clavicular artery Island flap in conjunction with karapandzic flap for  reconstruction of lower facial defects.  Keywords: Supraclavicular flap; Karapandzic flap; Facial defect; Island flap; Supraclavicular artery. https://jcr.tums.ac.ir/index.php/jcr/article/view/310 https://jcr.tums.ac.ir/index.php/jcr/article/download/310/280

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 6 4 2020 05 16 158 164 Abbas Karimi Department of Oral & Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nahid Azizimoghaddam Department of Prosthodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Elahe Soltanmohamadi Borujeni Department of Orthodontics, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran. 2020 04 12 2020 04 23 Introduction: The long term clinical success of dental implants depends on the stability of crestal  bone level. Different dental implantation systems focus on micro-and macro-design to reduce  late bone resorption. The purpose of this study was to evaluate bone loss at the proximal (mesial  and distal) surfaces of SLA implants from 2 different companies.  Materials and Methods: This retrospective cross-sectional study was done on 48 patients  receiving 161 SLA-surfaced (Straumann and Dentium) dental implants. The marginal bone loss  was measured at mesial & distal sides of the implants on peri-apical X-ray images. The effective factors  considered in this study were patients age, implant brand, time passed from fixture placement,  preprosthetic surgery and type of prosthetic treatment that were obtained from patient records &  interviews. Results: Average mesial and distal bone loss was 1.50±1.359 and 1.517±1.3465 respectively.  Pearson correlation coefficient indicates that 1) time passed from fixture placement, 2) commercial  brand, 3) history of pre-prosthetic surgery and 4) age affected the amount of bone loss.  Conclusion: SLA-surfaced dental implants showed an acceptable amount of bone resorption  and no statistically significant difference was observed between commercial brands.  Keywords: Bone loss; Dental implants; Osseointegration. https://jcr.tums.ac.ir/index.php/jcr/article/view/314 https://jcr.tums.ac.ir/index.php/jcr/article/download/314/278

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 6 4 2020 05 16 175 178 EN Farnoosh Razmara Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Nima Dehghani Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Xaniar Mahmoudi School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Reshadi School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Mahdi Mohammadi School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. 2020 03 05 2020 04 23 Background: Lipoma is a rare benign tumor that overgrows in oral cavity. Its occurrence rate  is about 1-4% with predilection for males rather than females. Lipoma is associated with adipose  tissue and is usually seen in major salivary glands, buccal mucosa, and vestibule. Fifty percent of  lesions are seen in buccal mucosa. The progressive and aggressive growth of these lesions may interfere  with speech and mastication owing to the dimensions and location of the tumor. The lesion  basically affects the individuals of 4th to 5th decades. Lipoma is managed by surgical excision using  scalpel, laser, or electro-cautery.  Case Presentation: This study presents two 63 and 18 years old male patients with lipoma  in their buccal mucosa along with their improved situation following the treatment. The treatment  included surgical excision of the lesion and suturing the surgical area.  Conclusions: The incidence of intraoral lipoma is low and buccal mucosa is the most common  region for the occurrence of oral lipoma. Most clinicians suggested surgical techniques as a certain  treatment.  Keywords: Lipoma; Intraoral lipoma; Soft tissue tumor; Mouth; Intraoral neoplasm; Adipose tissue. https://jcr.tums.ac.ir/index.php/jcr/article/view/312 https://jcr.tums.ac.ir/index.php/jcr/article/download/312/281