Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 8 2 2021 10 02 44 50 Sona Rafieyan Department of Oral and Maxillofacial Pathology, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran. Yousef Kananizadeh Department of Oral and Maxillofacial Surgery, Urmia University of Medical Sciences, Urmia, Iran. Elahe Reyhani Faculty of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran. 2021 04 10 2021 07 01 Oral cancer comprises a group of neoplasms affecting any fields of the oral cavity, pharyngeal regions and salivary glands. However, this term tends to be used interchangeably with oral squamous cell carcinoma (OSCC), which represents the most common of all oral neoplasms. It is estimated that more than 90% of all oral neoplasms are OSCC. Oral SCC prefers to spread through the lymphatic system than the bloodstream, and in this region tongue tumors have the greatest potential  for neck metastases. Primary tumor’s histopathologic features like depth of invasion, thickness, growth pattern, differentiation, lymphovascular or vascular invasion have a limited prognostic value for nodal disease. Cervical lymph node status accurate assessment in HNSCC patients is critical issue because of its influences on prognosis and treatment decisions, USgFNAC proved widely accepted not only because of safety and availability in diagnosis but also it is repeatable, minimally invasive and cost-effectiveness. Keywords: Squamous cell carcinoma; Hhead and neck cancer; Ultrasound-guided fine needle aspiration cytology; Ultrasound; Sentinel lymph node biopsy. https://jcr.tums.ac.ir/index.php/jcr/article/view/369 https://jcr.tums.ac.ir/index.php/jcr/article/download/369/322

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 8 2 2021 10 02 51 59 Izzati Ismail Department of Oral and Maxillofacial Surgery and Diagnosis, Kulliyyah of Dentistry, International Islamic University Malaysia. Mohammad Abu Bakar Kulliyyah of Dentistry, International Islamic University Malaysia. Khairul Hairul Anuar Kulliyyah of Dentistry, International Islamic University Malaysia. Mohamad Ramlee Dental and Maxillofacial Surgery, Sultan Ahmad Shah Medical Center, International Islamic University Malaysia. 2021 04 30 2021 06 28 Objectives: This study is aimed at analysing the accuracy and reliability of the cone beam CT (CBCT) measurements and direct physical measurements of the posterior mandible. Materials and Methods: Eighteen cadaveric hemi-mandibles were dissected from the soft tissues and the CBCT images of the mandibles were taken. Direct physical and cone beam CT measurements of six landmarks which includes height of ramus (R), distance of lingula to sigmoid notch (LS), distance of lingula to inferior border (LI), position of lingula in relation to occlusal plane (L-OP), ramus thickness at crestal level (RT-C), and ramus thickness at midway between sigmoid notch and lingula (RT-M) were determined. Accuracy and reliability of the measurements were tested. Results: Four landmarks showed high accuracy when measuring the posterior mandible, while two landmarks, LI and RT-M, showed statistically significant weaker accuracy (p<0.05). Inter-reliability were good for all landmarks when measured directly physically on mandibles (ICC>0.7 and p>0.05), but were low on two landmarks, LI and RT-C, on CBCT measurement (ICC<0.5 and p<0.05). Conclusion: A generally strong accuracy between direct physical and CBCT measurements for most landmarks on posterior mandible were found. Reliability between two researchers were high on direct physical measurements. Meanwhile, two landmarks on CBCT which include LI and RT-C showed low inter-reliability. Hence, CBCT measurements proved to be a good tool for pre-operative assessment, since high inter-reliability and strong accuracy corresponding to direct physical were recorded. Keywords: CBCT accuracy; CBCT measurements; CBCT reliability; Physical measurements; Posterior mandible. https://jcr.tums.ac.ir/index.php/jcr/article/view/370 https://jcr.tums.ac.ir/index.php/jcr/article/download/370/323

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 8 2 2021 10 02 84 90 Mehrnoush Momeni Roochi Department of Oral and Maxillofacial Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Narges Hajiani Department of Oral and Maxillofacial Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Sayna Nezaminia Department of Oral and Maxillofacial Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2021 05 11 2021 06 07 A therapeutic challenge to maxillofacial surgeons is management of panfacial fractures, especially when treating multiple comminuted bone fractures. One of the most important goals in these fractures is achieve and stablish a correct occlusal relationship of the mandibular-maxillary unit in parallel with the proper positioning of the jaws with the skull base and other facial units. Also, it is important to prevent long-term sequelae such as facial asymmetry, enophthalmos, and malocclusion that could be caused by inadequate correction. To achieve all these goals some usual guides of management are proposed as follow: “Bottom to up”, “Top to down”, “outside to inside,” or “inside to outside”. We present 3 cases of Panfacial fracture and the proposed methods were based on different sequences of management with introducing “reference point” as the most intact area to determine the management concept & “confirming point” as the areas that should be reduced and fixed completely. These points act as an orientation aid during surgery and aid to successfully restore the entire face contour and maxillomandibular occlusion and also to improves surgical procedure. Keywords: Panfacial fracture; Internal fixation; Open reduction; Reference point; Confirming point. https://jcr.tums.ac.ir/index.php/jcr/article/view/372 https://jcr.tums.ac.ir/index.php/jcr/article/download/372/327

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 8 2 2021 10 02 60 66 Abdollah Farhadi Nasab Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Malihe Roozbakhsh Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Naghmeh Bahrami Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2021 03 06 2021 04 18 Background and Objectives: Delirium refers to acute loss of consciousness and is characterized by confused thinking and impaired orientation. It is a life-threatening, but reversible syndrome manifested by cognitive impairment, abnormal psychomotor activity and sleep disturbances. Due to high prevalence in hospitalized patients and high rate of morbidity and mortality, delirium significantly decreases the prognosis of hospitalized patients. Materials and Methods: This experimental animal study evaluated 54 adult male Wistar rats over 2 months of age that weighed 200 to 230g. Of all, 24 rats received biperiden (40mg/kg) while the remaining 24 received 50μg/kg LPS. Induction of delirium was ensured using a Y-maze after 3 hours. The control group included 6 rats The efficacy of different doses of haloperidol for treatment of delirium was assessed 3 h after injection using the Y-maze. Data were compared using one-way ANOVA followed by Tukey’s post-hoc test via GraphPad Prism. Results: Haloperidol at 0.1, 0.2 and 0.5mg/kg dosage significantly increased the percentage of spontaneous alternation and improved the memory, consciousness and learning compared with biperiden and LPS groups (P<0.01). No significant difference was noted between the haloperidol groups regarding efficacy (P>0.05). Conclusion: Delirium is characterized by attention deficit, impaired orientation, changes in memory, consciousness, perception and mood, and psychotic symptoms. Detection of the complete spectrum of delirium signs and symptoms in an animal that cannot talk (rat) is obviously difficult. Using of Y-maze can facilitate this problem. Keywords: Delirium; Y-maze; Biperiden; Haloperidol; Spatial memory. https://jcr.tums.ac.ir/index.php/jcr/article/view/366 https://jcr.tums.ac.ir/index.php/jcr/article/download/366/324

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 8 2 2021 10 02 67 75 Bayad Mahmood Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Sulaimani, Iraq. 2021 06 09 2021 08 15 Background: Facial plastic surgeries are usually associated with various post-surgical undesirable symptoms, particularly pain, Swelling, and ecchymosis. Depending on the nature of the procedures, these symptoms could last for days, sometimes over a week or more. Considering the optimal efficacy of Bromelain, this study is used to justify the benefits of pre-operative use of Bromelain found in pineapple using fresh pineapple juice to reduce such complications. Materials and Methods: A randomized clinical study was performed among 100 patients undergoing various facial surgical operations; the patients were randomly divided into two groups; fifty patients received the pre-operative fresh pineapple juice (350ml glass) twice every day, a week before and continued for seven days after surgery. The pain level was determined using a visual analog scale, Swelling, and ecchymosis judged by visual inspection. Average scores for all symptoms were added to obtain the clinical sum score for each visit. Results: Pre-operative use of fresh pineapple juice was significantly reduced post-surgical pain, swelling, and ecchymosis with statistically significant results (p<0.005) in each pineapple groups. Conclusion: Bromelain found in pineapple fruit can be used as a successful therapy before various facial surgical procedures to minimize and provide faster recovery from undesirable post-operative symptoms. Keywords: Facial surgeries; Bromelain; Pineapple juice; Wound healing; Complications. https://jcr.tums.ac.ir/index.php/jcr/article/view/375 https://jcr.tums.ac.ir/index.php/jcr/article/download/375/325

Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 8 2 2021 10 02 76 83 Gholamreza Shirani Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Reshadi School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. 2021 07 26 2021 09 05 Purpose: This study aimed to assess the effect of light-emitting diode (LED) phototherapy on pain and trismus following surgical extraction of impacted mandibular third molars. Materials and Methods: This double-blind randomized controlled clinical trial evaluated 50 patients between 20 to 35 years requiring extraction of their impacted mandibular third molars. The patients were randomized into two groups of LED phototherapy and control by flipping a coin. Patients in the LED group underwent LED phototherapy immediately after surgery with red light at 618nm wavelength, 20 mW/cm2 power density and 4 J/cm2 energy density in continuous-wave mode (irradiated area: 3.15cm×1.5cm=4.725cm2). The LED device was used in off mode in the control group (as placebo). The level of postoperative pain was measured by the numerical rating scale, and trismus of patients was evaluated by measuring the maximum mouth opening (MMO). The two groups were compared by the Mann-Whitney and NPar tests. Results: The mean difference in MMO postoperatively, compared with baseline, was lower in the LED group than the placebo group but not significantly (P=0.465). The two groups were not significantly different regarding the level of pain. Conclusion: LED phototherapy with the parameters applied in this study failed to significantly decrease the level of pain and trismus following surgical extraction of impacted mandibular third molars. Keywords: Impacted mandibular third molars; LED; Phototherapy; Trismus; Pain. https://jcr.tums.ac.ir/index.php/jcr/article/view/379 https://jcr.tums.ac.ir/index.php/jcr/article/download/379/326