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PurposeThis study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT).Materials and MethodsIn the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined.ResultsThe mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group.ConclusionThe average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients.

Objectives: Assessment of pubertal status and pubertal growth spurt in orthodontic patients has a considerable impact on the diagnosis, treatment plan and the outcome of orthodontic treatments. Hand-wrist radiography is routinely used to evaluate skeletal development. Some studies have shown that there is an association between bone development and different stages of dental calcification; therefore, the stages of dental calcification can be used as the first tool for diagnosis, in case there is an association. This study was performed with the aim to evaluate the association between the phases of dental development and the stages of skeletal maturity. Study design: In this study, a total of 52 patients (26 males and 26 females), referring to Mashhad School of Dentistry for orthodontic treatment, were evaluated; the subjects were within the age range of 9-14 years. Hand-wrist radiographic evaluation of skeletal maturation was performed using Fishman method. Also, the Demirjian method was used to identify the stages of dental calcification by panoramic radiographs. Independent t-test and Spearman correlation coefficient were used for data analyses. Results: The mean age of males and females was 11.05 ± 1.05 and 10.62 ± 1.12 years, respectively (p=0.156). The Spearman correlation coefficients between skeletal maturity indicators (SMIs) and developmental stages of mandibular left and right canines and second molars were significant in males only (p<0.05). Also, correlation coefficients were significant between adductor sesamoid ossification and mandibular right and left canines developmental stages in males (p<0.05). Conclusions: Findings of this study showed that the correlation between dental developmental stages and skeletal maturity only were significant in males; thus, different skeletal maturity patterns in males and females might be perceptible. Key words:Skeletal maturation, hand-wrist radiography, panoramic radiography.

The aim of this study was to evaluate the effects of low-level laser irradiation on the rate of orthodontic tooth movement (OTM) and the interleukin-6 (IL-6) concentration in gingival crevicular fluid (GCF) during orthodontic treatment. In this randomized split-mouth double blind clinical trial, 11 female patients aged 14 to 25 years (mean 19 ± 4.21 year), who required canine retraction following four first premolars extraction, were selected. The GaAlAs laser diode laser (A.R.C. Laser GmbH, Nürnberg, Germany) (980 nm, 100 mW, 5.6 J/cm, three points from the buccal side and three from lingual side of the tooth, 56 s, running in continuous mode) was used for canine retraction in only one maxillary quadrant (LG). The irradiation time for each cervical and middle third of the tooth was 10 s, and 8 s for the apical third of the tooth. The other maxillary quadrant served as the control group (CG) using the laser pseudo-application in this side. The laser irradiation was applied on days 0, 7, 14, 21, and 28 of each month during the canine retraction phase. Canine retraction was done using closed coil spring with 150 g force on rectangular wires after the alignment and leveling. This study was done in 11 months. Dental casts were made at different time points during the treatment, and the amount of tooth movement was measured. To evaluate the levels of IL-6, GCF samples were collected from the distal side of the maxillary canine teeth on both quadrants at the beginning of the trial, the end of aligning phase, and on day 21 of each month during canine retraction. Although the mean rate of canine retraction was higher in the LG (0.013) than the CG (0.012) and there was definitely a tendency for more canine retraction in the LLLI, but the results failed to show any significant difference between the mean rate of canine retraction of both groups (P = 0.068). A paired t test showed that there was no significant difference in the mean concentration of IL-6 at various stages of the treatment between the groups during canine distalization (P > 0.05). Therefore, conclusive evidence could not be provided to support the efficacy of the diode laser (980 nm) in accelerating OTM in female subject.

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Background: Congenital pseudarthrosis of the tibia is a rare condition that has long been one of the most challenging concerns in pediatric orthopedic surgery. When the fracture occurs, a recalcitrant nonunion is expected. This is why successful treatment means maintaining a long-term union. In this study, we aimed to assess the therapeutic outcomes for the middle and distal third fractures of the tibia and to explore whether the treatment of concurrent fibular pseudoarthrosis affects the outcome. Methods: We studied 12 patients with congenital pseudarthrosis of the tibia (Crawford type 4) from 2014 to 2019. A combination approach including intramedullary rod, Ilizarov apparatus, corticocancellous bone graft, and periosteal graft was used. In the initial surgery, we did not fix the ankle and subtalar joints. Results: As a result, the union was achieved in 67% of the cases after the index surgery. All of the cases with primary nonunion were related to the concurrent fibular and distal third tibial pseudarthrosis. In addition, ignoring the treatment of fibular pseudarthrosis in the index surgery led to ankle valgus deformity both in the middle and in the distal third tibial pseudarthrosis. We finally achieved a 100% union rate in all cases, with no subsequent refracture. Conclusions: Surgery at an early age was associated with favorable results and minimized deformity. In concurrent fibular and distal third tibial pseudarthrosis, it is recommended to transfix the ankle and subtalar joints to create a cross-union with fibula so that the intense union can be confidently obtained with more cross-section to prevent ankle valgus deformity. Level of Evidence: Level IV-case series.

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Information regarding the canal anatomy especially in complex cases such as C‐shaped canals is essential for a successful treatment. In this study, five different methods for identification of C‐shaped canal configuration were compared. 108 extracted mandibular molars with fused roots were studied. Radiographic evaluation was carried out using periapical radiography and CBCT. After access cavity preparation, all specimens were evaluated by direct visual examination and then under dental operating microscope. Finally, the actual anatomy of each sample was determined by preparing horizontal cross sections of the roots (1 mm thick) and examining them under stereomicroscope as the gold standard. Among the techniques used, high‐resolution CBCT manifested the highest accuracy, whereas periapical radiography had the lowest. All approaches can be useful in reaching a correct diagnosis. CBCT, especially the low‐resolution modality, is an effective technique in the diagnosis of C‐shaped anatomy.