Introduction: Thin gingival biotype (GBT) is of clinical relevance in orthodontic and periodontic treatment, so thick biotype is a requisite for good periodontal health. The aim of this study was to evaluate the effectiveness of platelet-rich fibrin (PRF) with tunnel flap compared to connective tissue graft (CTG) with tunnel flap in increasing gingival thickness (GTH). Material and Methods: Twenty orthodontic patients presenting thin GBTs were included in this study. Treatment sites were divided into test group (PRF) and control group (CTG). Clinical parameters as GTH, GBT, and width of keratinized gingiva (WKG) were assessed at baseline and 6 months post-surgically. Statistical analysis was performed using independent T-test for intergroup comparison. Statistical significance was set at 0.05. Results: The mean GTH at 6 months was 1.57 mm for test group and 1.64 mm for control group. The gain of WKG was 1.57 and 2.08 mm in test and control sites, respectively. Conclusion: Within the limits of this study, using PRF in modifying thin GBT is a successful treatment option and could serve as an alternative to connective tissue grafts (CTGs).

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Introduction: Minor surgeries in the mouth region have been associated with a risk of temporomandibular disorders (TMDs). One of the most common surgeries is third molar removal. The aim of this study was to determine the prevalence of temporomandibular joint (TMJ) problems in candidate patients for impacted third molar surgery with and without previous temporomandibular problems. Materials and Methods: In this prospective cohort study, 15 to 30-year-old patients with and without TMD were chosen before third molar surgery. According to the clinical examinations and Research Diagnostic Criteria for TMD questionnaire, frequency of joint click, severity of TMJ pain using visual analog scale (VAS), and maximum mouth opening (MMO) were evaluated at before the surgery and 1 week, 1 month, and 6 months after the surgery. The changes in the click frequency at different times in the two groups were analyzed statistically by Chi-square test and the difference of the parameters of the MMO and VAS values in the two groups were analyzed by Student t test. Results: In the group with TMD, the click had a significant increase 1 week after the surgery. However, 6 months after the surgery, the incidence of click decreased significantly compared to 1 month after the surgery (P = 0.032). MMO at all the times was significantly higher in the group without TMD symptoms (P = 0.012). At all the times, VAS values were higher in the group with TMD symptoms (P = 0.024). The maximum VAS values were observed at 1 week after the surgery (P = 0.041). Conclusion: The reduction in MMO and increase in VAS score in patients with TMD were evident compared to patients without TMD. Furthermore, it seems that the surgical trauma resulting from the removal of the third molars is a predisposing factor for developing TMD.

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Introduction: The fissured epulis is a reactive tissue growth that develops underneath a dental prosthesis. Its etiology is related to removable of partial or total dentures and other irritative or traumatic factors. Oral cancer (CAB) is a malignant neoplasm of aggressive behavior, and it has become one of the most serious health problems worldwide. Currently, squamous cell carcinoma is considered a disease with a high mortality rate. This article aims to describe the clinical management of a squamous cell carcinoma, as a result of a fissured epulis in upper total edentulous patient. Case Report: A female patient, 58 years of age, with no systemic or family history, went for a lower removable prosthesis. The clinical examination in the maxilla presented an enlargement of soft tissue in the bottom of the vestibule on the left side, asymptomatic, compatible with a fissured epulis. Two surgical procedures were performed to remove the pathology and a sample was taken to perform a biopsy, which resulted in a squamous cell carcinoma. The patient was referred to a center specialized in cancer treatments (Society for the Fight Against Cancer) where she currently is receiving the attention of the case. Conclusions: The lack of knowledge of this injury on the part of the patient, and the lack of symptomatology, absence of periodic controls, maladjustment, and incorrect prosthetic design were the risk factors that triggered the injury.

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Introduction: Pain management is one of the most important aspects of behavioral controlling in pediatric dentistry. Local anesthesia by inferior alveolar nerve block (IANB) is the primary method used for pain controlling in pediatric dentistry, and access to the mandibular foramen is the prerequisites for the success of this technique. However, the position of the mandibular foramen relative to the occlusal plane is not the same in all individuals. The aim of this study was to evaluate the effect of age and vertical facial dimension on the relative location of mandibular foramen in children aged 7 to 12 years using panoramic and cephalometric images. Materials and Methods: In this descriptive-analytical study, the cephalometric and panoramic images archived in Zahedan Faculty of Dentistry, belonging to 150 patients aged 7 to 12 years, were analyzed. Based on cephalometric analysis, these images were divided into three groups of short, normal, and long in terms of facial height, and they were divided into three age groups as well. With the help of panoramic radiography, position of the mandibular foramen was studied from different directions. The association of age and vertical facial dimension with the location of mandibular foramen was studied through ANOVA analysis and Kruskal-Wallis test. Kolmogorov–Smirnov test was used for checking the normality. Results: The results indicated that the mean and standard deviation of the anterior–posterior position of mandibular foramen (P = 0.201), the distance between the foramen and the edge of the condyle (P = 0.217), and the distance from the lower edge of the mandible (p = 0.051) showed no significant difference in all age groups. However, the mandibular foramen distance from the occlusal plane in patients aged 7 to 8 years was significantly less than in patients in the age group of 9 to 10 and 11 to 12 years (P < 0.001). Moreover, no significant difference in any of the variables under study was found between the short, normal, and long face groups (P > 0.05). Conclusion: According to the findings of this study, the needle should be inserted directly on the opposite side of the occlusal plane for the IANB anesthesia in case of children 7 to 8 years old. In other older age groups, the needle should be inserted parallel to the occlusal plane at a distance of 2 mm.

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