Publications by authors named "Farzin Sarkarat"

15 Publications

  • Page 1 of 1

Comparison of strengths of five internal fixation methods used after bilateral sagittal split ramus osteotomy: An study.

Dent Res J (Isfahan) 2020 Jul-Aug;17(4):258-265. Epub 2020 Aug 14.

Private Practice, School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.

Background: Results on the strength and displacement of internal fixation methods for bilateral sagittal split ramus osteotomy are controversial, and some designs have not been adequately studied. Therefore, this study was conducted to compare techniques using bicortical or monocortical screws.

Materials And Methods: In this study, 35 sheep hemi-mandibles were randomly assigned to five groups of seven each: fixation using (1) a 13 × 2 screw, (2) two 13 × 2 screws (arranged vertically), (3) three 13 × 2 screws, (4) 1 plate with 4 holes and four monocortical screws, and (5) a Y-shaped plate and five monocortical screws. Specimens underwent vertical forces until failure. Breakage forces and displacements of groups were recorded and compared statistically. Using one-way analysis of variance (ANOVA) with a Tukey's post hoc test and Kruskal-Wallis test. Level of significance was predetermined as 0.05.

Results: Strengths of Groups 1-5 were, respectively, 14.43 ± 4.35, 28.00 ± 8.89, 28.29 ± 8.01, 29.43 ± 8.24, and 61.29 ± 12.38 N, respectively ( = 0.000, analysis of variance). The corresponding displacement extents were 7.98 ± 0.04, 7.85 ± 0.26, 8.00 ± 0.00, 7.35 ± 1.73, and 6.79 ± 2.03 mm ( = 0.298, Kruskal-Wallis test).

Conclusion: Use of a single bicortical screw is the weakest method, while Y-shaped plates might provide the highest strength. Using two or three bicortical screws or 4-hole plates might deliver similar strengths.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688040PMC
August 2020

Comparative study of impact of animal source on physical, structural, and biological properties of bone xenograft.

Xenotransplantation 2020 11 12;27(6):e12628. Epub 2020 Jul 12.

Nova Teb Research Laboratory, Dental Equipment and Biomaterials Incubation Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Due to the unique features of xenografts including large supply from donors, minimal risk of human disease transmission, and the lower cost of preparation and production compared to autografts and allografts, they are considered as attractive alternatives to traditional bone grafts. The animal source accessibility and production process have a direct correlation with the cost and quality of the final product. To evaluate whether the animal source of the bone has any effect on the physicochemical and histological properties of the final xenograft, three deproteinized bone grafts were prepared from sources that are easily available in Iran, including the bovine (DBB), camel (DCB), and ostrich (DOB).

Methods: In the current study, three bone substitute materials intended to serve as bone xenografts were derived from the cow, camel, and ostrich using the thermochemical processing procedure. The physicochemical properties, in vitro cytocompatibility and in vivo bone regeneration capability of the prepared deproteinized bone grafts, were assessed and compared with OCS-B as an approved product in the global market.

Results: The physical tests confirmed the hydroxyapatite nature of the final products. SEM and BET analysis showed morphological and structural differences between the products due to differences in the animal sources. In vitro studies showed the prepared deproteinized bone was free of processing chemicals and was biocompatible with mouse fibroblast and myoblast cell lines. In vivo studies revealed that the bone formation capability of the DBB, DCB, and DOB has no significant difference with one another and with OCS-B despite their structural differences. The DCB showed the highest graft residue after two month. No signs of immunogenicity were observed in the study groups compared to the blank group.

Conclusion: DBB, DCB, and DOB may offer a favorable cell response and bone regeneration similar to those of commercial bovine bone material.
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http://dx.doi.org/10.1111/xen.12628DOI Listing
November 2020

Nasal Framework Osteotomy: An Innovative Approach to Manage an Extremely Long Nose With Meningoencephalocele.

J Oral Maxillofac Surg 2019 Jun 12;77(6):1276.e1-1276.e6. Epub 2019 Feb 12.

Associate Professor, Buali Hospital, Department of Neurosurgery, Islamic Azad University, Tehran, Iran.

Meningoencephlocele is a relatively rare deformity, usually characterized by penetration of brain or meningeal tissues through a defect in skull. This protruding tissue may affect facial structure and subtle to severe facial deformities may appear. Surgical treatments of these deformities are usually done by a team including a neurosurgeon and craniofacial surgeon. The conventional treatments includes several complicated operations to relocate herniating tissues, then correcting malformed facial structure. The nasal framework osteotomy, is an innovative approach that uses transfacial incisions to gain access to herniating tissue. Then, by completing the osteotomy around the nose, the entire nasal structure is lifted and transposed to it is original position. The authors believe that this technique may considerably reduce the complexity and risks of conventional approaches, while aesthetic demands are readily achieved at the same stage.
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http://dx.doi.org/10.1016/j.joms.2019.02.003DOI Listing
June 2019

Efficacy of Photodynamic Therapy in Minimizing Bisphosphonate-Related Osteonecrosis of the Jaws After Dental Extraction: A Preliminary Animal Study.

J Oral Maxillofac Surg 2019 Feb 11;77(2):307-314. Epub 2018 Oct 11.

Dentist in Private Practice, Tehran, Iran.

Purpose: Except for a few case reports, there is no study on the efficacy of photodynamic therapy (PDT) in decreasing or preventing bisphosphonate-related osteonecrosis of the jaws (BRONJ). This preliminary animal study assessed the effectiveness of this clinical treatment.

Materials And Methods: Zoledronic acid was administered to 20 rats for 5 weeks. Two weeks later, a first molar was extracted from each rat. The rats were randomized to control and PDT groups. PDT was performed in the experimental group after surgery and at weeks 1, 2, 3, 4, 5, 6, and 7 after surgery. In the 8th week, BRONJ signs were evaluated by an observer blinded to randomization. Rats were euthanized and underwent histopathologic and histomorphometric evaluations. Clinical signs were compared using the Fisher test. Histomorphometric parameters were compared using the Mann-Whitney U test (α = 0.05).

Results: Two rats were lost from each group. Bone exposure decreased from 7 rats in the control group to 1 rat in the PDT group (P = .010). The stage of BRONJ decreased significantly from 7 rats in stage 1 to only 1 rat in stage 1 (P = .010). PDT decreased inflammation considerably for gingival eosinophils and lymphocytes and bone neutrophils, eosinophils, and lymphocytes. A larger percentage of live bone and smaller percentages of necrotic bone, empty lacunae, and neovascularization were observed in the PDT group. PDT also maintained bone remodeling, indicated by a large number of osteoclasts (P ≤ .001 for all comparisons by Mann-Whitney U test).

Conclusions: Within the limitation of this preliminary animal study, PDT was found to be considerably effective clinically and histopathologically in decreasing or preventing BRONJ in rats. Future human studies are needed to verify these results.
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http://dx.doi.org/10.1016/j.joms.2018.09.036DOI Listing
February 2019

Scleral exposure alterations following Le Fort I osteotomy (with and without maxillary impaction) in skeletal class III patients: A before-and-after clinical trial.

J Craniomaxillofac Surg 2018 Sep 12;46(9):1480-1483. Epub 2018 Jun 12.

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

Purpose: Exposure of sclera below the iris in natural head positions is aesthetically undesirable. Studies on post-surgical changes in inferior scleral exposure following orthognathic surgery are scarce and mostly retrospective. The aim of this clinical trial is to examine the effect of Le Fort I osteotomy, a procedure for correction of malocclusion and maxillo-mandibular deformities, on the inferior scleral exposure and overall scleral surface area in skeletal class III patients.

Materials And Methods: This trial was performed on 40 eyes of 20 skeletal class III patients undergoing Le Fort I osteotomy without impaction (n = 20 eyes) and with impaction (n = 20 eyes). Standard true-size frontal photography was performed pre-operatively and post-operatively at 6 months. After measuring the overall eye height and the height of visible inferior sclera, the ratio of inferior sclera to overall eye height (S:E) was calculated three times. Also, overall surface area of the sclera was measured three times. The average of three attempts was considered the main measurement. Changes in the sclera after the surgery and between both methods were compared.

Results: The average age of patients (9 men, 11 women) was 24.5 years. Age and gender were balanced between the two groups (P > 0.05). S:E ratios decreased in both groups after surgery (P < 0.05, Wilcoxon test). The decrease was greater in the impaction group (P < 0.05, Mann-Whitney test). Similar results were observed for overall sclera surface areas.

Conclusion: Maxillary advancement, with or without impaction, reduced the inferior scleral exposure and overall scleral surface area. The effect was more pronounced in the impaction group.
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http://dx.doi.org/10.1016/j.jcms.2018.06.006DOI Listing
September 2018

Fat Graft with Growth Factors.

Atlas Oral Maxillofac Surg Clin North Am 2018 Mar 15;26(1):33-39. Epub 2017 Dec 15.

Department of Oral and MaxilloFacial Surgery, Craniomaxillofacial Research Center, Buali Hospital, Islamic Azad University Tehran Dental Branch, 10th Neyestan Street, Pasdaran Street, Tehran 1946853813, Iran.

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http://dx.doi.org/10.1016/j.cxom.2017.10.003DOI Listing
March 2018

Family history and risk factors for cleft lip and palate patients and their associated anomalies.

Stomatologija 2017 ;19(3):78-83

No 14, Pesiyan St., Vali Asr St. Tehran 1986944768, Iran.

Background And Aims: Several environmental and genetic issues have been suspected as risk factors for oral clefts; and many studies have been conducted in this regard; however, large socioeconomic impacts of cleft lip and or palate (CL/P) justifies the need for further multifactorial researches. Current study aimed to assess parental risk factors for CL/P and its associated malformations.

Material And Methods: Hospital records of 187 consecutive syndromic and non-syndromic children with cleft lip and or palate (103 boys and 84 girls) with a mean age of 1.7 (SD 2.2) years and 190 consecutive non-cleft children (103 boys and 87 girls) with a mean age of 2.8 (SD 2.2) years formed this study. Parental risk factors and abnormalities and physical problems and anomalies were evaluated in all subjects.

Results: Family history of clefts (OR 7.4; 95% CI), folic acid consumption (OR 7.3; 95% CI) and consanguineous marriage (OR 3.2; 95% CI) were quite strongly associated with increased risk of CL/P. In addition, all congenital abnormalities and physical problems had significantly higher incidence in CL/P patients.

Conclusions: The findings of this study suggest that expecting mothers of consanguineous marriage and families with a history of CL/P should be extra cautious about the occurrence of CL/P.
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August 2018

Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in inferior alveolar nerve block: Effects on the vital signs and onset, and duration of anesthesia.

J Dent Anesth Pain Med 2015 Dec 31;15(4):201-205. Epub 2015 Dec 31.

Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran and Craniomaxillofacial Research Center, Azad University, Dental Branch, Tehran, Iran.

Background: This prospective, randomized, double-blind, clinical study was conducted to compare the effects of 4% articaine with 1:100,000 epinephrine (A100) and 4% articaine with 1:200,000 epinephrine (A200) on the vital signs and onset and duration of anesthesia in an inferior alveolar nerve block (IANB).

Methods: In the first appointment, an IANB was performed by injecting A100 or A200 in 1 side of the mouth (right or left) randomly in patients referred for extraction of both their first mandibular molars. In the second appointment, the protocol was repeated and the other anesthetic solution was injected in the side that had not received the block in the previous session. Systolic and diastolic blood pressures (SBP and DBP) and pulse rate were measured during and 5 min after the injection. The onset and duration of anesthesia were also evaluated. Data were analyzed using t-test and Mann-Whitney U-test, and p-value was set at 0.05.

Results: SBP and pulse rate changes were slightly more with A100; however, DBP changes were more with A200, although the differences were not significant (P > 0.05). There were no statistically significant differences in the parameters evaluated in this study. The onset and duration of anesthesia, and the changes in SBP, DBP, and pulse rate during and 5 min after the injection were the same in both the groups.

Conclusions: For an IANB, A200 and A100 were equally efficient and successful in producing the block. Epinephrine concentration did not influence the effects of 4% articaine.
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http://dx.doi.org/10.17245/jdapm.2015.15.4.201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5564155PMC
December 2015

The effect of adding fentanyl to epinephrine-containing lidocaine on the anesthesia of maxillary teeth with irreversible pulpitis: a randomized clinical trial.

Iran Endod J 2014 7;9(4):290-4. Epub 2014 Oct 7.

Department of Endodontics, Dental School, Shahid Beheshti University of Medical Science, Tehran ,Iran.

Introduction: Deep and long-lasting anesthesia is essential throughout endodontic treatment. This study was conducted to compare the effect of adding fentanyl to epinephrine-containing lidocaine on depth and duration of local anesthesia in painful maxillary molars with irreversible pulpitis (IRP).

Methods And Materials: This randomized double-blind, clinical trial with parallel design was conducted on 61 healthy volunteers; the control group received a mixture of normal saline and 2% lidocaine with 1:80000 epinephrine and the experimental group received a mixture of fentanyl and 2% lidocaine with 1:80000 epinephrine. The depth and duration of pulpal anesthesia were evaluated by means of electric pulp testing in 5-min intervals during a period of 60 min. Pain intensity was recorded five times: before injection, after injection, during access cavity preparation, initial file placement and pulpectomy using visual analog scale (VAS). All data were analyzed and compared using the chi-square and Mann-Whitney tests.

Results: Except for one patient in the control group, all others had deep and long-lasting anesthesia. The difference between pain intensity of the control and experimental groups was not statistically significant (P>0.05).

Conclusion: Addition of fentanyl to conventional local anesthetic solution did not increase the effectiveness of infiltration in patients diagnosed with IRP.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224769PMC
November 2014

Platelet-Rich Plasma in Treatment of Zoledronic Acid-Induced Bisphosphonate-related Osteonecrosis of the Jaws.

Trauma Mon 2014 Apr 18;19(2):e17196. Epub 2014 Mar 18.

School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

Background: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a well-known challenging entity warranting management. Platelet-Rich Plasma (PRP) plays an important role in bone biology by enhancing bone repair and regeneration.

Objectives: The aim of this animal study was to evaluate the effects of PRP on zoledronic acid-induced BRONJ.

Materials And Methods: Seven rats were given 0.04 mg Zoledronic acid intravenously once a week for five weeks. Two weeks later, the animals underwent extraction of their first lower molars, bilaterally. After clinical confirmation of the osteonecrosis, PRP was injected randomly into one of the extraction sockets of each rat. Three weeks later, all rats were sacrificed in order to obtain histological sections. The analysis of epithelialization was performed by McNamar's test, and the analysis of osteogenesis and angiogenesis was performed by the Wilcoxon Sign Rank test. P value was set at 0.05.

Results: We found no significant differences between the two groups regarding the amount of epithelialization, angiogenesis or sequestrum formation (P > 0.05), but a significant difference was seen between the two groups regarding the amount of existing vital bone (P < 0.05).

Conclusions: Our study demonstrates positive results (preservation or regeneration of bone) using PRP in treatment of BRONJ. Although PRP may enhance osseous regeneration, long-term follow-ups are required to confirm its benefits.
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http://dx.doi.org/10.5812/traumamon.17196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080617PMC
April 2014

Analysis of stress distribution on fixation of bilateral sagittal split ramus osteotomy with resorbable plates and screws using the finite-element method.

J Oral Maxillofac Surg 2012 Jun 6;70(6):1434-8. Epub 2011 Aug 6.

Department of Oral and Maxillofacial Surgery, Buali Hospital, Azad University of Medical Sciences, Tehran, Iran.

Purpose: To determine the most appropriate stress distribution in fixation with resorbable screws and plates after bilateral sagittal split ramus osteotomy using the finite-element method.

Materials And Methods: This experimental study was performed on simulated human mandibles using computer software. The osteotomy line was applied to the simulated model and experimental loads of 75, 135, and 600 N were exerted on the model in accordance with the vector of occlusal force. The distribution pattern of stress was assessed and compared in 8 fixation methods: 1 resorbable screw, 2 resorbable screws in a vertical pattern, 2 resorbable screws in a horizontal pattern, 3 resorbable screws in an L pattern, 3 resorbable screws in a backward-L pattern, 1 miniplate with 2 screws, 1 miniplate with 4 screws, and 2 parallel miniplates with 4 screws each.

Results: Among the simulated fixations, 2 parallel miniplates showed the greatest primary stability and the single screw and the 2-hole miniplate showed the least tolerance to posterior forces.

Conclusions: This study showed the 2-miniplate/4-hole plate pattern was the strongest and the single-screw and 2-hole plate patterns were the weakest of fixations in this bilateral sagittal split ramus osteotomy model. The finite-element method showed that polymer-based resorbable screws and plates (polyglycolic acid and d,l-polylactide acid) provide satisfactory primary stability in this model.
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http://dx.doi.org/10.1016/j.joms.2011.05.017DOI Listing
June 2012

Biomechanical stress distribution on fixation screws used in bilateral sagittal split ramus osteotomy: assessment of 9 methods via finite element method.

J Oral Maxillofac Surg 2010 Nov 12;68(11):2765-9. Epub 2010 Aug 12.

Department of Oral and Maxillofacial Surgery, Buali Hospital, Azad University of Medical Sciences, Tehran, Iran.

Purpose: The aim of this study was to assess the biomechanical stress tolerance of screws used in 9 fixation methods after bilateral sagittal split ramus osteotomy to determine which configuration leads to lesser force load on the cortical bone at fixation points.

Materials And Methods: A 3-dimensional computerized model of a human mandible with posterior teeth was generated. The bilateral sagittal split ramus osteotomy was virtually performed on this model. The separated model was assembled with 9 fixation methods: single screw, 2 screws one behind the other, 2 screws one below the other, 3 screws in an L configuration, 3 screws in an inverted backward L configuration, miniplate with 2 screws, miniplate with 4 screws, 2 parallel plates (upper + lower border), and square miniplate with 4 screws. Then, 75-, 135-, and 600-N vertical loads were applied on the posterior teeth of these models. The stress distribution on the screw sites on the buccal cortex was measured by the finite element method.

Results: In this model all the fixation methods withstood forces between 75 and 135 N. However, the single-screw and the 2-hole miniplate models showed that the stress distributions in the configurations were intolerable when 600 N of posterior force was applied. The results of this study indicated that the inverted backward L configuration with 3 bicortical screws was the most stable.

Conclusion: Although this study indicated that the inverted backward L configuration with 3 bicortical screws was the most stable pattern, most of the patterns had adequate stability for clinical applications (mean, 125 N).
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http://dx.doi.org/10.1016/j.joms.2010.03.014DOI Listing
November 2010

Trigeminocardiac reflex during Le Fort I osteotomy: a case-crossover study.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010 Aug 9;110(2):178-81. Epub 2010 Apr 9.

Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Azad University of Tehran, Tehran, Iran.

Objective: The present study aimed to assess the occurrence of trigeminocardiac reflex (TCR) during Le Fort I osteotomies.

Study Design: This case-crossover study included 25 Le Fort I osteotomy candidates without systemically compromising conditions. Mean arterial blood pressure and pulse rate values were recorded before downfracture (DF) (MABP1, PR1), during DF (MABP2, PR2), and after DF (MABP3, PR3). The data were analyzed using repeated measure ANOVA tests (alpha = 0.05).

Results: PR1 and PR3 were significantly higher than PR2 (P < .001). MABP2 value was significantly lower compared with MABP1 and MABP3 values (P < .001). PR2 and MABP2 showed a mean decrease of 6.5% and 9.7% compared with PR1 and MABP1, respectively.

Conclusion: Different values have been suggested for TCR. Considering the limitations, the present study may suggest a revision of the values or descriptions for TCR, at least in maxillofacial Le Fort I osteotomy.
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http://dx.doi.org/10.1016/j.tripleo.2009.12.054DOI Listing
August 2010

Selecting the osteotome in rhinoplasty.

Aesthet Surg J 2009 Jul-Aug;29(4):335; author reply 335-7

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http://dx.doi.org/10.1016/j.asj.2009.03.002DOI Listing
November 2009

A study of the relationship between ameloblastoma and human papilloma virus.

J Oral Maxillofac Surg 2003 Apr;61(4):467-70

Department of Oral and Maxillofacial Surgery, Taleghani Medical Health Sciences Center, Shahid Beheshti Medical Sciences University, Tehran, Iran.

Purpose: The purpose of this study was to determine the relation of ameloblastoma with one of its probable etiologic factors, human papilloma virus (HPV).

Materials And Methods: This study was carried out in a retrospective, observational, and blind manner with information forms using an exact polymerize chain reaction. Fifty paraffinated blocks of ameloblastoma tumor were compared with 50 impacted third molar follicles.

Results: The results indicate that statistically the incidence of HPV positivity in the case group is significantly higher than that in the control group (P <.025). Furthermore, in determination of trace HPV type in HPV-positive samples, the incidence of type 6 HPV in the case group is significantly higher than that in the control group (P <.005). None of types 8, 11, 16, 18, 31, and 33 were observed.

Conclusion: The results of this research conclude that HPV could be regarded as a possible etiologic factor of ameloblastoma.
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http://dx.doi.org/10.1053/joms.2003.50011DOI Listing
April 2003