Comparison prove that Tahrir N. Aldelaimi ( dean of college of dentistry / Anbar University ) have plagiarized from a case report belong to Ismail Yazdi and Amir Hossein Fakhraee
3.Tahrir N. Aldelaimi Article BONY SYNGNATHIA (CONGENITAL FUSION OF MAXILLA ...MohammedAbdulhammed
Tahrir N. Aldelaimi's ( dean of college of dentistry / Anbar University ) Published paper Show plagiarized paragraph (High light ) from a case report belong to Ismail Yazdi and Amir Hossein Fakhraee
Septal cartilage for repairing partial defect of auricule. eniacs
MD. Bizhga Gjergji
ENT Clinic, General Trauma University Hospital,Tirana, Albania.
MD. Hoxhallari Xhevahir
ENT Clinic,University Hospital ‘Mother Tereza’ Tirane.
Chronic Osteomyelitis of the Mandible - Case ReportMustafa Batoor
In this presentation you find a case presentation about "Chronic Osteomyelitis of Mandible". It would be so kind of you if you could share your suggestions with we.
3.Tahrir N. Aldelaimi Article BONY SYNGNATHIA (CONGENITAL FUSION OF MAXILLA ...MohammedAbdulhammed
Tahrir N. Aldelaimi's ( dean of college of dentistry / Anbar University ) Published paper Show plagiarized paragraph (High light ) from a case report belong to Ismail Yazdi and Amir Hossein Fakhraee
Septal cartilage for repairing partial defect of auricule. eniacs
MD. Bizhga Gjergji
ENT Clinic, General Trauma University Hospital,Tirana, Albania.
MD. Hoxhallari Xhevahir
ENT Clinic,University Hospital ‘Mother Tereza’ Tirane.
Chronic Osteomyelitis of the Mandible - Case ReportMustafa Batoor
In this presentation you find a case presentation about "Chronic Osteomyelitis of Mandible". It would be so kind of you if you could share your suggestions with we.
The primary goal of the present book is to produce a comprehensive text that fully integrates the latest concepts and techniques in management of odontogenic infections. The main aim is to provide the readers with an update information regarding pathophysiology, clinical and radiographic presentation, microbiology, diagnosis, management, and complications of odontogenic infections. Accordingly, the text has been divided into six chapters. Chapter one is concerned with oral microbiology and immunology. Chapter two is dealing with the pathophysiology of odontogenic infections. In chapter three, management of odontogenic infections is presented. In chapter four, antibiotic therapy of odontogenic infections is given. Chapter five deals with life-threatening complications. In chapter six osteomyelitis of the jaws is discussed.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 20TH PUBLICATION - IJADS
Hemi facial microsomia /orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
Detailed discussion on diagnosis and management of TMJ ankylosis. Surgical anatomy and applied aspects of TMJ is discussed. Reconstruction of ramus-condyle unit is also discussed. Compications of TMJ surgery are also discussed
The primary goal of the present book is to produce a comprehensive text that fully integrates the latest concepts and techniques in management of odontogenic infections. The main aim is to provide the readers with an update information regarding pathophysiology, clinical and radiographic presentation, microbiology, diagnosis, management, and complications of odontogenic infections. Accordingly, the text has been divided into six chapters. Chapter one is concerned with oral microbiology and immunology. Chapter two is dealing with the pathophysiology of odontogenic infections. In chapter three, management of odontogenic infections is presented. In chapter four, antibiotic therapy of odontogenic infections is given. Chapter five deals with life-threatening complications. In chapter six osteomyelitis of the jaws is discussed.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 20TH PUBLICATION - IJADS
Hemi facial microsomia /orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
Detailed discussion on diagnosis and management of TMJ ankylosis. Surgical anatomy and applied aspects of TMJ is discussed. Reconstruction of ramus-condyle unit is also discussed. Compications of TMJ surgery are also discussed
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Ortho management of clp /certified fixed orthodontic courses by Indian dental...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Cleft lip and palate importance in orthodontics /certified fixed orthodontic...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Phenotypic analysis of a case of “3MC syndrome” with review of literatureBIJCROO
3MC syndrome is a very rare entity. Its prevalence is unknown, but most cases are reported from the Middle East.
The first case was reported in 1978 and named as Michels syndrome, and recently, with other three syndromes
together, these syndromes are named as 3MC syndrome. All are autosomal recessive disorders and have been
reported by both consanguineous and non-consanguineous parents. Here, we phenotypically analyzed a case presented with the features of blepharophimosis syndrome associated with craniosynostosis suggestive of Michel syndrome, which is a part of the “3MC syndrome.”
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3.turnitin originality report for tahrir n. aldelaimi article the evaluati...MohammedAbdulhammed
turnitin originality report confirm that " Tahrir n. aldelaimi ( dean of college of dentistry / Anbar University ) have been plagiarized from article belong to Faiez N. Hattab, Ma'amon A. Rawashdeh and Mourad S. Fahmy
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Comparison prove that Tahrir N. Aldelaimi ( dean of college of dentistry / Anbar University ) have plagiarized 60% from a article belong to Margot L. Van Dis and Edwin T. Parks it under his name
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turnitin originality report confirm that " Tahrir n. aldelaimi ( dean of college of dentistry / Anbar University ) have been plagiarized 60% from a article belong to Margot L. Van Dis and Edwin T. Parks
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turnitin originality report confirm that " Tahrir n. aldelaimi ( dean of college of dentistry / Anbar University ) have been plagiarized a case report belong to Ismail Yazdi and Amir Hossein Fakhraee
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
1.Comparism between Ismail Yazdi & Amir Hossein Fakhraee Article and Tahrir N.N. Aldelaimi Article
1. 1
BONY SYNGNATHIA (CONGENITAL FUSION OF MAXILLA AND MANDIBLE)
Author : Tahrir N.N. Aldelaimi Author : Ismail Yazdi & Amir Hossein Fakhraee
Journal : EGYPTIAN DENTAL JOURNAL Journal : ARCHIVES OF IRANIAN
MEDICINE
Publication : Vol. 57, 1:3, July, 2011 Publication : Volume 3, Number 3 Jul. 2000
Title :
BONY SYNGNATHIA (CONGENITAL
FUSION OF MAXILLA AND MANDIBLE)
Title :
Congenital Fusion of Maxilla and Mandible
(Bony Syngnathia): A Case Report
Abstract :
Congenital bony fusion of the jaws (syngnathia)
without any other anatomic oral anomalies is a
very rare condition. Numerous cases with
combination of cleft palate, aglossia, and soft or
bony adhesion between the maxilla and mandible
have been reported. Syngnathia could also occur
with popliteal pterygium syndrome and van der
Woude syndrome. This report presents a case of
syngnathia who was attend Maxillofacial surgery
Department at Ramadi Teaching Hospital, Anbar
Province, Iraq, with bilateral maxillo-mandibular
inter-alveolar adhesion, with no other intra-oral
anomalies.
Abstract :
Congenital bony fusion of the jaws (syngnathia)
without any other anatomic oral anomalies is a
very rare condition. Numerous cases with
combination of cleft palate, aglossia, and soft or
bony adhesion between the maxilla and mandible
have been reported. Syngnathia could also occur
with popliteal pterygium syndrome and van der
Woude syndrome.
This report presents a case of syngnathia with
bilateral maxillo-mandibular inter-alveolar
adhesion, unusually with no other intra-oral
anomalies.
Keywords :
Syngnathia, bony fusion, congenital defect,
maxilla, mandible
Keywords :
Congenital bony syngnathia • congenital fusion •
maxilla • mandible • syngnathia
المالحظ:ةبرنامج اشارTurnitinبين تطابق وجود الىالCase ReportالخاصبالدكتورينIsmail Yazdi & Amir
Hossein Fakhraeeعام والمنشور0222ول العلمي المنشورعام المنشور نزال تحرير .أ.د0222: باالتي االخير قام حيث
2-اسم نفس استعمل(Title)الCase Reportفقط القوسين موقع تغيير مع
0-ال بنسخ قامAbstract:فقط اضاف و تغيير اي دونwho was attend Maxillofacial surgery Department at
Ramadi Teaching Hospital, Anbar Province, Iraq
3-ال في كلمات خمسة اصل من كلمات ثالث نسخKeywords( كلمة باستبدال قام وFusion( عبارة في )Congenital
Fusion( بكلمة )Defect( العبارة لتصبح )Congenital Defect)
2. 2
Author : Tahrir N.N. Aldelaimi Author : Ismail Yazdi & Amir Hossein Fakhraee
Introduction :
Syngnathia is a rare congenital anomaly involving fusion
of maxillary and mandibular bones. The fusion may be due
to soft tissue adhesions between the two or a true bony
fusion between maxilla and mandible1,2. The effected
new born child is presenting with diffi culties in the airway
protection and maintenance as well as feeding problems3.
Most have other associated anomalies like popliteal
pterygium syndrome, Vander Woude syndrome requiring
concurrent management. Surgical management involves
division of the bony fusion or break down of the adhesions
in the fi rst few days of life. Depending upon the severity,
these children present formidable anaesthetic challenges.
The congenital bony fusion of the maxilla and
mandible (bony syngnathia), especially as an
isolated occurrence, is a very rare condition.
Syngnathia mostly appears in association with
other anatomic oral and maxillofacial anomalies.
About few such cases have been reported in the
literature in combination with cleft lip, cleft of
hard and soft palate, aglossia, popliteal pterygium
syndrome1, van der Woude syndrome, aglossia-
adactylia syndrome2, oral soft tissue synechiae,
hypoplasia of the proximal mandible, clefting of
mandible, bifi d tongue, hemifacial microsomia,
small or absent tongue, temporomandibular
(zygomaticomandibular) fusion and some other
regional and systemic anomalies 3-8
Introduction :
Congenital bony fusion of the maxilla and
mandible (bony syngnathia),especially as an
isolated occurrence, is a very rare condition.
Syngnathia mostly appears in association with
other anatomic oral and maxillofacial anomalies.
About 15 such cases have been reported in the
literature in combination with cleft lip, cleft of
hard and soft palate, aglossia, popliteal pterygium
syndrom1, van der Woude syndrome, aglossia-
adactylia syndrome2, oral soft tissue synechiae,
hypoplasia of the proximal mandible, hemifacial
microsomia, cleft of mandible, bifid tongue, small
or absent tongue, temporomandibular
(zygomaticomandibular) fusion and some other
regional and systemic anomalies3-14 This
condition is also seen in autosomal recessive
hypomandibular craniofacial dysostosis. To our
knowledge, only two isolated cases of bony
syngnathia have been reported in the
literature10,14,15 This report presents a case of
congenital syngnathia with bilateral maxillo-
mandibular inter-alveolar adhesion, unusually
with no other oral or maxillofacial anomalies.
المالحظ:ة( المقدمة في نزال تحرير .أ.د قامIntroduction)( بنسخ51من سطرا )Case Reportفي لصقه و انفا المذكور
برنامج اشار كما تغيير اي بدون العلمي منشورهTurnitin
3. 3
Author : Tahrir N.N. Aldelaimi Author : Ismail Yazdi & Amir Hossein Fakhraee
Case Presentation :
A newborn male ( weight 2800g) of 3 days of age
was referred to the Department of Maxillofacial
Surgery of Ramadi Teaching Hospital, Ramadi
city, Anbar Province, Iraq; for evaluation of the
fusion of maxilla and mandible that prevented
oral feeding. Medical consultation and laboratory tests
revealed low blood glucose. Urgently thorough clinical
and radiographical examinations were done and start
feeding via a nasogastric (NG) tube and the patient was
maintained on humidified oxygen by mask. There was no
other associated local or systemic anomaly. Clinical
examination revealed severe trismus due to
adhesion of the jaws, which extended bilaterally
from deciduous canine area to the molar regions
posteriorly and revealed a bony fusion between
the maxilla and the mandible involving the entire
alveolar margin with a small gap about 18 mm on left side
anteriorly in the canine region.
Case Presentation :
A newborn female of 2 days of age was transferred
to the Department of Oral and Maxillofacial
Surgery of Pars Hospital, Tehran, for evaluation of
the fusion of maxilla and mandible, which
prohibited oral feeding. She was admitted to the
neonatal intensive care unit where she was soon fed via a
nasogastric tube.Physical examination revealed
severe trismus due to complete adhesion of the
jaws, which extended posteriorly from the canine
area to the molar regions, bilaterally. The oral
cavity therefore could not be seen.The child was
the product of a normal vaginal delivery with a
birth weight of 2670 g. Systemic examination revealed
no anomalies in the rest of the body, but her general
condition was poor and her rectal temperature rose to
40C.Medical consultation and pertinent laboratory tests
المالحظ:ةال فيCase Presentationبرنامج اشارTurnitinقيام الىنزال تحرير .أ.د:باالتي
1-( مقطع بنسخ قامParagraph 1( من مكون )5:هو طفيف تغيير مع سطور )
( رقم استخدام : اوال3( رقم عن بدال )2)
استخدم : ثانيا(OF Ramadi Teaching Hospital, Ramadi city, Anbar Province, Iraq( عن بدال )Pars
Hospital, Tehran)
( استخدم : ثالثاMale( عن بدال )Female)
( استخدم : رابعاweight 2800g( عن بدال )weight of 2670 g)
( كلمة استخدم : خامساPrevented( عن بدال )Prohibitedلها مترادفه هي و )
2-( مقطع بنسخ قامParagraph 2( من مكون )4:هو طفيف تغيير مع سطور )
( كلمة استخدم : اوالClinical( من بدال )Physicalلها مترادفه هي و )
( ال صياغة اعادة : ثانياwhich extended posteriorly from the canine area to the molar regions, bilaterally)
( جعلها وwhich extended bilaterally from deciduous canine area to the molar regions posteriorly)
3-( مقطع بنسخ قامParagraph 2( من مكون )3:هو طفيف تغيير مع سطور )
( عبارة حذف : اوالof the skull and facial bones)
( كلمة استخدام : ثانياWereبدال )( عنWhich)
1
2
1
2
4. 4
The radiographs were obtained with difficulty,
revealed bilateral bony fusion of the maxilla and
mandible, Very feeble motion was palpable over each
temporomandibular joint (TMJ). Family history showed
no similar affliction could be elicited in the past
generations of either the parents and maternal and paternal
history was negative for any facial cleft. All other siblings
were normal. ( Fig. 1 and 2)
failed to reveal the cause of fever. The poor condition of
the baby did not allow a CT scan or MRI to be performed.
The radiography of the skull and facial bones,
which was obtained with difficulty, revealed
bilateral bony fusion of the maxilla and mandible,
normal teeth buds and presence of normally developed
condyles of the temporomandibular joints.The patient was
the first child of an 18-year old mother and a 23-year old
father who were first cousins, healthy and normal. No
similar affliction could be elicited in the past two
generations of either the parents.At the age of 50 days, the
patient’s systemic condition had relatively improved. She
was brought to the operating theater and a planned blind
awake nasal intubation was failed. Tracheostomy was
performed and anesthesia was maintained with nitrous
oxide and oxygen.The syngnathia was divided by means of
a scalpel and fine osteotomes via an intra-oral approach
which allowed the mouth to remain open. On inspection,
no other anomalies of the oral cavity,including tongue,
palate and pharynx were found.Both temporomandibular
joints seemed to function normally. The anesthesia was
without any complication and the patient was sent to the
intensive care unit in fairly good condition. The baby, who
primarily was unable to bottle-feed, probably due to lack of
natal sucking reflex, learned to do so after appropriate
nursing.The pre-existing fluctuating temperature of the
patient remitted after surgery and she was discharged from
the hospital at the end of second postoperative week. A few
weeks later, she was repeatedly readmitted into the hospital
because of high fever and pneumonia, for which she was
treated and discharged in relatively good condition each
time.Finally, the child died at the age of seven months.
Since permission to conduct an autopsy was not given, the
exact cause of death could not be determined. However, a
clinical diagnosis of acute pneumonia had been made.
3
3
5. 5
Author : Tahrir N.N. Aldelaimi Author : Ismail Yazdi & Amir Hossein Fakhraee
Discussion :
Fusion defects of the maxilla and mandible
including other anatomic oral abnormalities are
not common. They may be of the connecting
tissue either fibrous or bony 1,2 Soft tissue fusion
9,10 (synechiae) have been extensively reviewed
by Gartlan et al. (1993) and were classified as
buccopharyngeal membrane remnants or as
ectopic membranes on the basis of their presumed
origin 11 . Bony fusion (syngnathia), particularly
its isolated occurrence, is extremely rare. The
very few cases reported in the literature are mostly
inadequate in description, inconsistent and
confusing in nomenclature and with limited useful
conventional imaging 4,10. The cause of
congenital bony syngnathia is not certain. In
contrast, the review of five cases presented by
Dawson et al (1997) and previously reported
cases provide no evidence of any familial
tendency, history of drug and toxin exposure or
consanguinity3. Congenital bony syngnathia can
be clinically recognized and diagnosed at or after
the birth of the affected neonate without any
exception 3,7. The adequate useful conventional
radiography and / or CT scan can support the
clinical recognition of this condition and its
nature, which causes inability to open the jaws.
The management of patients with congenital
fusion of maxilla and mandible varies according
to the nature and extent of the abnormalities. The
condition is problematic and interferes with
feeding, breathing, general health of the patient
(aspiration pneumonitis), growth and
development, induction of anesthesia. The airway
is the first priority to be secured in the
management of any newborn with trismus.
Thereafter, feeding problems should be overcome
Discussion :
Fusion defects of the maxilla and mandible
including other anatomic oral abnormalities are
not common. They may be of the connecting
tissue either fibrous or bony1-17. Soft tissue
fusion15-16 (synechiae) have been extensively
reviewed by Gartlan et al. (1993) and were
classified as buccopharyngeal membrane
remnants or as ectopic membranes on the basis of
their presumed origin.13Bony fusion
(syngnathia), particularly its isolated occurrence,
is extremely rare. The very few cases reported in
the literature are mostly inadequate in description,
inconsistent and confusing in nomenclature and
with limited useful conventional
imaging3,4,10,14.The cause of congenital bony
syngnathia is not certain. Some of the postulated
causes, from reported cases in the literature, including
Goodacre and Wallace’s summarization of the various
experimental studies performed on the embryological
basis, include persistence of the buccopharyngeal
membrane, amniotic constriction bands in the region of
the developing branchial arches, environmental insults,
drugs such as meclozine and large doses of vitamin
A4,5,14,12.In contrast, the review of five cases
presented by Dawson et al (1997) and previously
reported cases provide no evidence of any
familial tendency, history of drug and toxin
exposure or consanguinity3.A case of a human fetus
with syngnathia without any clinical history7 and also a
case of vitamin A induced bony syngnathia with a cleft of
the secondary palate in rats, treated with vitamin A, has
also been reported17.Congenital bony syngnathia
can be clinically recognized and diagnosed at or
after the birth of the affected neonate without any
exception3,7.The adequate useful conventional
radiography and high resolution or spiral cut CT can
support the clinical recognition of this condition
and its nature, which causes inability to open the
المالحظ:ةقامأ.د.تحريرنزالفي( المناقشةDiscussion( بنسخ )05سطرا )منCase Reportالمذكورانفاولصقهفي
منشورهالعلميبدونايتغييركمااشاربرنامجTurnitin( المناقشة ان علماDiscussionب الخاصة )أ.د.تحريرمكونة نزال
( من05سطرا )
6. 6
by placing a nasogastric or gastrotomy tubes.
Since the occurrence of bony fusion of the maxilla
and mandible is extremely rare, and there is high
rate of association between bony syngnathia and
other regional and systemic
malformations3,4,6,8,12, the patient should be
under the supervision of a team of clinicians
skilled in the diagnosis and appropriate treatment
of congenital oral and maxillofacial anomalies 3 .
Surgical division of the bony fusion, under
general anesthesia (blind intubation or via
tracheostomy) is the optimal treatment for the
simple syngnathia in isolated occurrence or cases
with the presence of other anatomic
abnormalities6,8,12 . Proper physical therapy
should be commenced immediately and the infant
should be encouraged to feed normally as soon as
possible3. Maxillomandibular fusion is a rare group of
anomalies varying in severity from simple mocusal
adhesions (synechiae) to extensive bony fusion
(syngnathia). Proper physical therapy and feeding should
be resumed as soon as possible after the surgery. The
significant points about the case reported were; it was an
isolated pure bony fusion without any associated local
(cleft lip/palate) or systemic anomalies; only few cases
exist in the world literature so far.
jaws. The management of patients with
congenital fusion of maxilla and mandible varies
according to the nature and extent of the
abnormalities.The condition is problematic and
interferes with feeding, breathing, general health
of the patient (aspiration pneumonitis), growth
and development, induction of anesthesia
(intubation) etc.However, on the basis of the reports from
the literature, (though they are relatively imprecise and
not consistently well documented), functional results,
especially in the cases with isolated occurrence, are likely
to be good3-5,10,15. But the rarity of this condition
imposes some limitations on standardization of the
treatment.4In terms of jaw function and its outcome, it is
more problematic in complex cases. Dawson, et al having
added five new cases to the literature proposed a system
of classification and elaborated on treatment
recommendations3. Their proposed classification is aimed
at the treatment and likely functional outcome rather than
etiology or pathogenesis of the malformation3. The
airway is the first priority to be secured in the
management of any newborn with trismus.
Thereafter, feeding problems should be overcome
by placing a nasogastric or gastrotomy
tubes.Since the occurrence of bony fusion of the
maxilla and mandible is extremely rare, and there
is high rate of association between bony
syngnathia and other regional and systemic
malformations3-6,8,14 the patient should be
under the supervision of a team of clinicians
skilled in the diagnosis and appropriate treatment
of congenital oral and maxillofacial
anomalies.3Surgical division of the bony fusion,
under general anesthesia (blind intubation or via
tracheostomy) is the optimal treatment for the
simple syngnathia in isolated occurrence or cases
with the presence of other anatomic
abnormalities3-6,8,14. Proper physical therapy
should be commenced immediately and the infant
should be encouraged to feed normally as soon as
possible3.There are at least two significant points about
our case. First, it was an isolated case without any other
regional anatomic anomalies such as cleft lip and palate.
And only two such cases are reported in recent medical
literature10,14.Second, there is consanguinity in the
family (parents are first cousins) which suggests the
7. 7
possibility of autosomal recessive inheritance.The
pathogenesis of this condition still remains obscure
although some developmental defects may have occurred
in the region of the first branchial arch, in which
separation of the maxilla and mandible have failed to
occur. The poor general condition of the infant and her
high fever could be due to an aspiration pneumonitis and
respiratory distress.Whether this case and two similar
cases reported in literature10,14 should be considered as
amild expression related to some of the syndromes of the
head and neck region or categorized as an independent
anomaly, is open to question.
8. 8
Author : Tahrir N.N. Aldelaimi Author : Ismail Yazdi & Amir Hossein Fakhraee
References :
1. Hamamoto J, Matsumoto T. A case of facio-
genito-popliteal syndrome. Ann Plast Surg. 1984;
13: 224-9.
2. Johnsson GF, Robinow M. Aglossia-adactylia.
Radiology. 1978; 128: 127-32.
3. Dawson KH, Gruss JS, Myall RW. Congenital
bony syngnathia. A proposed classification. Cleft
Palate Craniofac J. 1997; 2: 141-6.
4. Rao S, Oak S, Wagh S, Kulkarni M. Congenital
midline palatomandibular bony
fusion with a mandibular cleft and a bifid tongue.
B J Plastic Surg. 1977; 50: 139-41.
5. Kamata S, Satoh K, Vemura T, Onizuka T.
Congenital bilateral zygomaticomandibular
fusion with mandibular hypolasia. B J Plastic
Surg. 1996; 49: 251-3.
6. Gorlin J, Cohen M, Michael, Levin L, Stefan.
Syndromes of Head and Neck. 3rd ed. England:
Oxford University Press; 1990: 630-1, 783.
7. Shah RM. Palatomandibular and maxillo-
mandibular fusion, partial aglossia and cleft
palate in a human embryo. Teratology. 1977; 15:
261-72.
8. Agrawal K, Chandra SS, Sreckumar NS.
Congenital bilateral intermaxillary bony fusion.
Ann Plast Surg. 1993; 30: 163-6.
9. Kamala G, Pillai V, Kamath V, Kumar GS,
Nagamani N. Persistent buccopharyngeal
membrane with cleft palate. Oral Surg Oral Med
Oral Pathol. 1990; 69: 164-6.
10. Dinardo NM, Christion JM, Benneth JA,
Shutack JG. Cleft palate lateral synechia
synchrome. Oral Surg Oral Med Oral Pathol.
1989; 68: 565-6.
11. Gartlan MG, Davies J, Smith RJ. Congenital
oral synechiae. Ann Otol Rhinol Laryngol. 1993;
102: 186-97.
References :
1. Hamamoto J, Matsumoto T. A case of facio-
genito-popliteal syndrome. Ann Plast Surg. 1984;
13: 224-9.
2. Johnsson GF, Robinow M. Aglossia-adactylia.
Radiology. 1978; 128: 127-32.
3. Dawson KH, Gruss JS, Myall RW. Congenital
bony syngnathia. A proposed classification. Cleft
Palate Craniofac J. 1997; 2: 141-6.
4. Rao S, Oak S, Wagh S, Kulkarni M. Congenital
midline palatomandibular bony
fusion with a mandibular cleft and a bifid tongue.
B J Plastic Surg. 1977; 50: 139-41.
5. Kamata S, Satoh K, Vemura T, Onizuka T.
Congenital bilateral zygomaticomandibular fusion
with mandibular hypolasia. B J Plastic Surg. 1996;
49: 251-3.
6. Gorlin J, Cohen M, Michael, Levin L, Stefan.
Syndromes of Head and Neck. 3rd ed. England:
Oxford University Press; 1990: 630-1, 783.
7. Shah RM. Palatomandibular and maxillo-
mandibular fusion, partial aglossia and cleft palate
in a human embryo. Teratology. 1977; 15: 261-72.
8. Agrawal K, Chandra SS, Sreckumar NS.
Congenital bilateral intermaxillary bony fusion.
Ann Plast Surg. 1993; 30: 163-6.
9.Salleh NM. Congenital partial fusion of the mandible and
maxilla. Oral Surg Oral Med Oral Pathol. 1965; 20: 74-6.
10.Miskinyar SA. Congenital mandibulomaxillary
fusion. Plast Reconstr Surg. 1979; 63: 120-1.
11.Behnia H, Shamse MG. Congenital unilateral fusion of
the mandibular and maxillary alveolar ridge, tempo
romandibular joint, and coronoid process. J Oral
Maxillofac Surg. 1996; 54: 773-6.
12.Goodacre TE, Wallace AF. Congenital alveolar fusion.
Br J Plast Surg. 1990; 43: 203-9.
13.Gartlan MG, Davies J, Smith RJ. Congenital
oral synechiae. Ann Otol Rhinol Laryngol. 1993;
102: 186-97.
المالحظ:ةقامأ.د.تحريرنزالفيالمصادر(References( بنسخ )21مصدرا )منال مصادرCase Reportالمذكورانفاو
لصقهفيمنشورهالعلميبدونايتغيير( اول تسلسل في8مصادر )
9. 9
12. Miskinyar SA. Congenital
mandibulomaxillary fusion. Plast Reconstr Surg.
1979; 63: 120-1.
14.Nwoku AL, Kekere-Ekun TA. Congenital ankylosis of
the mandible. J Maxillofac Surg. 1986; 14: 150-2.
15.Kamala G, Pillai V, Kamath V, Kumar GS,
Nagamani N. Persistent buccopharyngeal
membrane with cleft palate. Oral Surg Oral Med
Oral Pathol. 1990; 69: 164-6.
16.Dinardo NM, Christion JM, Benneth JA,
Shutack JG. Cleft palate lateral synechia
synchrome. Oral Surg Oral Med Oral Pathol. 1989;
68: 565-6.
17.Nada R. Maxillomandibular ankylosis and cleft palate
in rat embryos. J Dent Res. 1970; 49: 1086-90.