eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 262 273 article Zahra Jaberi Ansari zahrajaberiansari@yahoo.com 1 Azam Valian avalian14@yahoo.com 2 Mahsa Maghsoudlou nejad maghsoudlou.mahsa@gmail.com 3 Department of Restorative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Department of Restorative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Department of Restorative Dentistry, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran. Background and Aim: This study assessed the effects of composite type, adhesive type, adhesive application protocol, and storage time on repair microshear bond strength (µSBS) of composite restorations.    Materials and Methods: This in vitro, experimental study was conducted on Z350 and Point 4 (n=360) composite discs that were stored in water for 3 weeks at 37°C. After roughening by bur and etching, the specimens were divided into 24 groups (n=15) based on the type of composite (Z350 and Point 4), type of universal adhesive (G-Premio Bond and Clearfil Universal Bond Quick), adhesive application protocol (according to the manufacturer’s instructions, waiting for 30 seconds, or diode laser irradiation of adhesive prior to polymerization for 30 seconds), and storage time (24 hours or 1 year). The specimens were bonded to Z250 repair composite, and underwent µSBS test. The mode of failure was also determined. Data were analyzed by four-way ANOVA and Tukey’s test (alpha=0.05).    Results: Four-way ANOVA showed significant effects of adhesive application protocol (P=0.000) and storage time (P=0.000) on µSBS. The interaction effect of the two on µSBS was also significant (P=0.046). The µSBS after 24 hours was higher than that after 1 year irrespective of the adhesive application protocol. The µSBS was maximum in the laser group followed by waiting for 30 seconds, and all pairwise comparisons were significant in this respect (P=0.000). Conclusion: In aged composite restoration repair, diode laser irradiation of adhesive prior to polymerization or waiting for 30 seconds prior to adhesive curing can enhance the µSBS.   http://jrdms.dentaliau.ac.ir/article-1-745-en.pdf Composite Resins Dental Restoration Repair Shear Strength eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 274 284 article Parisa Bagheri pbagheri@tums.ac.ir 1 Behnam Bolhari behnambolhari@yahoo.com 2 Naghme Meraji meraji_n@yahoo.com 3 Mohammad Javad Kharazifard Kharrazi_mohammad@yahoo.com 4 Seyed Ali Morsali sasanaryanezhad@yahoo.com 5 Seyed Sasan Aryanezhad ariasasan7@gmail.com 6 Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Private Endodontist, Tehran, Iran. Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran Dentist, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Oral & maxillofacial radiologist, Department of Oral & maxillofacial Radiology, School of Dentistry, Islamic Azad University of Isfahan (Khorasgan), Isfahan, Iran Abstract Background and Aim: This study quantified the amount of residual calcium hydroxide (CH) mixed with saline, propylene glycol (PG), nano-silver (NS), and 0.2% chlorhexidine (CHX) carriers after root canal irrigation with the conventional needle (CN), safe-end needle (SEN), and ultrasonic irrigation (UI).    Materials and Methods: In this in vitro study, the root canals of 190 single-rooted premolars were instrumented with Mtwo, and longitudinally sectioned in half. After smear layer removal, the root canals were filled with CH mixed with either saline, PG, 0.2% CHX, or NS. CH was removed with CN irrigation, SEN irrigation, or UI. The residual CH was quantified in the coronal, middle, and apical thirds using a stereomicroscope. The penetration depth of CH into dentinal tubules was measured under a scanning electron microscope (SEM). Data were analyzed using three-way and one-way ANOVA, and Tukey’s test (alpha=0.05).    Results: The effects of carrier type (P=0.0001), irrigation technique (P=0.0001), and distance from the apex (P=0.0001) were significant on the residual CH percentage. The efficacy of UI was slightly superior to other techniques in saline and CHX groups in the coronal third, and the NS group in the middle third. The irrigation technique had a significant effect on residual CH in the coronal and middle thirds, and no significant effect on the penetration depth of CH. The penetration depth of CH was not significantly different among different carrier groups (P>0.05). Conclusion: The efficacy of UI in removal of CH was variable, depending on the carrier type and distance from the apex.   http://jrdms.dentaliau.ac.ir/article-1-812-en.pdf Calcium Hydroxide Needles Root Canal Therapy Therapeutic Irrigation Ultrasonics eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 285 291 article Lakshmi Rathan Aarasoor Cunniah lakshmir5@srmist.edu.in 1 Suryakala Nadarajan 2 Vivek Narayanan 3 Damodharan Narayansamy 4 C V Swapna Manjari 5 Bakyalakshmi Kolanji 6 Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College & Hospital, SRM Institute of Science and Technology, SRM Nagar, Potheri, Chengalpattu district, Tamil Nadu State, India Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College & Hospital, SRM Institute of Science and Technology, SRM Nagar, Potheri, Chengalpattu district, Tamil Nadu State, India Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College & Hospital, SRM Institute of Science and Technology, SRM Nagar, Potheri, Chengalpattu district, Tamil Nadu State, India Department of Pharmaceutics, SRM College of Pharmacy, SRM Institute of Science and Technology, SRM Nagar, Potheri, Chengalpattu district, Tamil Nadu State, India Department of Microbiology, SRM Medical College & Hospital, SRM Institute of Science and Technology, SRM Nagar, Potheri, Chengalpattu district, Tamil Nadu State, India Department of Public Health Dentistry, Government Dental College & Hospital, Pudukottai Background and Aim: Surgical sutures are necessary to achieve hemostasis at the surgical site and promote healing. Currently, antibiotic-coated sutures are used to inhibit bacterial adhesion and proliferation. However, they can lead to bacterial resistance. To overcome this issue, herbal-coated suture materials are employed. This study aimed to assess the morphological and mechanical properties and antimicrobial efficacy of plain silk sutures with suture material coated with curcumin and honey.    Materials and Methods: This in vitro study included three groups (n=3). Group A consisted of plain silk sutures, group B consisted of silk sutures coated with curcumin, and group C consisted of silk sutures coated with honey extract. Morphological assessment was performed using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). Tensile strength was measured using straight-pull and knot-pull tests on a tensile tester, and antimicrobial efficacy was evaluated using antimicrobial culture tests for the three groups. Statistical analysis was carried out using SPSS version 22.0.    Results: The morphology of coated sutures was validated by SEM images and EDS analysis. The tensile strength was not significantly different among the three groups, as assessed by the straight pull test (P=0.494) and knot pull test (P=0.707). Group A demonstrated no antibacterial activity. Group B demonstrated increased resistance to Pseudomonas aeruginosa (P. aeruginosa) (P=0.034), while Group C showed resistance to Escherichia coli (E. coli) (P=0.037). Conclusion: The results showed that honey-coated sutures were highly resilient and had excellent antimicrobial properties. Curcumin-coated sutures expressed less resilience with better antimicrobial properties.   http://jrdms.dentaliau.ac.ir/article-1-827-en.pdf Anti-Infective Agents Plant Extracts Infection Control Microscopy Electron Scanning Wound Healing eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 292 298 article Poulami Chakraborty drkarthik79@yahoo.co.in 1 Kaarthikeyan Gurumoorthy 2 Nidhita Suresh 3 Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India Background and Aim: Europium (Eu) is the most reactive and volatile rare-earth element. This study aimed to develop Eu-doped bioglass for applications in bone regeneration.    Materials and Methods: To synthesize Eu-doped bioglass, 1.3 g of cetyltrimethylammonium bromide was dissolved in 40 mL of ethanol to form a homogeneous surfactant solution. Europium nitrate, tetraethyl orthosilicate, calcium nitrate, and orthophosphoric acid were then sequentially added under continuous stirring. The mixture was stirred for 24 hours at room temperature to allow complete reaction and precursor integration. Next, 50 mL of acetone was added to induce precipitation, followed by centrifugation at 12,000 rpm for 6 minutes. The supernatant was discarded, and the collected precipitate was sintered to obtain the final bioglass. The fabricated Eu-doped bioglass was subsequently characterized using scanning electron microscopy (SEM), attenuated total reflectance–infrared spectroscopy (ATR-IR), and antimicrobial analysis to evaluate its morphological, structural, and biological properties.    Results: The ATR-IR spectra revealed typical silicate bands, and SEM images displayed a hollow-shaped structure. The superior crystallinity of Eu contributed to the bioglass network’s enhanced mechanical properties. Antimicrobial evaluation revealed a notable reduction in the number of colonies for both Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). Conclusion: The synthesized Eu-doped bioglass exhibited notable antimicrobial activity and favorable characteristics for bone tissue engineering. Incorporation of Eu ions into the bioglass matrix enhanced biological performance, suggesting its potential applicability in bone regeneration. These findings indicate that Eu-doped bioglass could serve as a promising material for biomedical applications, particularly for promoting bone healing.   http://jrdms.dentaliau.ac.ir/article-1-970-en.pdf Anti-Bacterial Agents Bioglass Bone Regeneration Europium Materials Science Microscopy Electron Scanning eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 299 309 article Hanieh Jadidi hanieh.jadidi@yahoo.com 1 Arash Azizi drarashazizi@yahoo.com 2 Shadab Safarzadeh Khosroshahi shadab.kh@gmail.com 3 Gholamhossein Ramezani gh.h.ramezani@gmail.com 4 Department of Pediatric Dentistry, TeMS.C., Islamic Azad University, Tehran, Iran Department of Oral Medicine, TeMS.C., Islamic Azad University, Tehran, Iran Department of Restorative Dentistry, TeMS.C., Islamic Azad University, Tehran, Iran Department of Pediatric Dentistry, TeMS.C., Islamic Azad University, Tehran, Iran Background and Aim: Effective composite bonding to primary teeth is crucial. Cold plasma treatment could enhance this bonding. This study investigated the effect of cold atmospheric plasma on dentin microshear bond strength (µSBS) of primary anterior teeth.    Materials and Methods: In this in vitro study, 84 eligible primary anterior teeth were randomly assigned to six groups: (I) Adper Single Bond 2 fifth-generation bonding agent, (II) fifth-generation bonding agent + 15-second plasma treatment, (III) fifth-generation bonding agent + 30-second plasma treatment, (IV) Single Bond Universal adhesive, (V) universal adhesive + 15-second plasma treatment, and (VI) universal adhesive + 30-second plasma treatment. The µSBS test was then performed. Fracture mode was determined under a stereomicroscope. Scanning electron microscopy (SEM) and stereomicroscopic assessments were also performed. Data were analyzed by one-way and two-way ANOVA, and Tukey and t tests.    Results: The universal adhesive group had a significantly higher µSBS (39 MPa) than the fifth-generation bonding group (13.5 MPa). A significant difference existed between the no plasma and 30-second plasma treatment groups (P=0.001). In the universal groups, significant differences were noted between no plasma and both 15-second and 30-second treatments (P<0.05). Universal adhesive outperformed the fifth-generation bonding agent in the no plasma and 15-second treatment groups (P=0.007). Adhesive failures predominated in all groups, and SEM analysis showed distinct differences in dentinal tubules among the bonding systems. Conclusion: It is recommended to use Single Bond Universal adhesive without plasma, and consider plasma treatment to enhance bonding in Adper Single Bond 2 fifth-generation system.   http://jrdms.dentaliau.ac.ir/article-1-814-en.pdf Dental Bonding Dentin-Bonding Agents Plasma Gases Therapeutic Use Tooth Deciduous eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 310 320 article Mohammad Esmaeilzadeh dr.m.esmaeilzadeh@sbmu.ac.ir 1 Ahmad Eghbali a.eghbali@gmail.com 2 Ghassem Ansari profgansari@gmail.com 3 Masoud Fallahinejad Ghajari masfalnegh@sbmu.ac.ir 4 Ali Soleymani drsoleymaniali@yahoo.com 5 Jina Yavarifar leyla_eft@yahoo.com 6 Leila Eftekhar leila.eftekhar.a@gmail.com 7 Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Anesthesiology Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Private Dentistry Practice, Tehran, Iran Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Background and Aim: This study aimed to evaluate the efficacy and safety of intravenous propofol-fentanyl versus ketamine-midazolam combinations for sedation of 2-6-year-old uncooperative dental patients.    Materials and Methods: This triple-blind crossover randomized clinical trial included 24 (13 boys and 11 girls) healthy (ASA I) uncooperative (Frankl I) 2-6-year-old (mean age: 3.7±1.1 years) children who were randomly divided into two groups. The first group (AB) received intravenous propofol (2 mg/kg) in addition to fentanyl (1 µg/kg) in the first session and ketamine (2 mg/kg) along with midazolam (0.2 mg/kg) in the second session. The second group (BA) received the two drug combinations in a reverse order to allow testing the potential sequence effect. Oral midazolam (0.3 mg/kg) was administered as premedication. Changes in hemodynamic indices and reactions to dental stimulations were recorded using the monitoring device and Houpt scale, respectively. Data were analyzed using the Pearson Chi-Square test, independent t-test, and Mann-Whitney U test (alpha=0.05).    Results: There were no significant differences in hemodynamic indices, namely the SpO2 (P=0.179) and heart rate (HR) (P=0.062), and overall behavior (P=0.378) of the two groups during the treatment phases, including catheter insertion, local anesthetic injection, and at 15 and 30 minutes following the onset of dental treatment. However, the recovery time was significantly longer in the ketamine-midazolam than the propofol-fentanyl group (P=0.00). Conclusion: Based on the results of this study, the use of propofol-fentanyl combination for behavioral control of uncooperative children provided better sedation quality and scores, and lower hemodynamic changes compared to ketamine-midazolam, although this difference was not statistically significant.   http://jrdms.dentaliau.ac.ir/article-1-738-en.pdf Fentanyl Administration Intravenous Ketamine Pediatric Dentistry Propofol eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 321 329 article Deepthi Nirmal Gavarraju drdeepthipedo@sids.ac.in 1 Jahnavi Chalasani chalasanijahnavi@gmail.com 2 Sai Sankar A.J saisamata@gmail.com 3 Raja Satish Prathigudupu rajasatish79@gmail.com 4 Dhanush Ramayanapu dk.ramayanapu@gmail.com 5 Department of Pediatric and Preventive Dentistry, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India Department of Pediatric and Preventive Dentistry, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India Department of Oral & Maxillofacial Surgery, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India Background and Aim: Silver diamine fluoride (SDF) is an effective cariostatic agent used in minimally invasive dentistry. However, one major drawback of SDF is dark staining after its application, limiting its clinical use. This study quantified the color change associated with the application of SDF on extracted carious primary molars, the potential masking effects of potassium iodide (KI) and glutathione, and the effect of aging on their masking effect.    Materials and Methods: In this in vitro experimental study, 45 extracted primary carious molars with International Caries Detection Assessment System scores 5 and 6 were collected, cleaned of debris, and stored in distilled water until use. Previously restored teeth and those with pulpal involvement were excluded. The selected teeth were randomly categorized into 3 groups (n=15) for the application of SDF (group 1), SDF+ KI (group 2), and SDF+ glutathione (group 3). Test materials were applied, and images were captured immediately and on day 14. The mean gray values were calculated using Image J software and tabulated. Statistical analysis was done using paired t-test, one-way ANOVA, and Tukey’s test (alpha=0.05).    Results: KI and glutathione were able to mask the staining of SDF compared to SDF alone. SDF+ KI showed the least staining compared to other groups after a 14-day period, which was statistically significant (P<0.05). Conclusion: Within the study limitations, KI can be considered as a potential masking agent that can overcome the black staining caused by SDF, which is the main barrier to parental acceptance of SDF treatment.   http://jrdms.dentaliau.ac.ir/article-1-801-en.pdf Dental Caries Glutathione Potassium Iodide Tooth Deciduous Silver Compounds eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 330 337 article Kosar Yahyapour k.yahyapour98@gmail.com 1 Melika Mollaei Melika.mollaei.7@gmail.com 2 Mona Alimohammadi mona_y28@yahoo.com 3 Sara Yaghoubirad yaghoubirs951@mums.ac.ir 4 Hoora Hadian h.haadian@yahoo.com 5 Abolfazl Hosseinnataj hosseinnataj.a@gmail.com 6 Atefeh Gholampour atefehgholampour70@yahoo.com 7 Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran Department of Oral and Maxillofacial Radiology, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran Department of Restorative Dentistry, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran Department of Oral and Maxillofacial Radiology, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran Department of Oral and Maxillofacial Radiology, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran Background and Aim: Cone-beam computed tomography (CBCT) is a valuable imaging modality suitable for analyzing the hard tissue of the maxillofacial region. However, the artifacts caused by some dental treatments may reduce the image quality and lead to misinterpretations.  The present study aimed to assess the accuracy of CBCT measurements in the presence of stainless-steel crowns (SSCs).    Materials and Methods: This in vitro experimental study was conducted on 4 sheep hemi-mandibles. First, gutta-percha points were placed on the buccal and lingual surfaces of the alveolar ridge, and bone height and thickness were measured with a digital caliper (direct measurement). Then, three CBCT scans were obtained as follows: The first scan was performed without placing the SSCs, as the baseline image; the second scan was performed after placement of one SSC, and the third scan was performed in presence of 3 SSCs. Red wax was used for soft tissue simulation. Data were analyzed using SPSS version 22 (alpha=0.05).    Results: The findings revealed no significant difference between the direct measurement and the baseline image in terms of measuring the bone height and thickness (P>0.05). The difference between the baseline and scan image measurements in presence of one SSC was not significant (P>0.05). Furthermore, the accuracy of CBCT images did not decrease after the placement of 3 SSCs. Conclusion: The Presence of SSCs did not decrease the accuracy of linear measurement of alveolar bone height and thickness. Moreover, increasing the number of SSCs did not significantly affect the accuracy of measurements.   http://jrdms.dentaliau.ac.ir/article-1-934-en.pdf Cone-Beam Computed Tomography Anatomic Landmarks Artifacts Alveolar Process eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 338 345 article Mohsen Barzegar mohsen.barzegar90@gmail.com 1 Alireza Bemani alirezadent9779@gmail.com 2 Pegah Shadmehr 3 Adele Pouyafard a.pouyafard@gmail.com 4 Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Background and Aim: Recent evidence suggests a link between sleep bruxism and vitamin D deficiency. This study aimed to investigate the serum concentrations of calcium and 25-dihydroxyvitamin D, as well as calcium intake in patients with self-reported sleep bruxism versus healthy controls.    Materials and Methods: This case-control study evaluated 32 participants between 18 and 44 years old in each of the case and control groups, who were selected among patients referring to Yazd Dental School. The severity of bruxism was assessed using a questionnaire related to the classification of bruxism, and clinical examinations were performed to assess abnormal tooth wear. The daily calcium intake was estimated based on the frequency and amount of consumption of milk, yogurt, and cheese. The serum level of 25-hydroxyvitamin D was measured using the relevant kit, and the serum calcium level was measured by spectrophotometry. Data were analyzed using the Mann-Whitney test, Independent sample t-test, Fisher’s exact test, and Spearman’s correlation coefficient (alpha=0.05).    Results: The mean daily calcium intake in the case group was significantly lower than that in the control group (P<0.001). However, the mean serum calcium levels did not differ significantly between the case and control groups (P>0.05). The mean serum level of 25-hydroxyvitamin D in the case group was significantly lower than that in the control group (P<0.001). Conclusion: According to the present results, the mean serum level of 25-hydroxyvitamin D in bruxers was significantly lower than that in healthy controls. Bruxism was significantly associated with vitamin D deficiency in our study population.     http://jrdms.dentaliau.ac.ir/article-1-923-en.pdf Bruxism Calcium Serum Vitamin D eng Islamic Azad University Dental Branch Journal of Research in Dental and Maxillofacial Sciences 2588-4166 2383-2754 2025-12 10 4 346 352 article Seyedeh saba Sharifzadeh Sharifzadeh.Saba@Yahoo.com 1 Mohesen Mardani Mardanimo@sums.ac.ir 2 Jamaledin Motazedian Motazedian91@gmail.com 3 Mahdi Jamalpour mahdijamalpoor@ymail.com 4 Fatemeh Shirvani Farsani fatemehshirvani93@gmail.com 5 Mahjoubeh Entezar-e-Ghaem mahjubeentezarghaem@gmail.com 6 Niloofar Ghadimi omfrghadimi@gmail.com 7 Department of Oral Medicine, TeMS.C., Islamic Azad University, Tehran, Iran Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran Department of Oral and Maxillofacial Surgery, Shiraz University of Medical Sciences, Shiraz, Iran Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Sadoughi, Yazd, Iran Department of Oral and Maxillofacial Radiology, Medical Dental Material Research Center. Dental School, TeMS.C., Islamic Azad University, Tehran, Iran Background and Aim: Craniofacial teratomas are exceedingly rare congenital tumors, typically presenting at birth with variable degrees of facial distortion and airway compromise.    Case Presentation: We report a rare case of a 2-day-old female neonate with a massive craniofacial teratoma affecting her left facial region, accompanied by a cleft palate and feeding difficulties. Computed tomography (CT) imaging revealed a large heterogeneous mass with destructive extension into the orbit, maxilla, mandible, and anterior and middle cranial fossae. Complete surgical excision was achieved via the Weber-Ferguson approach, and histopathological evaluation confirmed a mature teratoma.    Conclusion: This case report highlights the importance of early imaging and prompt surgical intervention in managing large craniofacial teratomas. Despite the rarity of such cases, multidisciplinary planning is essential to achieve optimal functional and cosmetic outcomes.   http://jrdms.dentaliau.ac.ir/article-1-1115-en.pdf Congenital Craniofacial Abnormalities Surgery Teratoma