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Objectives: This study was conducted to evaluate the precision of the implant placed using a surgical guide by comparing it with simulated implant position. Methods: Preoperatively cone beam computed tomography scan was taken, which was converted into Digital Imaging and Communication in Medicine files (DICOM). Intraoral scans in form of Standard Tessellation Language (STL) files were taken; both the DICOM and STL files were transferred into 3Shape Implant Studio. After superimposing the data prosthesis was digitally designed and implant simulation was done and surgical guide fabricated. Thereby implants were placed through the guiding hole of the guide. The angular deviation and the linear deviation of the implants at the coronal and the apical end were done by superimposition of the simulated and placed implants in ‘Navident-ClaroNav’ software with closest point algorithm and verified. Result: The mean angular deviation of the implant was 2.73°± 2.05°, the P value for angular deviation was found to be > 0.05. The median lateral deviation of the implant at the coronal end was 0.81 mm.The median lateral deviation of the implant at the apical end was 0.97 mm. Conclusion: The surgical guide designed to reduce the inaccuracies due to manual implant placement has proved to have high accuracy in achieving ideal positioning. The computer aided stereolithographic guide helps in transferring ideal implant position from simulated planning to actual implant site during the surgery, thereby reducing the inaccuracies in its positioning.

To evaluate the effectiveness of reduction of the sphenozygomatic suture in zygomaticomaxillary complex fractures by orbital volume and facial symmetry analysis. 16 patients with severely displaced or comminuted unilateral zygomatic complex fractures were studied. All patients underwent ORIF via hemicoronal incision as fixation of zygomatic arch was deemed necessary. This provided direct visualisation of reduction of the sphenozygomatic suture. The orbital volume and symmetry were analysed using different softwares. Descriptive statistics were computed. Patients were followed up for 3 months. The average reduction in orbital bony volume was 1.8 cc. Comparing the post-operative value with the contralateral normal side an average difference of only 0.5 cc was obtained. Preoperatively average deviation in symmetry was 3.66 ± 1.94 mm. Post-operatively the average deviation in symmetry was reduced to 2.19 ± 0.9 mm. On follow up, the complication noted was only one case of hardware failure was noted in the infraorbital rim. To evaluate the effective reduction of sphenozygomatic suture, restoration of symmetry and orbital volume should be assessed concurrently.

Chronic non-suppurative osteomyelitis, also known as Garre's osteomyelitis is a well-described pathologic entity in dental literature. We present here a case report of a unilateral hard bony swelling of the lower jaw associated with infection. Radiograph revealed the pathognomic feature of 'onion skin' appearance. Surgical recontouring of the lower jaw was performed since there was no evidence of bone remodelling after removal of the infected tooth.

Tongue plays an important role in speech and deglutition. It is important to restore the anatomical form to achieve optimum function and aesthetics after ablative cancer resection of tongue lesions. Ideal reconstruction of these defects should be done with a flap that provides adequate bulk and pliable tissue [1]. Usually smaller defects are left to granulate without any reconstruction these may produce unaesthetic anatomical form and speech deformity [2,3]. We describe a technique of primary closure which will restore the anatomical form of the tongue and result in optimal speech.

Gastric infarction is a rare condition often associated with high mortality due to a delay in diagnosis. The stomach which has a rich supply of blood is a rare site for such a condition. Gastric infarction has a long list of etiological factors. We report a case of a patient who was managed successfully following gastric infarction from gastric dilatation. An 18-year-old female student presented with a three-day history of abdominal pain associated with abdominal distension of two days. The abdomen was distended with generalized tenderness, rebound tenderness, and guarding. Bowel sounds were absent. Digital rectal examination was unremarkable, and a pregnancy test was negative. Biochemical tests were all normal. Intraoperatively, two litres of serosanguinous fluid was suctioned from the abdomen. About 300 mL of pus was suctioned from the pelvis. The gangrenous portion was resected, and repair was done in two layers using Conell and Lambert suture techniques. Acute gastric necrosis is a rare surgical condition that requires a high index of suspicion and prompts aggressive resuscitation and surgical intervention to obviate the high mortality rate associated with the condition.