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Aim: The aim of this study was to compare the efficacy of nasolabial flap, split thickness skin graft and collagen sheet in increasing postoperative mouth opening as a reconstructive material in surgical management of Oral Submucous Fibrosis (OSMF). Materials and Methods: 15 patients were included in this prospective cohort study and were randomly divided into 3 groups of 5 patients, based on type of graft material used for reconstruction. Group 1 patients received nasolabial flap, Group 2 patients received split thickness skin grafts and Group 3 patients received collagen sheet after resection of fibrous bands. Histologically proven cases of OSMF with mouth opening less than 25 mm were included in the study. Patients were evaluated at regular intervals and mouth opening was documented preoperatively, intraoperatively, and at 1 and 3 months of follow-up. Results: In all three groups, mouth opening differed substantially at all periods of follow-up from preoperative values. At 1 month follow up mean mouth opening increased to 28.4 mm in Group 1, 26.2 mm in Group 2 and 25.0 mm in Group 3. At the end of 3 months of follow up mean increase in mouth opening was greater in Group 1 (29.6 mm) in comparison to Group 2 (20.2 mm) and Group 3 (19.2 mm). Conclusion: No statistically significant difference in mouth opening was observed in three groups. Nasolabial flaps, split thickness skin grafts and collagen sheet are good options for reconstruction of defects created by resection of fibrous bands in patients with OSMF.

Objective: The objective of this study was to assess average improvement in maximal mouth opening, pain at rest, and active mouth opening after platelet-rich plasma (PRP) injections using ultrasonography (USG)-guided platelets rich plasma injection in the management of internal derangement of the joint. Materials and Methods: Ten patients with internal derangement of the temporomandibular joint (TMJ) underwent PRP injections guided by the ultrasonography. The extent of maximal mouth opening, pain, and tenderness of the TMJ and the masticatory muscles at rest, motion, and mastication were thoroughly assessed at the beginning of the study and scheduled for next follow-up at 2, 4, 12, and 24 weeks. Results: USG-guided platelet-rich plasma injection was significantly effective in improvements of the extent of maximal mouth opening, pain at rest, and on movement. Statistics result demonstrated a significant reduction in the visual analog scale values of pain at rest and on movement. Conclusion: USG-guided PRP injection to the upper TMJ space provided improvement in signs and symptoms of patient with internal derangement of the TMJ.

A pilot study was conducted to analyze and compare the stability of dental implants using 2 different graft materials (autologous dentin graft and an alloplastic hydroxyapatite [HA] crystal) in the same patient. As far as we know, this study is first of its kind where socket preservation has been done using 2 different grafts in the same patient. Ten patients undergoing extraction of at least 2 teeth were selected. Atraumatic extractions were performed. Out of the 2 extraction sockets, 1 was grafted with autogenous tooth graft and other with HA crystals. Computed tomography scan was performed 3 months after grafting to evaluate bone mineral density. Primary implant stability was measured using resonance frequency analysis. It was observed that among both sites, autogenous tooth grafted sites showed better results.

INTRODUCTION: The treatment of temporomandibular joint is mainly surgical and aims at restoring the function of joint and correcting the aesthetics deformity caused by ankylosis. Studies are available in the literature which showed that there is osteogenic potential in condylar stump remaining after gap arthroplasty, especially in children. Our objective was to assess the growth of ramus operated after surgery using orthopantomogram as the tool of assessment. MATERIALS AND METHOD: Fifteen patients of prospective study design were selected for study. This study was undertaken to evaluate the mandibular ramal growth in TMJ ankylosis patients treated without growth center transplantation using orthopantomogram as a tool of assessment. RESULTS: Mean ramal length of the operated right side was found to be 42.02 mm in immediate postoperative, 43.18 mm in sixth month postoperative and 44.57 mm in 1 year postoperative follow-up. Mean ramal length of the operated left side was found to be 40.15 mm in immediate postoperative, 42.10 mm in sixth month postoperative and 44.80 mm in 1 year postoperative follow-up. CONCLUSION: Our investigations showed that mandibular growth rate increases after successful treatment of ankylosis in children. One drawback of this treatment protocol that we observed was that the total growth deficit manifested in all our patients could not be made up.

In the conventional method of fixation of symphyseal fractures, 2 miniplates are fixed in the interforamina region of the mandible at the lateral cortex. However, with the better understanding of tension and compression areas defined according to the place of energy insertion, it is now possible to fix miniplates at the lower border of the mandible. In this study we assumed that the application of perpendicular miniplates, in contrast to the placement of the plates on the lateral surface of the mandibular cortex, will constrict the motion in horizontal as well as vertical planes leading to better functional outcomes, which can be evaluated by measuring bite forces. The results obtained were affirmative with the hypothesis.

Management of temporomandibular joint (TMJ) ankylosis is mainly through surgical intervention. Interpositional materials are a necessity when it comes to prevention of TMJ re-ankylosis after arthroplasty. Early aggressive postoperative physiotherapy is essential for the prevention or treatment of TMJ hypomobility or ankyloses. Recently, it has been shown that abdominal dermis fat helps promote smooth, pain-free joint function and it is stable after interposition and less prone to fragmentation. The purpose of this study was to assess that whether dermal fat is a good choice of interpositional material when it comes to decreased pain perception during aggressive physiotherapy after release of ankyloses thus ensuring good compliance by the patient. We also assessed the fate of the graft material on computed tomography to evaluate any volume changes if occurred after interposition.

PURPOSE: The purpose of this study was to suggest a protocol for the management of odontogenic space infections in patients with hemophilia which is often incompletely addressed by clinicians because of the fear of excessive bleeding leading to prolonged morbidity. METHODS AND RESULTS: Six diagnosed cases of hemophilia (four cases of hemophilia A and two cases of hemophilia B) with odontogenic fascial space infection were included in the study. Apart from routine investigations, assessments were also done to identify inhibitors to factor VIII/IX. Factor VIII/IX was replaced along with infusion of factor eight inhibitor bypass activity (FEIBA) one hour before incision and drainage. All the cases were treated by incision and drainage along with removal of foci under local anesthesia. The postoperative outcome was uneventful in all cases except one in which postoperative bleeding was noted from the extraction site on the third day which was again managed following the designed protocol. CONCLUSION: Maintaining good oral hygiene and seeking early dental care are of prime importance in patients with hemophilia to avoid invasive procedures. However, if odontogenic infection develops in these patients, performing timely incision and drainage using our protocol will minimize the complications and give successful outcome.

We describe a case of maxillofacial trauma in a paediatric patient in which the left mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact and the right condyle was also displaced similarly but the zygomatic arch was also fractured on this side. Also, there was an associated mandibular symphyseal fracture. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12663-017-1042-7) contains supplementary material, which is available to authorized users.

AIM AND OBJECTIVE: To perform the comparative finite element analysis of conventional and perpendicular plating in mandibular symphyseal fracture. MATERIAL AND METHOD: Two FE model of mandible were developed and symphyseal fracture was created in both of them. Each fractured model was fixed by conventional method 2.0 mm system and perpendicular method 2.00 mm system. Stresses which developed in plates and mandible after application of load were observed in the model. RESULTS: Results of the study indicated that perpendicular method was more resistant to displacing forces and rest of the parameters was within the permitted limits. CONCLUSION: Perpendicular method was reasonably effective as conventional method of fixation for mandibular symphyseal fracture.

Background: Stromal response to cancer is usually characterized by intense lymphoplasmacytic infiltrate. However, recently, the attention has shifted to tumor-associated tissue eosinophils (TATE). Tumor-associated blood eosinophils (TABE) are rare in solid cancers; however, carcinoma of the head and neck shows its prevalence. Aim: The aim of the study was to investigate the prevalence and relationship of tissue and blood eosinophils in various grades of oral cancer. The purpose of the article is to emphasize the possible clinical and biological significance of eosinophils in patients of oral squamous cell carcinoma (OSCC) so that appropriate therapeutic strategies can be devised accordingly. Study Design: Thirty histologically confirmed cases of oral squamous cell carcinoma were divided into well, moderate and poorly differentiated carcinoma. Eosinophilic infiltration in the tissue was graded as low, moderate and massive TATE. The number of eosinophils per 100 WBCs was taken as the differential eosinophil count. Blood eosinophilia (BE) >6% was considered to be TABE. Materials and Methods: Hematoxylin and eosin-stained tissue sections at 5 μ were evaluated. Prolonged staining in dilute 0.05% aqueous eosin demonstrated eosinophils selectively. Blood smears were stained by Leishman stain. Statistical Analysis: Student's t-test, Chi-square test, ANOVA, Newman–Keuls Multiple Comparison Test and Karl Pearson correlation coefficient® method were used. Results: The mean TATE value was highest in poorly differentiated carcinoma. TABE was seen only in a few cases and was associated mostly with poorly differentiated OSCC. Conclusion: There was a statistically significant correlation between TATE and histological grades of OSCC. Eosinophilia of the peripheral blood is an adverse sign in patients with carcinoma.

A retrospective review of maxillofacial trauma cases reported over a period of two years among urban Indian population with age

Introduction: The purpose of this study is to compare the efficiency of culture methods in detecting microorganisms appearing in the bloodstream after various oral surgical procedures and effect of preoperative antibiotics and antiseptic rinses on bacteremia. Materials and Methods: The prevalence of bacteremia at various intervals of time (pre- and post-surgical) was studied in three different groups presenting with indications to surgical intervention. Two of the groups were given presurgical prophylaxis (systemic antibiotic and antiseptic rinse) while, in one group, no prophylactic measure was adopted. Blood samples were withdrawn from the subjects at specifi c pre- and post-surgical time intervals, and microbiological analysis was done. The fi ndings were compared with a control group involving healthy individuals and a group involved in maxillofacial trauma where the breach of oral mucosal integrity was not surgically planned. Results: The presence of bacteremia was not observed in all five groups at baseline while postsurgery (30 min, 60 min, and 90 min) in only three groups (preoperative antibiotic, without prophylaxis, and 1% Povidone iodine rinse). At all postsurgery periods (30 min, 60 min and 90 min), the presence of bacteremia was evident highest in without prophylaxis group followed by 1% Povidone iodine rinse and preoperative antibiotic the least.

Juvenile aggressive ossifying fibroma (JAOF) is an uncommon benign lesion which is distinctly aggressive in behavior with high tendency for recurrence. It appears in early age and in 79% of patients is diagnosed before 15. It has two histological variants: psammomatoid and trabecular, with the latter being less common with a stronger tendency to recur. In this article, we present a case of trabecular JAOF, in which treatment could not be given despite the availability of all requisites for surgery and good financial status, due to parental indifference and negligence.

We describe what is to our knowledge the first report of a patient who presented with a superolateral dislocation of the mandible, in which the medial portion of the left condyle was fractured and the lateral fragment was hooked on the zygomatic arch without any other associated fracture.

Submerged tooth is the one that is depressed below the occlusal plane. Dental ankylosis is thought to be a major cause of submergence. Submerged deciduous teeth have the potential to cause malocclusion not only by prevention of their exfoliation and subsequent replacement by permanent teeth but also by causing tilting of proximal teeth and extrusion of opposing tooth. The purpose of this report is to present three different cases of submerged deciduous teeth and their clinical effects.