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Introduction: Aneurysmal bone cysts recognized since 1893 was described as an ossifying hematoma by Van Arsdale before being recognized by Jaffe and Lichtenstein as an intraosseous, osteolytic lesion in 1942. Bernier and Bhaskar described the first case of ABC in the craniofacial region in 1958. Aims: To find close follow-up is essential to prevent recurrent and relapse. Case Report: It is a benign blood-filled bony lesion affecting the long bones of the human skeleton. They manifest rarely in the head and neck region. They often lead to a delay in diagnosis due to the ambiguity of symptomatology and their rare occurence. Discussion: They should therefore be considered in differential diagnosis of bony, vascular lesions of the head and neck region. Conclusion: Since ABCs can be rare, expansile, rapidly growing and destructive and to make clinicians aware for accurate diagnosis and treatment, we present a case of a mandibular aneurysmal cyst and its management

Sinus augmentation requires careful manipulation of the Schneider membrane. Perforation of the membrane can be a challenging complication. The objective of this study is to evaluate the sexual dimorphism of Schneider membrane (sinus membrane) using cone-beam computed tomography (CBCT) imaging modality and discuss its clinical applications vis-a-vis the sinus lift procedure for dental implants and also its forensic implications. One hundred CBCT scans in the maxillary first molar region of fifty men and fifty women in the age group of 25–50 years were examined at two standardized points on the floor and lateral wall of maxillary sinus, and its mean was obtained. Measurements were taken for thickness of sinus membrane at most prominent antero-posterior and mesio-distal dimensions. The mean sinus membrane thickness and correlation in age groups (25–35 and 36–50 years) of both the genders were evaluated statistically. The results showed a thicker sinus membrane in women, especially in 36–50 age group than that of men. This study correlates the thickness of the sinus membrane with gender dimorphism and delves on its association with the risk of perforation during sinus lift procedures and also its forensic implications.

Purpose: This study aims to derive a series of biometric measurements using cone-beam computed tomography (CBCT) from a cross sectional group of population to help the surgeon accurately locate the mandibular foramen and the mental foramen during mandibular osteotomies. Methods: CBCT images of 800 subjects were evaluated. Various measurements were noted and compared between the two sides of the mandible in and between the sexes. Result: Statistically significant values were noted between the right and left sides of Line X to Point A in female subjects, Line Z & Line B only in male subjects and Line X’ in both male and female subjects. However, Line Y was found to be significant when comparing both sides in both males and females and also on correlation between the genders. Conclusion: Although the identification of the mandibular lingula and anatomical landmarks is an important step during mandibular osteotomies, the position of one side, however, cannot be blindly extrapolated to the contra lateral side. Also, pre operative CBCT is a useful tool to derive measurements which when transferred clinically during the surgery gives an accurate and safe approach for localisation of lingula, thus reducing the incidence of post operative neurologic morbidities.

Aerosol has been considered one of the main concerns in the dental community because of possible risk of infection transmission. Antiseptics used in the form of pre-procedural rinses can reduce aerosol contamination during dental procedures. The aim of this study is to evaluate and compare the efficacy of 0.05% cetylpyridinium chloride and 0.2% chlorhexidine pre-procedural rinses at 47ºC and 18ºC in reducing aerosol contamination during ultrasonic scaling procedures. Forty subjects were divided randomly and equally into four groups: A1 and A2 to receive cetylpyridinium chloride and B1 and B2 to receive chlorhexidine as pre-procedural rinses. Aerosol produced during the ultrasonic scaling procedure was collected on blood agar plates at three different locations, which were incubated at 37ºC for 48 hours and analysed for bacterial colony forming units (CFU). Cetylpyridinium chloride (0.05%) as a pre-procedural rinse was found to be equally effective in reducing aerosol contamination when compared with 0.2% chlorhexidine rinse (p0.05). Also, greater reduction of CFU was found with the use of tempered rinses at 47ºC with a highly statistically significant difference (p0.001). Cetylpyridinium chloride (0.05%) can be considered as a promising alternative to the gold standard 0.2% chlorhexidine, with tempering the rinse showing the definite edge.

A large periapical cyst in the right maxillary sinus region with expansion of the medial anterior and posterior walls of the sinus as well as expansion of the buccal and palatal cortical plates enucleation of the cystic lesion was performed and regeneration of the Bone using the patient rsquo s bone marrow hematopoietic cells was done Achieved results were above satisfactory level The interesting point to view and understand in this case report is not the pathologic lesion described in the case presentation but the positive results that we have achieved by the process of Regenerative Stem Cell Therapy using autogenous bone grafting techniques Regenerative Stem Cell Therapy using our patient rsquo s bone marrow cells proved to be successful in this case adequate bone regeneration was seen year post operatively in the right posterior maxilla as well as in the inferior wall of the maxillary sinus

A ranula is a large mucocele located in the floor of the mouth. Ranulas is usually a mucous extravasation phenomenon due to injury to sublingual salivary gland. unilateral presentation has been reported in many cases but bilateral presentation and that too in an edentulous patient is quite uncommon. This is a case report of bilateral ranula in an edentulous patient and its management along with a brief review of pertinent literature.

Replacing a missing tooth in a maxillary anterior esthetic zone displaying a Seibert's class III ridge defect is a big challenge in the field of perioesthetics. In order to achieve maximum esthetics, form and function, an ideal pontic should have a natural emergence profile and support the labial soft tissue as well as the adjacent papillae. This is of paramount importance, especially if the patient has a high smile line. Augmentation protocols differ based on the treatment plan for implants or fixed prosthesis. The most popular techniques for soft tissue ridge augmentation for Seibert's Class III ridge defects include the roll technique, the wedge technique and the pouch technique among others. This article presents a case of an 18-year-old female patient with a challenging Seibert's Class III ridge defect treated for pontic site development using a combination of the pouch and the roll technique followed by a fixed prosthesis with ovate pontics.How to cite this articleRathod AA, Padhye AM, Ram S, Chandavarkar S. Efficiently Plumping the Deficient! Pontic Site Development. J Contemp Dent 2014;4(3):173-177.

Introduction Palatal injection, in spite of many modernized injection techniques, remains a painful experience for the patient. The aim of this study was to demonstrate if maxillary third molars could be extracted using only buccal infiltration of 2% lignocaine hydrochloride (HCl) with adrenaline 1:80,000 without the need for supplemental palatal injection. Materials and methods Three hundred patients were selected randomly and divided into two groups of 150 each. In the experimental group, 2 ml of 2% lignocaine hydrochloride with 1:80000 adrenaline was injected into the buccal vestibule of the tooth to be extracted. Extraction was performed after a waiting period of 7 minutes postinjection. Equal number of 150 patients were used as control and were subjected to the same protocol, with additional palatal injection. Pain experienced during extraction of both groups were recorded using visual analog scale and faces pain scale. Mann-Whitney test was used to analyze pain between both the groups. Results Statistical analysis of the two groups, experimental and control groups do not defer with respect to visual analog and faces pain score. Conclusion Palatal injection for extraction of maxillary third molar is not mandatory. How to cite this article Pawar S, Desai RA, Padhye M, Shevale V, Khosa R, Keswani E, Thakker S, Shah V. Palatal Injection: A Myth or a Reality in Maxillary Third Molar Extraction. World J Dent 2014;5(1):28-32.

The aim of this article is to provide emergency care to the diseased temporomandibular joint (TMJ) when conservative methods have failed to do so and to increase mouth opening, especially in cases of closed lock. Our study was carried out on 18 healthy adult individuals who reported to our institute complaining of pain in one or both TMJs and restricted mouth opening. Mouth opening of each patient was recorded in mm prior to the procedure and pain recorded on a visual analog scale (VAS). Arthrocentesis was performed using 100 cc of Lactated Ringers solution on these individuals after conservative management of these individuals failed, followed by injection of Dexamethasone in the superior joint space. Pain was once again recorded on a VAS and mouth opening in mm 1 day after the procedure, then after 1 week, 1, 3 and 6 months. In this sample, mean mouth opening (MMO) prior to the procedure was 24.3 mm (SD ± 3.114), ranging from 18 to 30 mm. MMO postarthrocentesis was 37.85 mm (SD ± 7.457), ranging from 28 to 55 mm. From this study, the following conclusions may be drawn: Arthrocentesis is an effective mode of treatment for closed lock of the TMJ when conservative methods have failed. Mouth opening is seen to increase in patients with restricted mouth opening due to closed lock of the TMJ. It provides instant relief from pain and has long lasting effects. How to cite this article Thakkar SH, Padhye M, Kini Y, Desai R, Shah V, Pawar S, Shevale V, Mehta F. Arthrocentesis: A Minimally Invasive Approach for Temporomandibular Joint Pain. Int J Head Neck Surg 2014;5(2):61-65.

Controversy exists concerning the suspension or maintenance of anti-platelet drugs before elective surgical procedures. We assessed the association of the risk of prolonged postoperative bleeding with anti-platelet therapy by type of minor surgical procedure and the association between anti-platelet therapy and the level of hemostatic measures required. Five hundred and forty-six patients were included in the study group: those on aspirin (n = 310), clopidogrel (n = 97), and aspirin + clopidogrel dual therapy (n = 139); the control group comprised 575 healthy individuals. Cramer's V test was significant (P < 0.05) but showed a weak association between anti-platelet therapy and prolonged immediate postoperative bleeding. Compared to controls, the odds ratio revealed that the risk of prolonged bleeding in the immediate postoperative period was significantly higher with dual therapy, followed by clopidogrel and aspirin. Prolonged bleeding occurred in 22 patients in the study group and 20 in the control group, and was successfully controlled with local hemostatic measures. Fisher's exact test showed a significant association between dual therapy and higher levels of hemostatic measures (P = 0.004; P = 0.035). Prolonged bleeding in patients on anti-platelet therapy was independent of the type of minor surgical procedure. The greatest risk of prolonged bleeding was found in patients on dual therapy; this required higher levels of hemostatic measures.

The radicular cyst is the most common inflammatory odontogenic cystic lesion of the jaws. It usually originates as a sequel to a periapical inflammatory process, following chemical, physical or bacterial injury. Due to its chronic etiology, the cyst usually appears towards the later stage of life. It has a male sex predilection, with the maxillary anterior region as the most common site of involvement. This article reports a rare case of a large radicular cyst in the mandible, its management and follow up along one year.

Backround Routine use of posterior superior alveolar (PSA) nerve block or maxillary infiltration for the removal of maxillary molars has been validated. Objective The present study was undertaken to determine the relative contribution of posterior superior alveolar (PSA) block in cases of anesthesia required for maxillary molars. Study design One hundred patients requiring removal of maxillary second and third molars were enrolled. These patients were divided into 2 groups. One group received infiltration for anesthesia and other group received PSA nerve block using lignocaine with vasoconstrictor. All extractions were performed using a consistent technique of intraalveolar extraction. Data relating to the pain during extraction obtained on a visual analog scale and a verbal response scale, requirement of repeated injection for anesthesia, efficacy of these injections in localized infections, and requirement of rescue analgesics 3 hours after extraction. Results Statistical data confirmed clinical equivalence between infiltration and PSA nerve block. Conclusions Considering the difficulty in mastering the technique of PSA nerve block, and the possibility of more complications associated with it (compared with infiltration); it may not be necessary for anesthesia of maxillary molars.

Purpose: The purpose of this study was to analyze the incidence of various complications following routine exodontia performed using fixed protocols. Materials and Methods: A total of 22,330 extractions carried out in 14,975 patients, aged between 14 and 82 years, who reported to the Department of Oral and Maxillofacial Surgery at Padmashree Dr. D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, were evaluated for various complications. Results: The most common complications encountered were tooth fracture, trismus, fracture of cortical plates and dry socket. Wound dehiscence, postoperative pain and hemorrhage were encountered less frequently. Luxation of adjacent teeth, fracture of maxillary tuberosity, and displacement of tooth into adjacent tissue spaces were rare complications. Conclusion: The practice of exodontia inevitably results in complications from time to time. It is imperative for the clinician to recognize impending complications and manage them accordingly.

Local anesthetics are generally much less effective when administered in inflamed tissues. This study was conducted to validate the addition of sodium bicarbonate in local anesthetics to increase its effectiveness as local infiltrations in teeth associated with periapical infections. Two hundred subjects requiring extraction of maxillary teeth with periapical infections were enrolled. These subjects were divided in two groups of 100 subjects each. One group received local infiltration with 2 % lignocaine and 1:80,000 adrenaline, and the other group received local infiltration with sodium bicarbonate as an adjunct to the above mentioned local anesthetic solution. All extractions were performed using a consistent intra-alveolar technique by a single operator. Both the patient and the operator were blinded to the contents of local anesthetic solution. Data related to the onset of action of local anesthesia, pain experienced by the patient while undergoing extraction on two scales—"the visual analog scale and the verbal response scale", and any requirement of repeated injections during the procedure was recorded. Clinical and statistical data confirmed that the addition of sodium bicarbonate in local anesthetics did increase the efficacy of local anesthesia in inflamed tissues. It has been observed in this study that the action of sodium bicarbonate in local anesthetics increases the pH levels of these solutions, thus possibly making them more effective in an acidic environment.

Objective The objective of this study was to study incidence of type of impaction of mandibular third molars in the Indian population. Study Design Data of 1200 patients examined during a 5-year period were reviewed, which included status of mandibular third molar for inclination, emergence in oral cavity, and prevalence of caries. Radiographically, angulation of tooth, level of occlusal surface of third molar with respect to second molar, relationship between ascending ramus of mandible and distal surface of third molar, and proximity to inferior alveolar nerve were studied. Results Of 1200 patient data reviewed, 620 (51.77%) were of men and 580 (48.3%) were women in the age group of 20 to 40 years (26.3 years). Mesioangular impaction was most prevalent followed by distoangular. A strong statistical significance was found between gender and ramus relationship. Fifty percent of cases showed proximity to the inferior alveolar nerve, which was more frequent in males (58.3%). Conclusion Our study highlights mesioangular impaction as the most frequently encountered angulation in impacted teeth.

Existence of unicystic ameloblastoma with desmoplasia is a seldom occurrence. It was first described by Waldron and El-Mofty in the year 1987 as the term hybrid ameloblastoma. Here, we account a case of hybrid lesion depicting outstanding unicystic, follicular ameloblastoma with desmoplasia and mucus cell differentiation showing inductive changes. The patient is a 38-year-old male with a swelling in the lower right posterior region of the jaw. Radiologically, a mixed radiopaque-radiolucent lesion was sighted in this region. Taking into account of patient's complaint, clinical, radiographic, and histologic features; diagnosis of ameloblastic fibrodentinoma was made. It was followed by complete excision of the tumor. The challenge in the management of this tumor was to render complete excision as recurrence may occur in incomplete removal and also to reconstruct the bony defect to give a moderate cosmetic and functional result to the patient. The excisional biopsy report was established to be of hybrid ameloblastoma. Since there are few cases reported in the past of this lesion, the present case is an addition for better perception of this odontogenic tumor. This article identifies some profound concepts and new developments in the histopathologic design of ameloblastoma and its hybrid variant. It also briefly reviews the literature referring to this rare tumor entity. Considering the characteristics of ameloblastoma, priority of surgical management for hybrid lesion is also described.

Background: A prospective analysis was carried out over a 1-year period to assess gloves used during 100 major and 100 minor oral surgical procedures to test for efficacy of double gloving in oral surgical procedures. Purpose: The purpose of this study was to assess the efficacy of double gloving technique in preventing cross infection in both major and minor oral surgical procedures. Materials and Methods: Gloves used during 100 major and 100 minor oral surgical procedures were analyzed to check for glove perforations and skin punctures. 100 sterile gloves were tested as control. Statistical Analysis Used: Chi-square test was used to determine whether there was any difference between the expected and observed values in various categories. Results: A higher number of glove perforations was seen in minor oral surgical procedures compared with major surgeries, dominant hand compared with the nondominant, outer gloves compared with the inner, in procedures which took a longer duration of time to complete, in procedures involving wiring and in the index finger followed by the thumb and the palm. Conclusion: Double gloving technique using sterile gloves can be used as an effective means of infection control for all major and minor surgical procedures, especially high-risk procedures involving patients who maybe suffering from or carriers of blood-borne infections.

Dentigerous cysts are the most common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth and impacted canines. Bilateral dentigerous cysts are rare and occur typically in association with a developmental syndrome. The occurrence of bilateral dentigerous cysts is rare and, to date, only 21 cases have been reported in literature till 2009. Here, we report a case of bilateral dentigerous cysts in maxillae of non-syndromic 10-year-old patient with brief review of literature.