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Extraction of premolars for orthodontic purposes may prove challenging when the tooth is blocked or lingualised. The standard buccal approach may prove difficult in such cases. A novel technique was used for 16 patients with healthy linguoverted mandibular premolars using maxillary extraction forceps. The ease of extraction increased and resulted in uneventful postoperative healing in all patients. The authors suggest this as a preferred technique for extracting mandibular premolars in linguoversion.

Maxillofacial trauma is amongst the most frequently encountered trauma seen in the hospital emergency setting. It may be life-threatening on rare occasions, and with concomitant injuries, it is often severely debilitating.The present study was conducted to determine the occurrence of concomitant orbital and ocular injuries amongst patients with maxillofacial trauma, and also helps in deriving a correlation between different patterns of maxillofacial fractures.All the records of the patients with maxillofacial trauma who were admitted to our institution over a 10-year period were analyzed. The files were screened to isolate the patients with concomitant ocular and orbital injuries.Out of a total of 686 patients, 370 had associated ocular injuries. A total of 566 (82.5%) patients were males and 120 (17.5%) females. A total of 236 patients (34.4%) were in the 3rd decade. A total of 351 cases of orbital fracture (isolated + concomitant) were reported. About 44 (12.5%) cases of isolated orbital floor fractures were seen.Subconjunctival hemorrhage accounted for the maximum number of cases amounting to 59.19%. The least associated ocular injuries seen were of traumatic mydriasis (0.28%). Out of 370 cases of ocular injuries, 249 (67.3%) were associated with fractures of the zygomaticomaxillary complex.The present study draws attention to the concomitant orbital and ocular injuries in maxillofacial trauma patients. This study is strongly suggestive of a very high probability of concomitant ocular injury in maxillofacial trauma patients which necessitates strong interdepartmental coordination for holistic management of the maxillofacial trauma patients.

The incidence of head injury in maxillofacial trauma patients varies widely in the literature. A good understanding of the patterns of association between these injuries would aid in efficient multidisciplinary treatment. The aim of this study therefore was to understand the associations between head injury and facial trauma by retrospectively analysing the records of patients seen at a tertiary care trauma centre. Demographic data were also described. Records of 4350 facial trauma patients over a five-year period were reviewed. A total of 3564 (81.9%) patients were victims of motor vehicle accidents (MVA). Male patients predominated, comprising 3711 (85.3%), and 36.6% were in the third decade of life. Facial fractures were seen in 2120 (48.7%), the most common being zygomatic fractures (60%). At the time of trauma, 2383 (57.3%) patients were under the influence of alcohol, and 2821 (87.8%) victims of two-wheeler MVAs were not using their helmet. Of all patients, 29.75% sustained a traumatic brain injury (TBI). Midface fractures were strongly associated with TBI. Maxillofacial injury may be considered a risk factor for TBI, and as such should immediately be suspected and investigated in all patients. Prompt recognition and management can improve outcomes in these patients.

AIM: To carry out clinical in vivo evaluation of efficiency of the 2-mm lambda plate for open reduction and internal fixation of condylar fractures. MATERIALS AND METHODS: This prospective clinical study was conducted on a group of 16 patients who underwent open reduction for subcondylar fractures of the mandible and fixation using a 2-mm 7-holed titanium lambda miniplate. RESULTS: The average surgical time was found to be 79.5 min. The ease of access was found to be adequate in 13 cases (81.3%). All patients showed a gradual improvement in mouth opening and occlusion over the post-operative follow-up period. The maximum mouth opening seen at 3-month follow-up was 54 mm. None of the patients had transient or permanent weakness of the facial nerve. In our study, we encountered one case of hardware failure (6.25%). CONCLUSION: The 2-mm lambda condylar miniplate provides an excellent stabilisation of the fractured subcondylar segments and ensures satisfactory results, confirmed both clinically and radiographically. The plate reduces the amount of surgical exposure needed and does not cause any significant post-operative complications.