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Admixed ameloblastoma comprises of a combination of more than one histomorphological patterns of ameloblastoma. The present case report discusses a case of admixed ameloblastoma extensively involving the entire body of the mandible bilaterally in a 25-year-old male. The case was managed by segmental resection using osteotomy to remove the segment of the mandible along with the right coronoid process. Histopathological examination of the excised tumor revealed highly proliferative odontogenic epithelium in the forms of plexuses and follicles. A fibula reconstructed graft was provided for rehabilitation of the patient with no evidence of disease after a one-year follow-up.

With modern civilization and the rise in literacy, cases of human sacrifice are rarely encountered by forensic practitioners. Human sacrifice, also called ‘Narabali’ in India, involves an act of deliberately killing an individual due to ritualistic beliefs for the appeasement of the Gods, spirits, or ancestors. Human sacrifice and ritual murder are often considered synonymous, but ritual murder further involves offering the body part to the deity after killing. Diverse methods were historically adopted for human sacrifice across the globe, strongly influenced by their superstitious, religious, and cultural beliefs. Cases of human sacrifice mostly involve children. We report the rare case of human sacrifice involving an adult victim assaulted by a sharp weapon over the posterior aspect of the neck. The deceased succumbed due to the transection of the cervical spine and corresponding spinal cord. Corroboration of circumstances of death and profiles of the deceased and the perpetrator with autopsy findings were essential in the investigation. This case report discusses extreme superstitions and beliefs, resulting in homicide.

Abortion has always been a vital issue in reproductive and legal medicine. Globally, medical termination of pregnancy (MTP) is allowed primarily on six grounds: (1) to save the life of a woman, (2) risk to the physical and mental health of a woman, (3) pregnancy due to rape or incest, (4) risk of a child being born with a serious fetal anomaly, (5) socio-economic reasons, (6) a woman's request. Most countries have standard legal abortion policies, yet there remains disparity with respect to prohibition, gestational age limit, specific grounds, etc. Abortion laws are constantly changing globally based on regional social and economic viewpoints. Recently, some countries have liberalised their abortion laws, while a few have further restricted theirs. While some countries still completely prohibit MTP. Like some others, India amended its MTP law in 2021. We consider the medico-legal and ethical issues and examine existing MTP laws both globally and as generally applied in India.

Forensic age estimation is an invaluable aspect of human identification. Out of these many means of age estimation, few regions with untapped potential for assistance in forensic age estimation are the age-related changes in the laryngeal cartilages. As the age advances, the thyroid and cricoid cartilages undergo gradual calcification in an individual. These age-related changes can be visualized in both the living and the dead using conventional radiography and can be objectively assessed. The objective of the present study was to evaluate the age-related changes in the laryngeal cartilages and the results may be utilized for age estimation in forensic examinations. The laryngeal cartilages were carefully dissected using standard procedures from 75 cadavers of age ranging from 17 to 65 years, during the post-mortem examination. The laryngeal cartilages were radiographed and replaced in the body cavity before culminating the post-mortem examination. The calcification of both cartilages was studied by using the standard grading method. Calcification scores of individual regions of both the laryngeal cartilages show a statistically significant positive correlation with chronological age (P 0.05). Regression models derived from the degree of calcification of thyroid and cricoid cartilages showed standard error of estimates that ranged between 9.90 and 11.07 years. Considering the standard error of estimates of the regression analysis, the present study concludes that these regression models can be used in adjunct with other methods of age estimation such as the skeletal and dental age or when such methods are not viable as in cases of charred or mutilated remains.

Cysts of the oral cavity are among the most commonly encountered biopsy specimen in histopathology. Shear categorized the cysts associated with maxillary antrum under four subheadings - mucocoele, retention cyst, pseudocyst, and postoperative maxillary cyst (PMC). PMC is also known as surgical ciliated cyst, postoperative paranasal cyst, or respiratory implantation cyst. Although it constitutes 20% of oral cysts in Japan, it is quite rare in the other parts of the world. Herewith, we report a case of a 65-year-old female who presented with the complaint of palatal swelling and having a history of maxillary sinus surgery 30 years ago.

Elongated styloid process or calcified stylo-hyoid ligament can exert pressure on vital structures of the neck and cause symptoms of Eagle syndrome. Although it is uncommon, both can cause death by compression of neurovascular structures. We report the case of an incidental finding of an elongated styloid process at autopsy, along with its clinical and medicolegal significance. The article attempts to review the literature in this regard and on variants of styloid process.

Radiolucent lesions of Temporomandibular Joint (TMJ) represent a diagnostic challenge and a treatment conundrum. Biopsy of the lesions is technically difficult owing to their complex anatomy. The Differential Diagnosis (DD) includes a wide array of lesions including Simple Bone Cyst, Ameloblastoma, Central Giant Cell Granuloma, Hemangioma, Osteoblastoma, Osteochondroma, Chondroblastoma, Chondrosarcoma, Neurofibroma and metastatic malignant lesions though none has a specific predilection for TMJ. Here we present a case report of a large expansile radiolucent lesion of right TMJ in a 22 year old male patient with difficulties involved in diagnosis and management. Though cystic lesion of TMJ is uncommon it is incumbent on the Maxillofacial Surgeon for an early diagnosis and prompt management.

The traditional Caldwell-Luc approach for maxillary diseases has been criticized for its shortcomings such as removal of a large amount of bone, numbness of the teeth, flap dehiscence, and recurrent sinusitis. On account of its minimal invasiveness and physiological approach, functional endoscopic sinus surgery (FESS) has come to replace the Caldwell-Luc approach for the treatment of chronic rhinosinusitis. Chronic maxillary sinusitis of dental origin (CMSDO) is a less common variant on the chronic rhinosinusitis spectrum whose treatment involves simultaneous management of both the diseased maxillary sinus and the dental source of infection. Thus, this study was undertaken to assess the efficacy of FESS when combined with an intra-oral approach for the treatment of CMSDO. Eighteen patients with CMSDO in the age group of 18–50 years were treated with a combined endoscopic and intra-oral approach (buccal advancement flap with/without buccal fat pad) in this study. The patients were followed up for a total duration of 18 months. The primary outcome measurements were the SNOT-22 Quality of Life questionnaire and the Lund and Mackay CT Scan Scoring Criteria. The Friedman test was used to assess improvement in the above variables and the level of significance was set at 0.05. There was a statistically significant reduction (p

Purpose The use of plates for open reduction and internal fixation of mandibular fractures has become a widely accepted method in the past 3 decades. However, the anterior mandible is well suited to lag screw fixation owing to the thickness of its bony cortices. Hence, the purpose of the present study was to comparatively evaluate clinical outcomes of fixation using lag screws and miniplates in anterior mandibular fractures. Patients and Methods Fifty patients reporting to the department of oral and maxillofacial surgery with noncomminuted anterior mandibular fractures were randomly divided into 2 groups of 25 patients each. Patients in group A were treated with 2.5-mm lag screws 22 to 26 mm in length and those in group B were treated with 2.0-mm 4-hole miniplates with a gap using monocortical screws. Subsequent follow-up was performed at 3, 6, 12, and 24 weeks postoperatively. The primary determinants included radiographic analysis of the fracture gap and biting efficiency of the patients in groups A and B. The secondary determinants included evaluation of duration of surgery, occlusion before and after injury, and postoperative complications. Results were evaluated using χ2 and unpaired t tests. Results The mean age of the patients in this study was 29.1 ± 8.32 years (range, 18 to 67 yr). The mean postoperative fracture gap was considerably larger in group B. The mean duration of surgery (minutes) was 37.60 ± 9.30 for group A and 47 ± 6.55 for group B. The difference was statistically significant (P = .001). The lag screw group showed faster improvement in biting efficiency compared with the miniplate group. Conclusions Lag screw fixation was found to have good stability and rigidity, was inexpensive, and was less time consuming in treating anterior mandibular fractures compared with miniplates.

Various surgical modalities have been used in the surgical management of oral submucous fibrosis with variable results. This prospective study evaluates the efficacy of nasolabial flap in the reconstruction of fibrotomy defect in surgical treatment of oral submucous fibrosis in terms of functional and esthetic outcomes. In this prospective study, we treated 20 patients of oral submucous fibrosis surgically. The surgical protocol was consisting of bilateral fibrotomy, temporal myotomy, and coronoidotomy or coronoidectomy followed by reconstruction of fibrotomy defect with bilateral extended nasolabial flaps. All patients were prescribed with nutritional supplements and antioxidants. Vigorous mouth opening exercise was made compulsory for every patient. Preoperative and postoperative evaluation was done for interincisal mouth opening, function of mastication, and cosmetic results. Patient’s regular follow-up was done for 2 years. Postoperatively, we noted excellent increase in the interincisal mouth opening relieving trismus. Patient’s ability to chew solid food was increased significantly. Extraoral scar was minimal and well accepted by all the patients. There was no morbidity of the donor site. There was no injury to the facial nerve in all cases. The only drawback was intraoral hair growth which went on reducing with mucosalization of the graft tissue. Random pattern nasolabial flap is a very good option for intraoral reconstruction of fibrotomy defect in surgical treatment of oral submucous fibrosis with excellent functional and cosmetic results with minimal complications.

Context: The platelet rich fibrin (PRF) is second generation platelet concentrate that has been widely used and researched for stimulation and acceleration of soft tissue and osseous healing. Its continuous delivery of growth factors and proteins mimic the need of physiological wound healing and regenerative tissue processes. Aims and Objectives: The aim of this study was to evaluate the efficacy of PRF in osseous regeneration after enucleation of cystic lesions. The objectives of this study were: (1) To evaluate osseous regeneration radiographically with the use of PRF in intrabony defects after cystic enucleation. (2) To evaluate the degree of bone density in intrabony defects with the use of PRF postoperatively after 1 st , 3 rd , and 6 th months. Subjects and Methods: 10 cases of cystic lesions were treated using PRF after cystic enucleation. Follow-up radiographs (orthopantomogram) were taken 1 st , 3 rd , and 6 th months postoperatively. Bone density was measured with grayscale histogram using Adobe Photoshop 7.0 software. Results: The subsequent follow-up examinations revealed progressive, predictable, and significant radiographic osseous regeneration. Conclusion: The use of PRF in management of cystic lesions seems to be a novel therapeutic approach promoting faster osseous regeneration within 6 months postoperatively however further study is required with larger sample size and with a control group.

Background: Marginal adaptability of restorative material is one of the prime factors for success of a restoration. Aim: To evaluate microleakage at enamel restoration and dentin restoration interface of Class V cavities restored with new alkasite restorative material Cention-N, with and without using bonding agent and flowable composite resin. Materials and Methods: Thirty Class V tooth preparations were divided into three groups (n = 10): Group-I restored with Cention-N (Ivoclar Vivadent) without adhesive, Group-II was restored with Cention-N after application of eighth-generation bonding agent (3M ESPE, Single Bond Universal Adhesive), and Group-III was restored with flowable composite resin (Tetric-N-Flow, Ivoclar Vivadent). All samples were subjected to 200 thermocycles between temperature baths at 5°C and 55°C. All samples were cut longitudinally through the center of the restorations with the help of isomet diamond saw. The sections were then observed under binocular stereomicroscope at 20×. Two evaluators scored the depth of dye penetration independently at enamel and dentin margins. Statistical Analysis: Kruskal–Wallis nonparametric analysis followed by Dunn's multiple comparison tests were done to evaluate differences among the experimental groups. Mann–Whitney test was used to compare the difference between occlusal and gingival scores within each restoration. Results: Microleakage seen in decreasing order: Cention-N without adhesive >Flowable composite >Cention-N with adhesive. Conclusion: Microleakage at enamel restoration interface was less than microleakage at dentin restoration interface of each group, but the difference was not statistically significant. Least microleakage was seen with Cention-N with adhesive followed by flowable composite. More microleakage was seen with Cention-N without adhesive.

Although third molar extraction is a routinely carried out procedure in a dental set-up, yet it is feared both by the patient and the dentist due to an invariable set of complications associated with it, especially in the form of nerve injuries. Hence, prior to performing such procedures, it would be wise if the clinician thoroughly evaluates the case for any anticipated complications so that adequate preventive measures can be taken to minimize the traumatic outcomes of the procedure and provide maximum patient care, which would further save the clinician from any sort of litigation.

To create opportunity for a preventive approach to the management of caries, it is important to keep abreast of developments in diagnostic systems. It is apparent that conventional methods for the detection of dental caries do not fulfill the criteria for an ideal caries detection method. These methods rely on subjective interpretation and are insensitive to early caries detection. To overcome these shortcomings, researchers are developing advanced techniques. These not only detect mineral loss but also quantify it.

Purpose To compare the healing potential of platelet-rich fibrin (PRF) and collagen membranes in oral mucosal healing. Materials and Methods Thirty patients with oral premalignant lesions were randomly included in the study and divided in groups A and B. After excising the lesions under local anesthesia, patients in groups A and B underwent grafting with the PRF membrane and the collagen membrane, respectively. Patients were evaluated at postoperative days 7, 15, 30, and 60 for pain, healing, and complications, such as recurrence, fibrosis, scar hypertrophy, and loss of vestibular depth. Results In group A, 66.66% of patients reported substantially less pain postoperatively at 15-day follow-up than those in group B. At 30-day follow-up, 86.66% of patients in group A reported no pain versus 60% in group B. Pain scores were similar at 7- and 60-day follow-ups. Healing was accelerated in group A at 15- and 30-day follow-ups, but was the same on day 60. Complications, such as fibrosis, loss of vestibular depth, and scar hypertrophy, were seen in group B. Recurrence was seen in 1 patient in group A at 60-day follow-up. Conclusion PRF proved superior to collagen membrane for grafting of oral mucosal surgical defects. However, further study with larger samples is required to prove its efficacy.

Endodontic therapy, today, forms an integral part of everyday dental practice. The large number of teeth being treated endodontically makes it imperative for the dentists to provide satisfactory restoration for those teeth to remain intact within the dental arch as an integral functioning component. So this study was carried out to check the reinforcement of composite with polyethylene fibers placed in two different technique in root filled mandibular molar teeth with mesio-occlusodistal tooth preparation. Fifty freshly extracted molars were divided into five groups of ten teeth each. Group I: Intact teeth (positive control). Group II: Unrestored MOD prepared tooth (negative control). Group III: MOD tooth preparation restored with posterior composite resin. Group IV: Ribbond fiber was placed over the composite resin restoration and exposed fiber was covered with composite resin. Group V: Ribbond fiber was placed on the floor of the tooth preparation and the remaining prepared tooth was restored with composite resin restoration. The samples were subjected to compressive loading on Hounsfield tensometer until failure. The data were recorded and subjected to statistical analysis. Group-IV showed significantly higher fracture resistance than Group-V.

Allergic responses to lignocaine (amide local anaesthesia) used in dentistry is extremely rare. It is widely used by Oral Maxillofacial surgeons to carry out various procedures safely, comfortably and efficiently. It is important for the practitioners to be aware that allergic reactions though very rare, can occur after injection of lignocaine intradermally for allergy testing. A proper diagnosis and management of such allergic reaction is very essential to avoid undesired consequences. We report a case of a 50-year-old male who suffered itching and generalized skin reaction within 5 minutes after administration of test dose of lignocaine intradermally for allergy testing. Clinical presentation, Diagnosis & management of such allergic reaction are discussed. As local anaesthetic agents are commonly used drugs in day to day practice clinicians are encouraged to be familiar with the presentation of various allergic reactions and there management.

The dislocation of the mandibular condyle / condyles occurs most commonly in an anterior direction due to trauma. This is a known fact as due to pull of lateral pterygoid muscle. On the contrary, posterior, superior, or lateral dislocations of the intact mandibular condyle occur rarely, and very few such cases have been reported in the English language literature. The rarity of these dislocations can be attributed to the varying anatomy of the condyle, the direction of pull of muscles attached to the condyle and low incidence of skull base fractures from an indirect blow. A case of bilateral supero-lateral dislocation of the condyle associated with a symphyseal fracture is presented. We discuss the dynamics, diagnostic features and clinical management of such dislocations with extensive review of literature.

The main aim of the study is to propose a treatment protocol based on scoring system.One hundred patients were selected randomly having oral submucous fibrosis. They were classified into five groups based on clinical signs and symptoms, radiological and histopathological grading and severity of fibrosis. Patients of particular group were subjected to specific treatment for each group and followed for 2 years regularly.We found that almost all patients got symptomatic relief and they are able to take regular diet. Patient's interincisal mouth opening increased significantly.Based on this scoring and grouping we can give definite and prompt treatment to the patients with satisfactory results. This proposed scoring and staging can play major role in controlling and treating this widespread global disease. Thus, OSMF scoring index is very effective to decide the severity of disease and progress.