Oral and Maxillofacial Surgery

The forehead flap is a commonly used technique to reconstruct the deep and large nasal
defects. It can be conveniently performed under local or general anesthesia and provides
a very good color and texture matching to the nasal skin, which makes it a suitable graft
harvesting site for nasal reconstruction. It has only single disadvantage disadvantagethat it is
a two-stage procedure and “finishing” surgeries are needed occasionally for best surgical and
cosmetic outcome. In this paper, we describe three different applications of forehead flaps

We describe a case of Parotid gland tuberculosis which is a rarely encountered clinical entity. The condition is often misdiagnosed as a neoplasm or other inflammatory diseases of salivary gland and leads to unnecessary surgery. The paper highlights the importance of considering this condition in the differential diagnosis especially in the countries where tuberculosis is endemic.

Metastasis of the liver and lung malignancies to the jaw bones is very rare and the mandible is the commonest site of involvement. The frequent primary sites for metastasis to jaw bones are breast in females and lungs in males. This is a case report of the metastatic adenocarcinoma of the mandible which originated from liver or lung. Diagnosis of such metastatic lesions is difficult and challenging to identify the primary site.

To compare the maximum voluntary bite force generated at different periods during mandibular fracture healing using miniplates and microplates as means of rigid internal fixation. Maximum voluntary bite force was recorded in healthy young individuals of different age group from either gender. Patients suffering from symphyseal and parasymphyseal and body fractures were selected and randomly treated using miniplate and microplate osteosynthesis by open reduction and rigid internal fixation. Postoperative bite forces at intervals of 1(st), 2(nd), 4(th), and 6(th) week were recorded and compared with control group. It was noticed that bite forces were significantly reduced in the study groups in comparison to control group and at different intervals of treatment. There was a progressive improvement in the bite force with passage of time. There was no statistical significance in the observed bite force in both the study groups at different intervals of assessment. 1.5 mm microplates pro...

Transverse facial clefts are rare deformities, these mostly occur as part of syndromes such as facial dysostosis and branchial arch syndrome. This is a report of a case of isolated, asyndromic bilateral facial cleft seen at a semi-urban specialist hospital. Congenital facial defects remain sources of mental and social stress to the families. Infanticide, perhaps a thing of the past in the developed world may still be practiced in cases of congenital deformities in the developing countries, hence the need for early involvement of social workers and clinical psychologist in management.

Objective: The purpose of this study is to compare the outcome of two surgical approaches i.e. 1.intraoral superior border and 2. transbuccal lateral cortical plating for the management of angle of mandible fracture. Methods: Cohort study conducted during December 2014 to December 2016. Total 20 patients were selected for this study. Patients were equally divided into transbuccal and transoral groups. SPSS Inc was used to compare the outcomes of the two surgical methods. Results: Two patients showed sign of infection in which both showed dehiscence of incision and exposure of miniplates in Superior border fixation group. No patient showed a sign of infection in group 2. More time required for superior border fixation (mean-63.9000 minutes) as compared to lateral border fixation (mean-53.100 minutes). Neurosensory disturbance and the postoperative scar were higher in the 2 nd group. Conclusion: Transbuccal fixation technique is a superior fixation technique as compared to transoral fixation approach for the treatment of mandibular angle fractures.

Conventional plain radiographs are the first line of investigation in maxillofacial trauma but bear limited advantages. CT is now a preferred diagnostic tool due to its accurate diagnosis. Many studies have been done regarding the efficacy of CT scan in the diagnosis and management of maxillofacial trauma but most of them have been performed in radiologist perspective. In this study we did a comparative study of conventional radiographs and 3D CT in the evaluation of maxillofacial trauma based solely on Oral and maxillofacial surgeon's perspective (i.e. How much an oral and maxillofacial surgeon finds radiographs / 3D CT valuable in the diagnosis and management of maxillofacial trauma patients). Forty five patients of either sex ranging 3 to 55 years (mean average age 27.1+_11.9 years) were included in this study and were advised conventional radiographs and non-contrast CT scan with 3D reconstruction. Cases with maxillofacial fracture were divided into three groups 1) Middle third face fracture, 2) Lower third face fracture and 3) Both middle third and lower third face fracture. In each group, the conventional radiographs and 3D CT were done and analyzed. The result of our study indicate that 3D CT is statistically more significant (Z= 8.8, p<0.001) in terms of fracture sites detection as compared to conventional radiographs. Further 3D CT is superior in displaying extent of fractures and comminution as well as for displacement and it provides additional conceptual information as compared to conventional radiographs in majority of patients having maxillofacial trauma.

In recent years, traumatic dental injuries (TDIs) have emerged as a public health concern. [1] The dental traumatology literature has abundant descriptions of the prevalence, etiology, and management of TDI in both the primary and the permanent dentition. [2] However, these injuries do not always occur in isolation, but are often associated with bodily injuries, panfacial traumas, and various "Combination Dental Traumas." Guidelines from the International Association of Dental Traumatology (IADT) have been considered as the best available evidence-and consensus-based protocol for the management of TDI [2-4] and have been updated to reflect newer scientific evidence. Further, mobile applications and clinical decision support tools (CDST), such as the Dental Trauma Guide, have increased worldwide awareness of appropriate protocols. [5] One of the shortcomings of most available protocols and CDST is their description of TDIs in isolation. For example, a sequential approach and management protocol are lacking for Combination Dental Trauma or Combination TDI (C-TDI). [1] The present case describes the interdisciplinary management of a C-TDI with intrusive luxation, avulsion, and crown fracture, along with a follow-up of 10 years. case repOrt A 14-year-old boy reported with a history of trauma to the face and maxillary anterior teeth. Injury had been sustained Combination dental trauma or combination traumatic dental injuries (C-TDIs) are often seen with unique presentations. Although most guidelines address the evidence-based management of such injuries in detail, a sequential protocol and classifications for C-TDI are lacking. In these scenarios, clinical details with imaging tools play an essential role by helping the clinician apply the elements of the TDI protocol in the correct sequence. However, most cases of C-TDI are attended by a general dentist, who often finds it difficult to make such clinical decisions, adversely affecting the prognosis. This article reports a case of a 14-year-old male patient with avulsion of 12, intrusion of 11, 21, and 13, and uncomplicated crown fracture of 11, 21, and 14, with a sequential interdisciplinary approach for the management and long-term follow-up of 10 years.

Many dental diseases are the result of developmental and maturation defects of teeth. Few of them are prenatal and postnatal calcification defects, developmental disturbances due to endocrine abnormalities, influence of dietary factors, mottled and hypoplastic enamel, caries, and loose teeth. Calcium is considered an important element for the proper development and maintenance of calcified dental tissues and the body; however, knowledge its role in the development and progression of periodontitis is very important. In this review, article general concepts of diet, nutrition, and relationship between calcium and periodontal disease have been discussed.

Original Research Article Aim of this study is to compare the outcome of various intraoral incisions in the management of isolated mandibular fracture using miniplates as means of rigid internal fixation and to analyze the advantages and disadvantages of one over the other. Its a prospective study and carried out in patients with well-defined inclusion and exclusion criteria. Patients suffering from symphyseal, parasymphyseal and body fractures were selected and randomly taken for crevicular incision (study group-1), crevicular incision with a vertical release (study group-2) and vestibular incision(control group) for open reduction and rigid internal fixation (ORIF). Operative time and postoperative complications including pain, infection, dehiscence, sensory disturbance and need of plate removal were recorded at intervals of 1st, 3rd and 7th day of surgery with 12 weeks of postoperative follow up and compared with the control group. It was noticed that postoperative pain was signi...

The crevicular incision is a very simple incision. It has many applications in various surgeries like flap surgery, apicoectomy, transalveolar extraction, bone biopsy and orthognathic surgery. In the management of fracture mandible, a routine vestibular incision is used. There are many complications associated with the vestibular incision like infection, wound dehiscence, mental nerve injury. These postoperative complications are rare with the crevicular incision. Like in other oral surgeries it can also be used as one of the approach to access fracture in the mandible. It not only provides wide surgical exposure but simultaneously it gives more visibility to both upper and lower limits of the fracture line. Since this incision crosses the sulcus of gingiva it can affect the health of gingival tissues. With this question, we planned this study to find out the outcome of the crevicular incision on periodontal health if used in open reduction & internal fixation. This study was done o...

 Management of large periapical cysts often require removal of overlying lateral cortical bone to gain access. We report a case in which huge periapical cyst was treated using a novel technique to preserve the overlying lateral cortical bone to facilitate faster healing of the defect. 

Aims and objectives: To perform comparative finite element analysis (FEA)for 2.0 mm standard miniplate and 1.5 mm microplate in isolated symphyseal mandibular fractures. Material and method: Two FE models of mandible were developed and symphyseal fracture was created in both of them. Each fractured model was reduced and fixed using two mini plates and two microplates, respectively according Champ's principle. Stresses thus developed in the plates after application of masticatory load were observed in the models. Results: Results of the study indicated there was no significant difference in the stresses developed in either of the bone plating system. Conclusion: 1.5 mm Microplates can be used in place of 2.0 mm miniplates in isolated symphyseal fractures of the mandible.

Aim The present study was planned to investigate the etiology of injuries and to analyze correlation between clinical and radiological findings in cases of craniomaxillofacial trauma. Study Design An 18 months cross-sectional study was done and 325 patients with maxillofacial fractures were analyzed from January 2013 to June 2014 who reported to the department of oral and maxillofacial surgery, Aligarh, Uttar Pradesh. Data was recorded in a preformed case sheet which included: patient's demographic data, cause of injury, type of injury, treatment plan. Results Out of the 325 patients, 74.4 % were males with a male: female ratio of 2.91:1. The 21-30 year age group was found to be maximum. Road traffic accidents accounted for 71.3 %, followed by fall from height (19 %) and assault (9.5 %). Most commonly involved vehicles were two wheelers followed by public transport. Mandibular fractures (65 %) were most prevalent, followed by zygomaticomaxillary complex (44.27 %), parietal bone (48 %) and orbital fractures (21.3 %). Thirty-seven fractures (7.14 %) were missed clinically which were confirmed later by radiographic technique. Maximum were in cranium region (57 %) followed by mandible (27 %), mid face region (16.21 %). Thirty-three fractures (6.37 %) were overestimated or suspected clinically which could not be confirmed by radiographic technique. Maximum were in mandible (48.5 %) followed by mid face (36.33 %) and cranium (15.15 %). Conclusion The idea behind this article is to analyze the various trends and affecting factors and correlation between clinical and radiological findings. A better understanding of the above said would help in future treatment planning and management of facial injuries.