Patient-Specific Implants in Maxillofacial Reconstruction - A Case Report.

Rationale: The successful utilisation of three dimensional (3D) techniques in engineering a titanium patient specific implant (PSI) for a patient who underwent hemimaxillectomy following post COVID mucormycosis infection. Patient Concerns: Issues related to problems associated with resection following mucormycosis, such as occlusal function, aesthetics and facial asymmetry. Diagnosis: The patient affected by mucormycosis was left with Aramany class 1 and Cordeiro type II sub total maxillectomy defect. Treatment: The patient was operated for mucormycosis followed by reconstruction with patient specific implant. Outcome: Positive clinical outcomes, including improved facial symmetry, function and psychological well being with immediate replacement of the teeth, the benefits of which far outweigh the traditional approach. Take away Lessons: The advances in the use of PSI by integration of 3D printing and computer aided design computer aided manufacturing (CAD-CAM) technology for extensive and challenging defects in the maxillofacial region have been highlighted in this case report.

Age estimation in Indian adults by the coronal pulp cavity index.

BACKGROUND: Age estimation from tooth coronal index (TCI) using intraoral periapical radiographs by paralleling technique based on a reduction in the size of the dental pulp cavity with advancing age as a result of secondary dentin deposition. AIM AND OBJECTIVES: The aim of this study is to estimate age for Indian adults using radiographs of mandibular first molar and second premolar teeth using coronal pulp cavity index. MATERIALS AND METHODS: The study material consists of 400 intraoral periapical radiographs of mandibular second premolar and mandibular first molar from enrolled participants of either gender in the age group of 20-60 years. STATISTICAL ANALYSIS: Data analysis was done using SPSS (Statistical Package for Social Sciences), and Pearson's correlation coefficient (r) was used to find the correlation between age (years) and TCI. RESULTS: TCI was computed for each tooth and regressed on the real age of the sample. The correlation coefficient "r" was -0.865 (for premolar combined sample) and -0.850 (for molar combined sample). The obtained equations were tested on test sample of fifty teeth and age was determined. The absolute mean error between actual and predicted age for premolars was 6.72 months and for molars, it was 9 months. CONCLUSION: Age estimation using TCI is a precise, noninvasive, less time-consuming, and an inexpensive method.

Necrotizing sialometaplasia: A diagnostic dilemma!

Necrotizing sialometaplasia (NS) is a benign, self-limiting inflammatory reaction of salivary gland tissue which may mimic squamous cell carcinoma or mucoepidermoid carcinoma, both clinically and histologically, that creates diagnostic dilemma leading to unwarranted aggressive surgery. Most commonly affected site is the minor salivary glands of the palate. The pathogenesis is unknown but is believed to be due to ischemia of vasculature supplying the salivary gland lobules. A simple incisional biopsy is required to confirm the histological diagnosis and to rule out more serious disease processes. It is a self-limiting disease process and requires no treatment. It will be prudent to do repeat biopsy in case if the lesion does not heal within 3 months.