Central granular cell odontogenic tumor of mandible in a child.

Central granular cell odontogenic tumor (CGCOT) is sporadic benign odontogenic tumor and it especially occurs in women older than 50 years of age. Radiologically it manifests as unilocular to the multilocular radiolucency with sometimes mixed densities. Histopathology displays sheets and islands of large eosinophilic cells with abundant granular cytoplasm, however few cases exhibit inadequate epithelium, thus creating a diagnostic confusion. Though, resection is advocated by some surgeons, however because of the non-aggressive biological behaviour, enucleation or curettage is the treatment of choice for this lesion. Till now only 39 cases have been reported in the past six decades. We are reporting the first case of CGCOT occurring in the youngest age of eleven-year-old patient with massive size of 11 × 7 × 6 cm. This would add CGCOT as a differential diagnosis in the bony lesions of younger individuals. In addition, the importance of immunohistochemistry studies in cases with scarce odontogenic epithelium and the potential role of Carnoy's solution in the management of this rare tumor in this age group was emphasized.

Does the Surgical Intervention for Trigeminal Neuralgia Refractory to Pharmacotherapy Improve Quality-of-Life? - A Systematic Review.

PURPOSE: Trigeminal neuralgia (TN) refractory to pharmacotherapy requires surgical interventions which vary from percutaneous procedure to microvascular decompression (MVD). The aim of the systematic review is to find evidence for the surgical treatment for TN with high success rate and low complications which improves the quality-of-life (QOL). METHODS: A systematic literature search was made on published studies from MEDLINE, SCOPUS, Science Direct, and Cochrane Library databases that report the available surgical treatment for TN up to March 2020 and studies referred in the selected papers. Relevant studies were selected based on predefined eligibility criteria. The primary outcome measured was success rate, pain relief and secondary outcome measured was QOL, recurrence and complication rate. RESULTS: Ten studies with a sum of 11,154 individuals were included in this qualitative analysis. Seven studies compared MVD whereas 4 studies compared Gamma knife radiosurgery with other techniques like percutaneous balloon compression, percutaneous glycerol rhizotomy etc. The result showed that MVD has a considerable higher rate of initial pain-free outcomes (96.6%) followed by Gamma knife radiosurgery (96.2%), cryotherapy (95.4%), percutaneous balloon compression (87%), percutaneous glycerol rhizotomy (85%) and the lowest rate of cohorts who were never pain-free (1.7%).QOL was improved to 100% as a result of pain relief which was evaluated in only 2 studies . Overall the recurrence rate was 0.45 to 52%. MVD has lower rate of long-term recurrence 0.45 and 6.1% for 2 years and 8 years, respectively, and cryotherapy has the highest rate of 52% at 6 months. CONCLUSION: Outcomes of the literature search showed that it lacks the knowledge to generally support 1 or the other treatment. Each type of TN requires individualized protocols to treat based on pain response which ultimately improve the QOL. We also propose there should be more reliable data reporting by using a universally acceptable pain scale for better analysis of treatment outcome.

Effect of Preoperative Intramuscular Injection of Botulinum Toxin A on Pain and Mouth Opening After Surgical Intervention in Temporomandibular Joint Ankylosis Cases: A Controlled Clinical Trial.

PURPOSE: The aim of the present study was to determine the effect of intramuscular injection of botulinum toxin A (BTX-A) into the masticatory muscles on the physiotherapy pain and mouth opening outcomes after surgical intervention of temporomandibular joint (TMJ) ankylosis and to verify the effects using electromyographic studies. PATIENTS AND METHODS: The study included 20 patients with TMJ ankylosis. The patients were further subdivided into control and interventional groups. The interventional group was given intramuscular injections of BTX-A in the masticator muscles before surgery. Only saline injections were given to the control group. All 20 patients were evaluated for pain and ease of active physiotherapy at the 1-week and 1-, 3-, and 6-month follow-up visits using a questionnaire. Intergroup comparisons were performed for both groups. Electromyographic (EMG) studies were also performed in the intervention group for each patient. EMG recordings were performed of the individual masticator muscle in each patient before injection and at 1 and 3 months after injection. RESULTS: The intervention group showed better results with respect to pain during the mouth opening exercises and improvements in mouth opening. All the interventional group patients showed a transient decrease in the microvolt value on the EMG studies of their masticator muscles on injection of BTX-A. CONCLUSIONS: BTX-A injection can be a straightforward and useful adjunct to surgical treatment of TMJ ankylosis for the reduction of pain during postoperative physiotherapy.

Graphitic carbon coupled poly(anthraquinone) for proton shuttle flow-in-a-cell application.

Coupled electron and proton transport are an integral part of non-gassing electro-osmotic pumps (EOP). The kinetics of the electrode limits the kinetics of the electron transfer and hence the flow. This is observed in the present study with newly synthesized graphitic carbon covalently coupled to poly(anthraquinone) (PAQ). When EOP with identical electrodes were assembled, proton shuttle maintained the reversible flow, which was linearly dependent on the ks values. A Laviron plot was used to calculate the electron-transfer rate constant ks and transfer coefficient α, and their linear dependency on content of graphitic carbon was observed. The best ks value obtained was 0.67 s-1 for 15PAQ. The sandwich-type flow-in-a-cell showed the best result of ∼40 µL min-1 cm-1 V-1 electro-osmotic flux for 15PAQ. It reveals that a balanced combination of graphitic carbon and PAQ is the prime requirement for high-performance electrode materials to be used in microfluidic devices and energy applications.

Fate of the Coronoid Process After Coronoidotomy and Its Effect on the Interincisal Opening: A Clinical and Radiologic Assessment.

PURPOSE: Coronoidotomy (surgical detachment of the coronoid process from the mandibular ramus) is used to treat several conditions, including coronoid hyperplasia and temporomandibular joint (TMJ) ankylosis. The stability of the outcome, however, is considered questionable because of the risk of reattachment of the coronoid process. This study aims to radiographically and clinically evaluate the long-term anatomic and physiological outcome after coronoidotomy. MATERIALS AND METHODS: In 17 patients with unilateral TMJ ankylosis, 25 coronoidotomies were performed as an additional maneuver to relieve trismus after ankylosis release. Radiologic evaluation was performed immediately and 1 year postoperatively with panoramic radiography and computed tomography to assess changes at the coronoidotomy site. Clinical assessment included measurement of the interincisal distance at the 1-, 3-, 6-, and 12-month postoperative visits. RESULTS: A sharp osteotomy margin with a 3- to 10-mm gap between the ramus and coronoid process was observed immediately postoperatively in all cases. After 1 year, 23 cases (92%) showed partial (n = 5) or complete (n = 18) osseous union to the mandibular ramus, whereas in 2 cases, no evidence of fusion was observed radiographically. The mean interincisal opening achieved at 1 year was 33 mm. CONCLUSIONS: Coronoidotomy is an effective but more straightforward adjunct to arthroplasty than coronoidectomy (surgical excision of the coronoid process) in the management of TMJ ankylosis, with achievement and maintenance of adequate postoperative mouth opening.

A rare case of bilateral pseudoaneurysm secondary to mandibular condyle fracture-a case report with review of literature.

This paper aims to present a rare case report of bilateral pseudoaneurysm secondary to condylar fracture and its management with a brief review of literature. A patient of age 19 years with alleged history of road traffic accident presented 6 weeks lately to our department with slow growing swelling in right preauricular area. History revealed bilateral condylar fracture with right parasymphysis fracture of mandible for which patient underwent maxillomandibular fixation for 4 weeks. The diffuse swelling in preauricular region showed positive signs of pulsation and audible bruit. Ultrasonography and contrast-enhanced computed tomography suggested the bilateral presence of vascular anamoly from the terminal branches of external carotid artery. Diagnostic angiography confirmed presence of pseudoaneurysm at the bifurcation of the internal maxillary artery and superficial temporal artery (STA) on right side whereas on the left side it was at proximal STA. Bilateral endovascular coil and gel foam embolization was done and thrombosis was confirmed with high frequency ultrasound on fourth postintervention day. The swelling completely resolved in a period of 1 month with no evidence of recurrence in the following 2-year follow-up period. Routine investigation revealed presence of pseudoaneurysm on left side which was completely without any clinical signs as repoterd by many cases of condylar fracture in the literature review. Pseudoaneurysm may remain silent and are exposed intraoperatively with massive bleeding which causes significant morbidity. Hence, prompt diagnosis and management is essential to avoid unexpected complication perioperatively.

Total Alloplastic Temporomandibular Joint Replacement.

PURPOSE: End-stage temporomandibular joint (TMJ) disease are not uncommon and affects quality of life. Multiple surgical procedures have been mentioned in literature for management of TMJ disease which ranges from conservative management to aggressive resection of involved joint and replacement with alloplastic total joint prosthesis. The purpose of the present paper was to provide an overview of the role of alloplastic total joint prosthesis in TMJ replacement. METHODS AND RESULTS: Alloplastic total joint prosthesis is nowadays considered as a standard of care in the adult patients who require TMJ replacement. The requirement of alloplastic total prosthesis has increased in present era with the improvement in design and material of implants, surgical skills and reported victorious outcome along with improved quality of life after its use. It provides restoration of form and functions, improvement in quality of life, reduction in pain and maintenance of ramal height. Additionally, in TMJ ankylosis it reduces chances of re-ankylosis and allows facial asymmetry correction. Currently, enough evidence is however not available for replacement in skeletally immature patient. CONCLUSION: The authors conclude that the total joint replacement is a standard procedure for end-stage TMJ disease. Every maxillofacial surgeon should be well-acquainted with TMJ replacement.

Effect of botulinum toxin-A on pain and mouth opening following surgical intervention in oral submucous fibrosis - A controlled clinical trial.

The purpose of this trial was to study the effect on pain and mouth opening of intramuscular injection of botulinum toxin-A into masticatory muscles following surgical intervention in oral submucous fibrosis (OSMF) cases. Injections of either botulinum toxin A (BTX-A) (study group) or normal saline (control group) were given 2 weeks prior to surgical intervention in OSMF patients, into the bilateral masseter and temporalis muscles. All patients were evaluated for pain and ease of active physiotherapy at 1 week and 1, 3, and 6 months after surgery using a numerical rating scale and appropriate questionnaires, with comparisons made between the study and control group patients. Electromyographic studies of the masticator muscles were also carried out in all patients before injection, and at 1 month and 6 months after injection. 20 OSMF patients were equally divided into study and control groups (n = 10 each). At 1, 3, and 6 months after surgery, the study group patients showed significantly greater decreases in pain (p-values of 0.007, 0.001, and 0.005, respectively) and greater ease in physiotherapy compared with the control group. EMG recordings of masticator muscles showed a transient drop in microvolt value in the study group 1 month after injection, unlike the control group recordings. It was concluded that preoperative BTX-A injection was a good addition to surgical therapy in the patient group.

Development of Nickel-Based Negative Tone Metal Oxide Cluster Resists for Sub-10 nm Electron Beam and Helium Ion Beam Lithography.

Hybrid metal-organic cluster resist materials, also termed as organo-inorganics, demonstrate their potential for use in next-generation lithography owing to their ability for patterning down to ∼10 nm or below. High-resolution resist patterning is integrally associated with the compatibility of the resist and irradiation of the exposure source. Helium ion beam lithography (HIBL) is an emerging approach for the realization of sub-10 nm patterns at considerably lower line edge/width roughness (LER/LWR) and higher sensitivity as compared to electron beam lithography (EBL). Here, for the first time, a negative tone resist incorporating nickel (Ni)-based metal-organic clusters (Ni-MOCs) was synthesized and patterned using HIBL and EBL at 30 keV. This resist comprises a nickel-based metal building unit covalently linked with the organic ligand: m-toluic acid (C8H8O2). Dynamic light scattering confirmed a narrow size distribution of ∼2 nm for metal-organic cluster (MOC) formulations. High-resolution ∼9 nm HIBL line patterns were well developed at a sensitivity of 22 µC/cm2 and at a significantly low LER and LWR of 1.81 ± 0.06 and 2.90 ± 0.06 nm, respectively. Analogous high-resolution patterns were also observed in EBL with a sensitivity of 473 µC/cm2. Hence, the Ni-MOC-based resist investigated using HIBL and EBL elucidates the ability of its potential for the sub-10 nm technology node, under standard processing conditions.

Investigation of K-ion storage performances in a bismuth sulfide-carbon nanotube composite anode.

Herein, we synthesize a nanostructured bismuth sulfide/carbon nanotube composite and demonstrate its potential use as a high-capacity anode for K-ion batteries, for the first time. The composite anode shows reversible K-ion storage capabilities that are supported by density functional theory calculations.

Pleomorphic adenoma: a rare presentation in buccal salivary gland with extensive squamous and mucous metaplasia.

Pleomorphic Adenoma (PA) is the most common salivary gland tumor and accounts for about 60% of all salivary gland neoplasms. Intraorally, the hard palate is the most common presenting site (50-60%) followed by upper lip (15-20%) and rarely buccal mucosa (8-10%). Histopathologically, PA shows diverse morphology resulting from amalgamation of cellular and stromal components. The PA may show changes in the stromal and epithelial components, such as sebaceous, lipocytic and oncocytic metaplasia. A rare characteristic of PA is to show extensive squamous and mucous differentiation which poses diagnostic dilemma to the pathologist. Here, we present an unusual case of PA of buccal minor salivary gland with squamous and mucous metaplasia. The localization, gender and microscopic features of the presented case are unusual.

Nongassing long-lasting electro-osmotic pump with polyaniline-wrapped aminated graphene electrodes.

An efficient nongassing electro-osmotic pump (EOP) with long-lasting electrodes and exceptionally stable operation is developed by using novel flow-through polyaniline (PANI)-wrapped aminated graphene (NH2-G) electrodes. The NH2-G/PANI electrode combines the excellent oxidation/reduction capacity of PANI with the exceptional conductivity and inertness of NH2-G. The flow rate varies linearly with voltage but is highly dependent on the electrode composition. The flow rates at a potential of 5 V for pristine NH2-G and PANI electrodes are 71 and 100 µL min(-1) cm(-2), respectively, which increase substantially by the use of NH2-G/PANI electrode. It increased from 125 to 182 µL min(-1) cm(-2) as the fraction of aniline increased from 66.63 to 90.90%. The maximum flux obtained is 40 µL min(-1) V(-1) cm(-2) with NH2-G/PANI-90.9 electrodes. The assembled EOP remained exceptionally stable until the electrode columbic capacity was fully utilized. The prototype shown here delivered 8.0 µL/min at a constant applied voltage of 2 V for over 7 h of continuous operation. The best EOP produces a maximum stall pressure of 3.5 kPa at 3 V. These characteristics make it suitable for a variety of microfluidic/device applications.

Tuning of structural, optical, and magnetic properties of ultrathin and thin ZnO nanowire arrays for nano device applications.

One-dimensional (1-D) ultrathin (15 nm) and thin (100 nm) aligned 1-D (0001) and (0001¯) oriented zinc oxide (ZnO) nanowire (NW) arrays were fabricated on copper substrates by one-step electrochemical deposition inside the pores of polycarbonate membranes. The aspect ratio dependence of the compressive stress because of the lattice mismatch between NW array/substrate interface and crystallite size variations is investigated. X-ray diffraction results show that the polycrystalline ZnO NWs have a wurtzite structure with a = 3.24 Å, c = 5.20 Å, and [002] elongation. HRTEM and SAED pattern confirmed the polycrystalline nature of ultrathin ZnO NWs and lattice spacing of 0.58 nm. The crystallite size and compressive stress in as-grown 15- and 100-nm wires are 12.8 nm and 0.2248 GPa and 22.8 nm and 0.1359 GPa, which changed to 16.1 nm and 1.0307 GPa and 47.5 nm and 1.1677 GPa after annealing at 873 K in ultrahigh vacuum (UHV), respectively. Micro-Raman spectroscopy showed that the increase in E2 (high) phonon frequency corresponds to much higher compressive stresses in ultrathin NW arrays. The minimum-maximum magnetization magnitude for the as-grown ultrathin and thin NW arrays are approximately 8.45 × 10-3 to 8.10 × 10-3 emu/g and approximately 2.22 × 10-7 to 2.190 × 10-7 emu/g, respectively. The magnetization in 15-nm NW arrays is about 4 orders of magnitude higher than that in the 100 nm arrays but can be reduced greatly by the UHV annealing. The origin of ultrathin and thin NW array ferromagnetism may be the exchange interactions between localized electron spin moments resulting from oxygen vacancies at the surfaces of ZnO NWs. The n-type conductivity of 15-nm NW array is higher by about a factor of 2 compared to that of the 100-nm ZnO NWs, and both can be greatly enhanced by UHV annealing. The ability to tune the stresses and the structural and relative occupancies of ZnO NWs in a wide range by annealing has important implications for the design of advanced photonic, electronic, and magneto-optic nano devices.