Evaluation of polycaprolactone scaffold for guided bone regeneration in maxillary and mandibular defects: A clinical study.

OBJECTIVE: This study was carried out to assess bone regeneration following the use of polycaprolactone (PCL) scaffold in maxillary and mandibular osseous defects. MATERIALS AND METHODS: This prospective study included ten patients with maxillary or mandibular osseous defects present due to enucleation of periapical cysts or alveolar clefts requiring bone grafting and for lateral ridge augmentation that were treated with PCL scaffold. The patients were assessed clinically for pain, swelling, infection, and graft exposure at 1 week, 3rd, and 5th month postoperatively and were also evaluated radiographically for bone fill using intraoral periapical and/or panoramic radiographs at 4th, 6th, and 9th month postoperatively. RESULTS: PCL scaffold was used in a total of six alveolar clefts and three cases of periapical cysts and one case of lateral ridge augmentation. Nine out of ten cases demonstrated wound dehiscence and scaffold exposure in the oral cavity. Radiographically, on comparison to the control regions, all these nine cases failed to demonstrate appreciable bone density gain. Only one case of radicular cyst in the mandible was recorded to have satisfactory healing. CONCLUSION: Although PCL scaffold has the potential for bone regeneration in osseous defects, the scaffold exhibited marked tendency for dehiscence in intraoral defects that significantly affected bone healing. A long-term study designed with a larger sample size and categorization of the defects is required to assess its efficacy in varied defects. Moreover, comparative evaluation of PCL and autogenous or alloplastic bone grafting material could provide assenting results.

Ameloblastic fibroma in a young adult.

Ameloblastic fibroma is a rare mixed odontogenic tumor of the jaw comprising 2.5% of all odontogenic tumors. It is most commonly seen in young adults as a gradually increasing swelling in the jaw. Treatment considered is meticulous enucleation and curettage of surrounding bone. This study presents a case of ameloblastic fibroma in a 15-year-old female patient with a swelling on the right side of the mandible which was managed by enucleation and curettage.

Superolateral dislocation of the intact mandibular condyle: report of a rare case with a review.

Dislocation of the temporomandibular joint, which represents 3% of all dislocated joints reported in the body, occurs when the mandibular condyle is displaced anteriorly beyond the articular eminence. Although anterior dislocation of the mandibular condyle is well documented in the literature, superior, lateral, and posterior dislocation of the condyle is rare. Only a few reports documenting superolateral dislocation with anterior mandible fractures have been published in the past. However such dislocations without any associated fractures are even rarer. This report documents a case of superolateral dislocation of an intact mandible in a 48-year-old woman following a traumatic incident. This paper also reviews previously documented case reports and focuses on the causative mechanism, dynamics, and management of such dislocations.

Congenital epulis of the newborn.

Congenital epulis, a benign tumor of the oral cavity, is an extremely rare condition in newborn. It may lead to mechanical obstruction, therefore resulting in respiratory distress and difficulty in feeding. Addressing the problem may need a multidisciplinary team approach at the time of birth. Antenatal ultrasonography and perinatal magnetic resonance imaging are an adjunct to treatment planning. Prenatal diagnosis remains difficult as the findings are nonspecific due to the late development of the tumor. Surgical excision is, therefore, the treatment of choice. Our report discusses this condition and the treatment thereafter on a newborn, with an epulis originating from the upper alveolar ridge discovered at birth. Histological examination confirmed the diagnosis of large polygonal granular cells. The mass was excised under general anesthesia, and the outcome was good after surgery allowing regular feeds on the second postoperative day.