Oral and Maxillofacial Surgeon's Perspective on Gorlin-Goltz Syndrome - A Report of Two Cases.

Rationale: Gorlin-Goltz syndrome (GGS) is an autosomal dominant disorder and is associated with multisystem involvement, multiple cysts, neoplasms and other developmental anomalies. The purpose of the study was to highlight the incidental findings of GGS and to lay emphasis on its early diagnosis. Patient Concerns: Two patients complaining of pain, swelling and at times pus discharge from the oral cavity were reported with a coincidental finding of odontogenic keratocysts and positive family history. Diagnosis: Upon thorough examination, a diagnosis of GGS was made. Treatment: The patients were managed by enucleation and chemical cauterisation using Carnoy's solution and were maintained on follow-up semi-annually. Outcomes: Both patients showed no signs of recurrence post six months follow-up. Lessons: The role of an oral and maxillofacial surgeon is of utmost importance in the early diagnosis of this syndrome to render good quality of life to these patients.

Combined endoscopic and intra-oral approach for chronic maxillary sinusitis of dental origin-a prospective clinical study.

AIMS AND OBJECTIVES: 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. MATERIAL AND METHODS: 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. OBSERVATIONS AND RESULTS: There was a statistically significant reduction (p < 0.05) in both the above parameters at all post-operative intervals. Two patients presented with epistaxis (immediate post-operative phase) and synechiae (second week follow-up interval). Both complications were successfully resolved. Two patients showed recurrence at the 6th-month interval for which they underwent revision surgery successfully. Overall, results were maintained even at the 18th month follow-up interval. CONCLUSION: The endoscopic approach appears to be a reliable, minimally invasive technique associated with less morbidity and stable long-term results. Thus, a multi-disciplinary approach between maxillofacial surgeons and otolaryngologists is essential in the treatment of CMSDO.

High Palatoglossal Arch: A New Indication for Pre-prosthetic Surgery.

Pre-prosthetic surgery helps to overcome the challenge of prosthetic rehabilitation of the patient including restoration of the best masticatory function possible, combined with restoration or improvement of dental and facial esthetics. Maxillary denture prosthesis fabrication should include thorough examination of the soft palate and palatoglossal arch anatomy. This case report emphasizes on high palatoglossal arch as a rare and new cause of loss of posterior palatal seal and thereby retention of maxillary denture with rational, treated by pre-prosthetic surgery, ever reported in literature.

Morphology of Mandibular Incisors: A Study on CBCT.

BACKGROUND: The aim of the study was to identify the number of root canals and examine root canal morphology of permanent mandibular incisors in an Indian sub-population of Pune, Maharashtra, India using cone-beam computed tomography (CBCT). MATERIAL/METHODS: This study was conducted at Elite CBCT & Dental Diagnostics, Pune. One hundred mandibular incisors were evaluated for the number of root, root canals and root morphology. RESULTS: In the present study, amongst 102 mandibular incisors, all had one root, 36% of them had a second canal, and Vertucci Type I was the most common type. CONCLUSIONS: CBCT imaging is an excellent method for detection of different canal configurations of mandibular incisors.

Prevalence of mandibular fractures reported at C.S.M.S.S Dental College, aurangabad from february 2008 to september 2009.

AIM: The aim of this study is to determine the etiology, frequency of mandibular fractures among different age and sex, to determine the frequency of anatomic distribution, and to report the different modalities of treatment provided to the patients reported at our institution from February 2008 to September 2009. MATERIALS AND METHODS: All patients fulfilling the selection criteria and having mandible fracture were selected for the study. Patient information was collected by means of a medical data form specifically designed for the present study. The values were subjected to Z and Chi-square tests. RESULTS: Out of 35 patients, thirty one were males (88.57%) and four were females (11.43%) with a male:female ratio of 8:1. We found a peak occurrence in young adults, aged 21-30 years (n = 15, 42.86%). In case of etiology of fracture, road traffic accidents (RTAs) was the most common (n = 25, 71.43%) and condyle was most frequently involved site (n = 19, 38.78%). In most (n = 16, 45.71%) of the patients, an open reduction and rigid internal fixation using bone plate and screws was done. CONCLUSION: In the present study, the prevalence of mandible fractures was more prevalent in male patients, especially during the 3(rd) decade of life. The most common cause was road traffic accident and the more frequently affected region was condyle of the mandible. Open reduction and rigid internal fixation using miniplates and screws was the most commonly used treatment.