Evaluation of Efficacy of Herbert Bone Screw and Lag Screw in Management of Oblique Mandibular Fractures: A Prospective Randomized Comparative Study.

Purpose: To assess the efficacy of Herbert cannulated bone screw versus Lag screw in fixation of oblique mandibular fractures. Materials and Method: Study composed of two groups of 20 patients each and descriptive statistics were performed with p value set at 0.05 with confidence interval of 95%. Group A was treated by Titanium Lag screws; while, Group B was treated by Titanium Herbert Cannulated Bone Screws for the management of oblique mandibular fractures. Postoperatively, all the patients were evaluated clinically and radiographically by recording the incidence of complications (if any) which included trismus, neurosensory deficit, swelling, infection. Parameters such as occlusal discrepancy, rigid fixation (interfragmentary gap) and duration of surgery were also recorded for all the patients. Results: All the patients were followed for a period of three months. Difference in mouth opening was found to be statistically significant during 1st month follow-up (p-Value-0.002). Postoperatively, the mean interfragmentary gap in Group A was significantly more than Group B (p-Value-0.000). Other parameters like neurosensory deficits, occlusal discrepancies, chewing efficiency, stability of fractured fragments and post-operative complications in terms of swelling, hardware exposure, radiolucency surrounding screw and wound dehiscence did not show any statistically significant difference. Conclusion: The obtained results showed that both lag screws and Herbert cannulated bone screws fulfill the treatment goals of adequate reduction, fixation and stabilization of oblique mandibular fractures. Herbert screws have shown to have better results in terms of interfragmentary gap reduction as compared to lag screws.

A Comparative Study of Platelet-Rich Fibrin and Platelet-Rich Fibrin with Hydroxyapatite to Promote Healing of Impacted Mandibular Third Molar Socket.

Aim: The purpose of this study was to compare the efficacy of platelet-rich fibrin (PRF) and platelet-rich fibrin (PRF) with hydroxyapatite (HA) on postoperative pain, swelling, soft tissue healing and osseous regeneration in mandibular third molar extraction socket in human patient. Materials and Methods: This prospective study included total 40 patients who reported to the Department of Oral and Maxillofacial Surgery (OMFS), Teerthanker Mahaveer Dental College and Research Centre (TMDC&RC), Moradabad (U.P.). Twenty patients each in both the groups of PRF and PRF with HA were included for the management of impacted mandibular 3rd molar extraction sockets and were evaluated for effectiveness. Evaluation was done on the basis of following parameters pain and swelling at time interval of 1st, 3rd, 7th day, soft tissue healing at time interval of 3rd, 7th, 14th day and osseous regeneration at time intervals of 1st, 3rd, 6th month postoperatively. Results: Pain and swelling were less in the PRF with HA group when compared to PRF group. Soft tissue healing was better in the PRF with HA group compared to the PRF group. The result of the study shows rapid bone regeneration in the extraction socket treated with the PRF with HA group when compared with the PRF group. Also there was less postoperative discomfort in the PRF with HA-treated group. Conclusion: PRF a mitogenic promoter together with a bone graft forms a scaffolding, promotes early healing thus being creating beneficial for the patient and is also economic.

Efficacy of hybrid implants in oral and maxillofacial surgery: A clinical prospective study.

AIM: The present study was aimed to evaluate the efficacy of hybrid implants in replacement of missing teeth in either jaw. MATERIALS AND METHODS: Twenty hybrid implants were placed in maxilla and mandible and the implants were assessed for pain,implant exposure, mobility, infection and wound dehiscence at first, third and sixth month postoperatively. RESULTS: According to our study the statistical data showed that all the parameters which were seen clinically were nonsignificant. CONCLUSION: Hybrid implants being a new option in this field, our study provides a platform for further research with larger sample size with longer follow ups to be judgemental on their efficacy.

Efficacy of two-point fixation in the management of zygomatic complex fractures - A prospective clinical study.

INTRODUCTION: Anatomic disfigurement caused by zygomatic fracture warrants intervention tore establish facial symmetry. It is most predictably restored to pre morbid condition by ORIF. AIM: To evaluate the efficacy of 2 point fixation in Zygomaticomaxillary complex fractures. MATERIAL AND METHOD: 20 patients with established ZMC fractures were operated using two point fixation method and followed up for upto 3 months. RESULTS: 2 point fixation revealed satisfactory functional and esthetic results. CONCLUSION: 2 point fixation offers efficient outcome as compared to other modalities of management of ZMC.

Non-traumatic Occulomotor Nerve Palsy: A Rare Case Report and Discussion on Etiopathogenesis.

The ghost of the past has emerged as the horror of today. The fear of weakness/loss of eyesight following extraction is a common thinking amongst the orthodox people of Indian subcontinent. Occulomotor nerve paralysis following dental extraction is a rare complication. Although these ophthalmic complications in routine practice are rare, some time they do occur and pose difficulty to explain. Occulomotor nerve palsy is amongst the rare reported cases of ocular complication. Here we report a case of spontaneous recovery of occulomotor nerve palsy in an elderly diabetic patient and brief discussion on its etiopathogenesis.

Postextraction bleeding following a fever: a case report.

Postoperative hemorrhage is one of the few serious complications that can occur as a result of dental procedures. We report a case of an elderly patient with postextraction bleeding caused by dengue hemorrhagic fever (DHF). Although a major sequel of DHF is bleeding secondary to thrombocytopenia, prolonged hemorrhage as a result of extraction of tooth has not been reported. In the current scenario of emerging and reemerging infections worldwide, dengue is gaining global prominence. This case documents the course and progression of this disease from a dental perspective and highlights the as yet unreported capacity of causing oral complications after dental treatment.

The post-auricular approach for gap arthroplasty - a clinical investigation.

Objective of this prospective study was to evaluate and compare posterior auricular approach for surgery of temporomandibular joint ankylosis with preauricular approach. These evaluations were done on the basis of certain parameters like incidences of facial nerve injury, time taken to expose ankylotic mass, haemorrhage and quality of exposure of joint and surrounding structures. This study was conducted among 15 patients of temporomandibular joint ankylosis. A total number of 30 joints were operated. These joints were divided in two groups i.e. Group A - preauricular group, Group B - postauricular group. Fifteen joints were operated in each group. Age of patients was in range of 4-65 years. All the patients were operated under general anesthesia. Preoperative, intraoperative and postoperative evaluations were done according to parameters. Patients were recalled up to 3 months for observations. Results have shown that in postauricular group incidences of facial nerve injury was significantly less, more time was taken to expose the ankylotic mass, incidences of haemorrhage was more and exposure of structures anterior to joint was difficult. Whereas preauricular approach is less time consuming, incidence of facial nerve damage is higher, exposure of structures anterior to joint is good and intraoperative incidences of haemorrhage is less.

Application of osteomucoperiosteal flap in large unicystic ameloblastoma to promote early bone healing: An alternative to primary bone grafting.

BACKGROUND: The unicystic variety of ameloblastoma is reported to be significantly less prone to recurrence in young patients than its conventional counterpart, and therefore can be treated conservatively. This paper describes a technique of using an osteoperiosteal flap to allow complete enucleation of a unicystic ameloblastoma. The technique maintains the continuity of the mandible and restores full thickness as well as strength of the mandible to promote early healing. It also maintains blood supply and proper facial contour so that esthetics is unimpaired. MATERIALS AND METHODS: We describe two cases of unicystic ameloblastoma in which we used an osteoperiosteal flap. This flap was then infractured at the lower border to obliterate the dead space. RESULTS: The sequential radiographs demonstrate early incorporation of the graft and complete filling of the defect by 3 months. At 5 years of follow-up in our first case, complete healing of bone was observed. CONCLUSIONS: We believe that these procedures can be the treatment of choice in such cases, especially with larger lesions, as these rapidly restore the patient's facial contour to normal as well as reduce the healing time.

Dental management in autosomal recessive (intermediate) osteopetrosis: a case report.

Osteopetrosis (Albers-Schonberg disease) is the name given to a group of diseases that affect the growth and remodeling of bones. It is characterized by overgrowth and sclerosis of bone, resulting in thickening and narrowing of the marrow cavities throughout the skeleton. The exact cause is unknown, although failure of bone resorption related to defective osteoclasts is considered to be the basis of the problem. These patients present a significant challenge to the dentist for management of jaw and dental problems, as the disease process demands special strategies which are often at variance with conventional dentistry. The purpose of this paper was to report the management and follow-up of a child with intermediate autosomal recessive osteopetrosis who primarily complained of dental problems.