Modified Osteotomy for TMJ Ankylosis in Paediatric Patients with Deficient Interpositional Temporalis Muscle Mass and Buccal Fat Pad - A case Series and Literature Review.

Ankylosis of the temporomandibular joint (TMJ) is a bony or fibrous fusion of the articular surfaces of the mandibular condyle and the glenoid fossa. Gap arthroplasty, Interpositional arthroplasty, Condyle reconstruction with autogenic or alloplastic grafts and total joint replacement are some common modalities of management. In this article, we discuss a series of three cases of unilateral TMJ ankylosis in paediatric patients, managed by gap arthroplasty using a modified osteotomy cut. The modification was adapted due to inadequate interpositionable temporalis muscle or buccal fat on the affected side and chances of adaptive remodelling of the CCG (Costochondral graft), if placed were rendered negative.

Conservative management of pediatric mandibular distal fractures-A retrospective study.

BACKGROUND/AIM: Pediatric mandibular distal fractures present unique treatment challenges which are usually managed with open reduction and internal fixation (ORIF) with the risk of developing tooth bud injuries. Conservative management through maxillomandibular fixation (MMF) with orthodontic bracket-elastic as an out-patient department (OPD) service has been used for these fractures presenting with derangement of occlusion. The aim of this study was to retrospectively analyze MMF with orthodontic bracket-elastic as a treatment method and its outcome for management of pediatric mandibular distal fractures. METHODOLOGY: Data of seventeen pediatric cases diagnosed with displaced mandibular distal fractures managed with MMF with orthodontic bracket-elastic over a period of 5 years were analyzed. In this technique, two weeks of immobilization and one week for guiding elastics were used. RESULTS: The mean age of patients was 7.6 ± 1.6 years with a mean follow-up of 24 months. All fractures healed uneventfully with satisfactory occlusion. The cases included 23.5% minimally displaced, and 64.7% moderately displaced and 11.8% significantly displaced fractures with step deformity with successful remodeling of the lower border contours over a duration of 18 months ± 1 month. The developing tooth buds in the fracture line showed no complications except for root dilacerations/malformation (n = 3). CONCLUSION: MMF with orthodontic bracket-elastic is a viable and conservative technique for the management of pediatric mandibular distal fractures which need to be verified through randomized trials for generalization of the results.

Time-Lapse Between Presentation and Treatment of Mandibular Fractures: Is There a Correlation With Sensory Loss Recovery or No Recovery?

ABSTRACT: A prospective cohort study composed of 43 patients treated for unilateral mandibular fracture. The primary study variables were the post-traumatic IAN neurosensory score and the score after fracture reduction in two different groups on the basis of time lapse between presentation and treatment and displacement of mandible fracture. Appropriate descriptive and bivariate statistics were computed. The sample was analyzed over a one year period. It was observed that the recovery percentage (80%) was good in Group-A (n = 20) patients as compared to Group-B (n = 23) patients (43.47%) with significant P value of 0.015. Patients with displacement of ≥9 mm have neurosensory deficit of 80% while fracture displacement ≥ 5 mm to 8 mm have the neurosensory deficit of 34.21% which is significant with P value of 0.049. With each millimeter increase of displacement of fracture segments, more neurosensory deficit will be manifested. Delay in seeking in the treatment increases the risk because of continued movement. Where the injury is more severe, excessive displacement with increased time lapse from injury to surgical intervention, there is a higher possibility neurosensory deficit or no recovery. Early management can reduce the risk of permanent neurosensory deficits.

Full-mouth rehabilitation with immediate loading basal implants: A case report.

The aim of this article was to study a case report of full mouth rehabilitation in a severally periodontally compromised patient in which 18 single piece basal implants were inserted and functionally loaded with both maxillary and mandibular cement retained fixed partial denture. Basal implants were loaded immediately, and excellent results were obtained. Bone loss was measured and values were recorded immediately after implant placement and after 6 months. Basal implants are used to support single and multiple unit restorations in the upper and lower jaws. They can be placed in the extraction sockets and also in the healed bone. Their structural characteristics allow placement in the bone that is deficient in height and width. Basal implants are the devices of the first choice, whenever (unpredictable) augmentations are part of an alternative treatment plan. The technique of basal implantology solves all problems connected with conventional (crestal) implantology.

A radiological evaluation of marginal bone around dental implants: An in-vivo study.

CONTEXT: This article presents an original research conducted at Government Dental College, PGIDS, Rohtak. AIMS: (1) To evaluate the marginal bone level changes around dental implants based on the radiological examination. (2) To evaluate the relationship of various parameters, i.e., gender, implant length, implant diameter and location of implants on the amount of bone loss around dental implants. MATERIALS AND METHODS: An in-vivo study was undertaken to evaluate the crestal bone loss on mesial and distal aspect of implants, using standardized intra-oral periapical at the end of 6 months after placing the implants, but before prosthetically loading it. STATISTICAL ANALYSIS USED: Student's unpaired t-test. RESULTS: Bone loss was measured and values were recorded immediately after implant placement and after 6 months. CONCLUSIONS: (1) Bone loss on mesial and distal aspects of implants was found to be same after period of 6 months. (2) Bone loss was found to be same in both 13 mm and 10 mm implants on mesial aspect, whereas on distal aspect, it was more in 10 mm implants. (3) Bone loss was found to be same in both 3.5 mm and 4.3 mm diameter implants on both mesial and distal aspects of implants. (4) Bone loss was found to be same in both maxilla and mandible on both mesial and distal aspects of implants. (5) Bone loss was found to be more in females on both mesial as well as distal aspects of implants.