Efficacy of Arthrocentesis with and Without Sodium Hyaluronate Injection for Temporomandibular Joint Disorders: A Comparative Study.

Aim: To evaluate the efficacy of arthrocentesis with and without sodium hyaluronate injection for internal derangement of temporomandibular joint. Materials and Methods: Patients with clinically and radiographically confirmed cases of temporomandibular joint disorders were enrolled for this study. 20 patients were randomly allocated into two groups for arthrocentesis of TMJ with 10 patients in each group. In group 1, patients were treated with TMJ arthrocentesis followed by sodium hyaluronate injection, and in group 2, patients were treated with arthrocentesis alone. All the patients were treated under local anaesthesia. The patients were followed up at 1st week, 2nd week, 4th week and 12th week post operatively for maximum mouth opening, lateral mandibular movements, pain at rest and on mastication and the subjective efficacy of the treatment. Results: By the end of twelfth week follow up, the mean mouth opening showed significant improvement in group 1, the right and left lateral movements showed better results in group 1 than in group 2, pain at rest and pain on mastication were mild in both the groups with subjective efficacy good in group 1 and moderate in group 2. Conclusion: This study suggested that TMJ arthrocentesis with sodium hyaluronate injection had better clinical outcome compared to TMJ arthrocentesis alone for TMJ disorders.

Antero-medially displaced condylar head leading to pseudoankylosis: A case report.

Ankylosis is one of the most disruptive maladies affecting the masticatory system with trauma being the most common cause. Pseudoankylosis though uncommon can cause functional and psychological discomforts for the patient. Described here is operative management of a case of posttraumatic pseudoankylosis in a 27-year-old female, having fractured condylar head dislocated anteriorly and medially, with eventual fusion to sigmoid region. Retromandibular approach for condylar fracture has been advocated by many authors to be advantageous over other approaches given that they cause good cosmetic results, lower risk of facial nerve injury, reduced operation time. The question still remains whether open reduction internal fixation or removal of the condylar head should be favored for restricted mouth opening after closed reduction.

Polymorphous Adenocarcinoma: A Rare Case Report with Unique Radiographic Appearance on CBCT.

BACKGROUND: Polymorphous low-grade adenocarcinoma (PLGA) is a slow growing malignant tumor of minor salivary glands and is generally of indolent nature. However, according to the most recent WHO Classification of Salivary Gland Tumors (2017), the cancer is classified as Polymorphous AdenoCarcinoma (PAC). PAC presents as a less aggressive tumor, though it could on rare occasions demonstrate distant metastasis. Case Presentation. A 47-year-old man who was referred by a private practitioner for a CBCT scan in reference to a proliferative soft-tissue growth in the hard palate. The growth was mild and tender and there was Grade III mobility in relation to all the maxillary teeth. Panoramic radiograph taken previously had revealed evidence of alveolar bone loss in relation to the maxillary teeth and was inconclusive of any other findings. The CBCT scan revealed evidence of moth-eaten appearance of maxilla with destruction of medial and lateral walls and floor of maxillary sinus. There was also evidence of involvement of right eustachian tube, ethmoidal wall, and nasopalatine canal. An intraosseous malignancy of the palate was suspected, and a total maxillectomy was performed. The tissue sample was sent for histopathological assessment wherein changes diagnostic for polymorphous low-grade adenocarcinoma of the palate were observed. CONCLUSION: PAC is a distinct, yet commonly occurring, minor salivary gland tumor with varied clinical and histologic appearance. This case report highlights the importance of CBCT in diagnosing the intraosseous involvement of such tumors which can help shed some light in enhancing our knowledge about the minor salivary gland malignancies like PAC.

Pilomatrixoma: a common tumour of head and neck, but rarely reported.

Pilomatrixoma is a benign subcutaneous tumour arising from the sebaceous glands. Mutation in the CTNNB1 gene is seen, suggesting beta-catenin misregulation may be the cause of pilomatrixoma. The preoperative diagnosis may be improved by the awareness of the fact that pilomatrixoma is a common and benign skin tumour of the head and neck region. It presents as a well-defined mass, which may be firm to hard in consistency, usually attached to the skin, but not to the underlying tissue. The colour of overlying skin appears a reddish-brown tinge, indicating that it could be a case of pilomatrixoma. Here, we report a case of pilomatrixoma of the cheek in a woman along with the CT findings and histopathological appearances. Dental surgeons should consider it as one of the differential diagnosis in superficial head and neck swelling with calcification.

An innovative sectional silicone obturator in a patient with partial maxillectomy: A Case report.

Prosthodontic management of palatal defect is fundamental to close patient's oronasal communication and improve masticatory function, phonetics, esthetics, and comfort. Maxillary defects are the direct consequence of the surgical treatment of malformations, neoplasms, or trauma. The primary goal of an obturator is to close palatal defects after maxillectomy and to improve speech and masticatory function. This clinical report describes the use of a flexible silicone obturator for the treatment of a 34-year-old patient with partial maxillectomy due to osteosarcoma of the maxilla. A conventional cast partial denture with a hollow bulb made in acrylic was given as a definitive obturator initially, which was not comfortable for the patient. Alternatively, a new technique of fabrication of obturator with silicone to close palatal defect was decided to establish an acceptable phonetics, comfort, speech, and function for the patient. This silicone obturator gets retention by "snug fit" from the defect site.

Atypical presentation of salivary mucocele: diagnosis and management.

A mucocele is a common pathological lesion involving the minor salivary glands. It usually presents as an asymptomatic small superficial swelling over the lower labial mucosa. However, uncommon variants of oral mucoceles sometimes occur. Such lesions may be difficult to diagnose due to their unusual size and atypical clinical presentation. This article describes the case of a deeply embedded large mucocele over the buccal mucosa. Ultrasonography was used to visualize the size and position of the lesion, and aspiration was used to help in the eventual diagnosis. An intraoral approach was used in the complete removal of the lesion.