Dermoid Cysts of the Maxillofacial Region: Case Series.

The maxillofacial region can be affected by a number of subcutaneous pathologic conditions that include developmental, inflammatory, infective and neoplastic entities. Many of these lesions present as a soft to firm painless swelling. Differential diagnosis of such lesions requires thorough knowledge of maxillofacial pathology as well as anatomy to come to a correct diagnosis and provide effective treatment. Misdiagnosis and improper treatment can lead to other complications and morbidity. The commonly encountered lesions include dermoid cysts, branchial cysts, lipoma and thyroglossal cyst. Dermoid cysts are dysontogenetic cysts rarely involving the maxillofacial region (1.6-7% of all dermoid cysts of the body). The most common site of involvement in the maxillofacial region is near the frontozygomatic suture followed by cervical region. Some lesions have a deep component which may involve the cranial or orbital cavities. This is a retrospective study of the cases managed at our center from 2001 to 2017. Of the 12 cases in our study, all but one was involving the floor of the mouth. There were 11 males and 1 female. Swelling was the only symptom. The patients age ranged from 16 to 34 years (Table 2). The cysts were present for a period ranging from 6 months to 5 years at the time of reporting. All cases were managed with enucleation. The patients are on follow-up with no report of recurrence. The period of follow-up was 1 to 16 years. There were no complications postoperatively.

A comparative study of the effect of two dosages of submucosal injection of dexamethasone on postoperative discomfort after third molar surgery: a prospective randomized study.

INTRODUCTION: The aim of this clinical study was to evaluate and compare the relative efficacy of two different dosages of dexamethasone, i.e., 4 and 8 mg injected submucosally to reduce postoperative discomfort after mandibular third molar surgery. METHODOLOGY: A prospective randomized study was conducted on 45 patients requiring surgical removal of an impacted third molar. Selected patients were divided randomly into three groups of 15 patients each: group I patients received one regimen single dose of 4 mg dexamethasone submucosally, group II received one regimen single dose of 8 mg dexamethasone submucosally, and group III (control group), no dexamethasone was given but only received injection of normal saline submucosally after establishing local anesthesia. The postoperative sequelae were assessed on the second and seventh postoperative day. RESULT: As compared to group III, groups I and II showed statistically significant reduction in pain and swelling whereas no statistically significant difference was found between the test groups. CONCLUSION: It can be concluded that corticosteroids are effective in curtailing the postoperative edema of lower third molar surgery but have negligible analgesic effect. As no statistically significant difference is found between both the regimes of dexamethasone, i.e., 4 and 8 mg so within the confines of our study, it may be concluded that 4 mg dexamethasone can be given safely to reduce the postoperative edema after the third molar surgery.

To assess the efficacy of socket plug technique using platelet rich fibrin with or without the use of bone substitute in alveolar ridge preservation: a prospective randomised controlled study.

AIM: The purpose of this study is to evaluate the efficacy of Platelet Rich Fibrin (PRF) as a socket plug with or without use of Plaster of Paris (POP) as bone substitute to preserve the alveolar ridge post-extraction. MATERIAL AND METHODS: A prospective randomised single blind controlled study, was conducted for 18 months from November 2014 to May 2016 on 48 patients requiring extraction. All teeth were extracted atraumatically using periotomes and luxators without raising mucoperiosteal flap. Sockets were randomly allotted to groups A, B and C. Group A sockets were chosen as control, where figure of eight suture was placed. In group B sockets, PRF obtained by centrifugation was used as a socket plug and stabilised with figure of eight suture. Group C sockets were filled with POP and then covered with PRF. The socket was then closed with a figure of eight suture. Patients were informed of need for 6 months follow-up. RESULTS: Ninety sockets in 48 patients were subjected to our study. We found that results in the sockets where we have grafted POP showed better ridge preservation and post-operative comfort even though the difference in ridge resorption between the three groups was not statistically significant. Powered by Editorial Manager® and ProduXion Manager® from the Aries Systems Corporation. CONCLUSION: Atraumatic extraction may minimise the post-operative pain and discomfort to patient as well as the post-extraction alveolar height and width changes. The use of PRF and/or bone substitute even though clinically contributes to better post-operative healing and minimal loss of alveolar width and height, the values were not statistically significant.

Reconstruction of a traumatically transected Stensen's duct using facial vein graft.

Traumatic injuries to the lower third of the face can result in damage to various vital structures. We report a case of traumatically avulsed Stenson's duct and facial vein wherein the vein was used as a free graft to lengthen the duct. The paper highlights the need on how best to utilise the locally available and viable tissues as free grafts.

Secondary jaw aneurysmal bone cyst (JABC)--a possible misnomer? A review of literature on secondary JABCs, their pathogenesis and oncogenesis.

CONTEXT: Aneurysmal bone cysts are rare pseudocysts, commonly seen in long bones and vertebral column. Although a well described and reported lesion, many misconceptions still prevail regarding their etiopathogenesis. Many of the reported cases of jaw aneurysmal bone cysts (JABC) present with another bone pathology. AIMS: The purpose of this review was to evaluate the incidence of neoplastic lesions occurring simultaneously with a JABC (in contrast to primary JABCs). Any pathogenetic and oncogenetic association between primary and secondary jaw ABCs has been reviewed and discussed. SETTINGS AND DESIGN: A methodical narrative review of literature was performed, given the incidence of mostly case reports on this topic. METHODS AND MATERIAL: A methodical electronic search of Pubmed, Pubmed Central, Medline and Cochrane databases was performed for reported cases of JABC. These articles were analysed and segregated into primary and secondary ABC and, if secondary, the lesion it concurrently occurred with. Another search was conducted to yield articles discussing the cytopathogenetic and oncogenetic origins of ABCs. RESULTS AND CONCLUSIONS: About 15% of the ABCs reported were of secondary nature. Amongst the associated lesions, cement-ossifying fibroma and ossifying fibroma were the most common, followed by fibrous dysplasia and central giant cell granuloma. No ABCs were associated with metastatic changes. The search for histopathogenesis pointed to a specific cytogenetic abnormality as the origin of primary ABCs, with USP6 as its main oncogene and spindle cell as the neoplastic cell, unlike with secondary ABCs, suggesting that they are distinct pathological processes.