Two-Point versus Three-Point Fixation in the Management of Zygomaticomaxillary Complex Fractures: A Comparative Study.

Introduction: The zygoma plays an important role in the facial contour for both cosmetic and functional reasons; therefore, zygomatic bone injuries should be properly diagnosed and adequately treated. Comparison of various surgical approaches and their complications can only be done objectively using outcome measurements that require a protocol for management and long-term follow-up. The objectives of this study were to compare the efficacy of zygomatic bone after treatment with open reduction internal fixation (ORIF) using two-point fixation and ORIF using three-point fixation and compare the outcome of two procedures. Materials and Methods: Twenty patients were randomly divided equally into two groups. In Group A, ten patients were treated by ORIF using two-point fixation by miniplates and in Group B, ten patients were treated by ORIF using three-point fixation by miniplates. They were evaluated with their advantages and disadvantages and the difference between the two groups was observed. Results: We found that postoperative facial and neurological complications are minimum in two-point fixation group. Based on this study, open reduction and internal fixation using two-point fixation by miniplates is sufficient and the best available treatment of choice for the management of zygomaticomaxillary complex fractures. Discussion: Alignment of the fracture at three points and fixation at two stable points provide the most accurate and satisfactory postoperative results. Two-point interosseous fixation at the "buttress" fracture and the frontozygomatic (FZ) fracture is suitable for routine surgery. The results of these studies confirm with the present study that two-point fixation provided better stability in patients with clinical and radiological evidence of fracture in FZ and zygomaticomaxillary buttress area.

Comparative Evaluation of Healing Pattern After Surgical Excision of Oral Mucosal Lesions by Using Platelet-Rich Fibrin (PRF) Membrane and Collagen Membrane as Grafting Materials-A Randomized Clinical Trial.

PURPOSE: To compare the healing potential of platelet-rich fibrin (PRF) and collagen membranes in oral mucosal healing. MATERIALS AND METHODS: Thirty patients with oral premalignant lesions were randomly included in the study and divided in groups A and B. After excising the lesions under local anesthesia, patients in groups A and B underwent grafting with the PRF membrane and the collagen membrane, respectively. Patients were evaluated at postoperative days 7, 15, 30, and 60 for pain, healing, and complications, such as recurrence, fibrosis, scar hypertrophy, and loss of vestibular depth. RESULTS: In group A, 66.66% of patients reported substantially less pain postoperatively at 15-day follow-up than those in group B. At 30-day follow-up, 86.66% of patients in group A reported no pain versus 60% in group B. Pain scores were similar at 7- and 60-day follow-ups. Healing was accelerated in group A at 15- and 30-day follow-ups, but was the same on day 60. Complications, such as fibrosis, loss of vestibular depth, and scar hypertrophy, were seen in group B. Recurrence was seen in 1 patient in group A at 60-day follow-up. CONCLUSION: PRF proved superior to collagen membrane for grafting of oral mucosal surgical defects. However, further study with larger samples is required to prove its efficacy.

Is amalgamated ligno-bupivacaine an answer to complicated minor oral surgical anesthesia? A randomized split-mouth double-blind clinical trial.

PURPOSE: The purpose of this study was to find a suitable anesthetic combination for complicated and protracted minor oral surgical procedures. METHODS: Fifty patients with bilaterally impacted deep-seated mandibular third molars were included in this study and randomly divided on the basis of anesthetic used into two groups. Group A received 2% lignocaine with 1:200,000 adrenaline while in group B, amalgamated mixture of 2% lignocaine and 0.5% bupivacaine was used. The onset time, duration of anesthetic effect, supplementary injections, pain (during local anesthetic deposition, intra and postoperatively), and postoperative analgesia were the study parameters. Chi-square and unpaired t tests were used to compare means. RESULTS: The onset time in both the groups was comparable and showed statistically significant difference between the duration of anesthetic effect with notable requirement of supplemental anesthetic injections in group A (54%) (p < 0.05). Pain scores also revealed a statistically significant intergroup difference (p < 0.05). Requirement of postoperative analgesics was delayed in group B. CONCLUSIONS: The amalgamated mixture of lignocaine and bupivacaine had equivocally rational onset and provided a more profound and in-depth anesthesia especially in complicated and protracted minor oral surgical procedures. Though this mixture is widely used in other surgical fields, its efficacy still remains unexploited and undocumented in oral and maxillofacial surgical procedures.

Gigantic reactive lesion of mandibular gingival tissue / Lesión gigante reactiva del tejido gengival mandibula

Irritation fibroma are the most common form of reactive lesions found within the oralcavity. These lesions normally attain a small size and show a slow growth rate. This paper reports a case ofgigantic intraoral irritational fibroma with a history of rapid growth. Complete excision was performed andthe specimen was sent for immunohistochemistry (IHC) staining. It was found positive for vimentin, hencereported as irritation fibroma.

Los fibromas irritativos son las forma más común de lesiones reactivas encontradas en la cavidad oral. Estas lesiones normalmente son de pequeño tamaño y muestran una tasa de crecimiento lenta. Este artículo reporta el caso de un fibroma irritativo gigante intraoral con historia de crecimiento rápido. Se realizó la extirpación completa y fue enviado para análisis inmunohistoquímico. Arrojó positivo para Vimentina, por lo tanto, se reportó como fibroma irritativo.