Emerging Trends of Zygomaticomaxillary Complex Fractures and Their Etiological Analysis in a Tertiary Health Centre from Eastern India: A Retrospective Study.

INTRODUCTION: Maxillofacial region is one of the most complicated arrangements of bony and soft tissues in human body, superiorly bounded by cranial bones and inferiorly by the mandible with interposed dentition. This is one of the reasons which make injuries to this region difficult to manage and often controversial. The severity and patterns of these injuries have changed considerably due to the increasing reliance on fast road transportation facilities and interpersonal violence. MATERIALS AND METHODS: The aim of the present study is to analyze retrospectively the changing patterns of mid-face fractures in a sample of patients reporting to Department of Oral and Maxillofacial Surgery in AIIMS Bhubaneswar, India, from April 2017 to April 2018. A performa was prepared which included age, sex, etiology of injury, alcohol influence, and treatment given during hospital stay. RESULTS: Road traffic accidents contributed 68.11% of zygomaticomaxillary complex (ZMC) fractures, followed by assault (18.11%) and fall from height (13.76%). RTA was the major cause of atypical ZMC fractures as compared to conventional ZMC fractures (P < 0.001). DISCUSSION: Due to modern lifestyle and changes in fast transportation, recent fracture patterns do not follow the tell-tale signs or patterns and often need unique and patient-specific treatment plan, making the skills of maxillofacial surgeons the pivotal factor in better prognosis.

Clinical Evaluation of Buccal Fat Pad and Nasolabial Flap for Oral Submucous Fibrosis Intraoral Defects.

OBJECTIVE: Surgical defects following fibrotomy in oral submucous fibrosis (OSMF) are difficult to manage due to relapse, and local flaps play a pivotal role in covering the defect. The purpose of this study is to compare the buccal fat pad (BFP) and nasolabial flap (NLF) for the reconstruction of intraoral defects after the release of fibrous bands in patients with OSMF. METHODS: A prospective study was conducted on patients with OSMF with surgical treatment of fibrotomy excision and reconstruction of the defect with 2 options. Thirty patients with OSMF were divided into 2 groups, group I (BFP) and group II (NLF). Both groups were analyzed for preoperative and postoperative mouth opening and oral commissural width; the extraoral scar was assessed using the Stony Brook Scar Assessment Scale. The data were statistically analyzed using paired and unpaired t test. RESULTS: Thirty patients comprising 27 (90%) male and 3 (10%) female with ages ranging between 19 and 51 years were involved. The mean preoperative and postoperative interincisal mouth opening was 12 mm and 27 mm in group I and 11 mm and 38 mm in group II, respectively, showing a significant increase in group II, and the mean preoperative and postoperative commissural width was 52 mm and 58 mm in group I and 51 mm and 60 mm in group II, respectively. CONCLUSION: The proposed surgical protocol for the management of OSMF found NLF superior to BFP for the reconstruction of intraoral defects after the release of fibers in patients with OSMF, with a minimal residual scar.