Self-tapping Intermaxillary Fixation Screw: An Alternative to Arch Bar.

INTRODUCTION: The use of intermaxillary fixation (IMF) in the treatment of faciomaxillary fractures is the key factor for reduction and immobilization. Various techniques of IMF have been described in the past and recently IMF screws have been introduced. This technique has various advantages, including ease of use, less time consumption, less trauma to the surrounding soft tissues, and relatively reduced risk of needle stick injury. This study evaluates the efficacy of IMF screws over arch bar IMF before definitive fixation of facial fractures. MATERIALS AND METHODS: This study is a randomized clinical study. Study population consists of 20 patients with mandibu-lar fractures requiring IMF with open reduction and reported to Department of Oral Surgery, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India between September 2012 and April 2015. Two groups were formed with 10 patients in each group. In the first group, IMF was achieved using the Erich's arch bar and wires. In the second group, IMF was achieved using self-tapping IMF screw. The patients were assessed for various parameters, such as the time required in minutes for the IMF stability of fixation, postoperative occlusion, postoperative pain, periodontal health, oral hygiene, and incidence of needle stick injury. RESULTS: All the cases had stable IMF in both groups. At the end of 14th day, overall oral hygiene was poor in group I and good in group II, significant statistically (p = 0.031). Iatrogenic injury to tooth was absent in group I and present in 1 case in group II, not significant statistically (p = 0.305). Average time taken for the IMF in group I was 74.9 minutes, with the range of 58 to 88 minutes, and in group II was 16.1 minutes, with the range of 11 to 22 minutes, which is highly significant statistically (p = 0.001). Needle stick injuries were taken as positive if glove perforation was present and these were reported in four cases in group I, whereas in group II, no case had incidence of needle stick injuries, which shows significant statistically (p = 0.025). CONCLUSION: After this study, we can conclude that IMF self-tapping screw is a proven useful technique of IMF. Intermaxillary fixation is a safe and less time-consuming method but with various shortcomings and complications, which the surgeon must be aware of while providing treatment. CLINICAL SIGNIFICANCE: Keywords: Erich's arch bar, Intermaxillary fixation, Self-tapping intermaxillary fixation screws.

Prevalence and distribution of odontogenic cyst in Indian population: a 10 year retrospective study.

The purpose of this study is to determine the prevalence of odontogenic cyst in an Indian population and compare it with various reports from the other geographic areas of the world. The files on odontogenic jaw cysts treated between 2001 and 2011 at the oral and maxillofacial surgery unit were retrieved retrospectively. Patient's demographic information mainly age, sex and location of the lesion was recorded and analyzed using descriptive statistics. The diagnosis of odontogenic cyst accounted in 150 cases and accounted for 15.31 % of all lesions biopsied throughout the period. Mean age of the patient was 32.2 years, and 58 % were males. The overall male to female ratio was 1.38:1. Radicular cyst was most prevalent histological type (48.67 %) followed by dentigerous cyst, odontogenic keratocyst, lateral periodontal cyst, paradental cyst, residual cyst, adult gingival cyst, glandular odontogenic cyst, calcifying odontogenic cyst. The most common locations of the odontogenic cysts were the mandibular (49.33 %) and posterior region (33.33 %). The distribution pattern of odontogenic cyst in this study is relatively similar to that in other parts of the world but there are some geographic differences with regard to the relative frequency, sex, and anatomic distribution of the odontogenic cyst.

Efficacy of 4 % Articaine and 2 % Lidocaine: A clinical study.

OBJECTIVES: This study was undertaken to compare the anesthetic properties of 4 % Articaine hydrochloride and 2 % Lidocaine both with 1:100,000 epinephrine for mandibular inferior alveolar nerve anesthesia. MATERIALS AND METHODS: Thirty healthy patients were included in this randomized double-blind clinical cross over study. Each subject received each test solution at different times. Inferior alveolar nerve block anesthesia was used for extraction of bilateral impacted mandibular third molar on different occassions. The time of onset of action, duration of anesthesia, efficacy of anesthesia, hemodynamic parameters and oxygen saturation were monitored during the procedure. A visual analog scale was used to assess pain during surgery, and thus subjectively evaluate the anesthetic efficacy of the two solutions. RESULTS: No statistically significant differences were seen in the onset and duration of anesthesia between the Articaine and Lidocaine solutions. CONCLUSIONS: 4 % Articaine offers better clinical performance than 2 % Lidocaine, particularly in terms of latency and duration of the anesthetic effect. However, no statistically significant differences in anesthetic efficacy were recorded between the two solutions.

Non-Hodgkins lymphoma of maxilla: A rare entity.

Non-Hodgkin's lymphomas are a group of neoplasms that originate from the cells of the lymphoreticular system. Forty percent of non-Hodgkin's lymphomas arise from extra nodal sites. Non-Hodgkin's lymphomas detected primarily in the bone are quite rare, but among jaw lesions, they are more frequently present in the maxilla than in the mandible. There are no classical characteristic clinical features of lymphomas involving the jaw bones. Swelling, ulcer or discomfort may be present in the region of the lymphoma, or it may mimic a periapical pathology or a benign condition. Extranodal non-Hodgkins lymphoma of the maxilla could present as one of the early manifestation of detrimental diseases. Clinically these types of lymphoma can mimic an inflammatory endo-periodontal lesion with symptoms of pain and local discomfort. The greater the delay in diagnosis subsequently worsens the prognosis. A case of maxillary non-Hodgkin's lymphoma with an unusual presentation is discussed.

Peripheral neurectomy: a minimally invasive treatment for trigeminal neuralgia. A retrospective study.

AIM: Investigate the efficacy of peripheral neurectomy as a surgical procedure in the treatment of trigeminal neuralgia and to evaluate the results obtained by this procedure and their recurrences in a period of three years followup. MATERIALS AND METHODS: Thirty patients were retrospectively reviewed who underwent peripheral neurectomy. The factors analyzed were the demographic details of the patients, side of involvement, branch of nerve involved and procedure used postoperative complications, prognosis and any additional procedure used in cases of recurrences. RESULTS: The mean age of the patient was 57.1 years (range 35-71 years) more were males (M:F = 1.73:1) and the surgical treatment was peripheral neurectomy of the involved branch following failure of carbamazepine therapy. There was no intra operative and postoperative complications noted and follow up over 3 years revealed only two cases (6.66%) of recurrence. Two patients were lost to followup, total number evaluated between 0 and 3 years after treatment was 28 patients. CONCLUSION: Peripheral neurectomy is one of the oldest, minimal invasive forms of surgery, well tolerated by the patient and can be done under local anesthesia.

Specific binding of [3H]ketanserin to hypothalamus membranes of juvenile rainbow trout, Oncorhynchus mykiss.

This study examines the existence and pharmacological specificity of [3H]ketanserin binding in hypothalamus of juvenile rainbow trout. Hypothalamic membranes were incubated with [3H]ketanserin (selective 5HT2 antagonist) under several experimental conditions; reactions were terminated by filtration and bound radioactivity was counted by liquid scintillation spectroscopy. Tissue dilution experiments revealed that specific [3H]ketanserin binding (B(sp)) was tissue dependent; 1 hypothalamus equivalent per tube (1100 +/- 115 cpm/mg protein) was subsequently used throughout the rest of this study. In association experiments, B(sp) increased progressively with time, achieved equilibrium binding levels (1192 +/- 120 cpm/mg protein) within 80 min, and remained stable for at least 60 min thereafter; k(obs), and k(+1) were 0.032 and 0.048 min(-1) x nM(-1), respectively. In dissociation experiments, B(sp) completely dissociated within 20 min following addition of excess ketanserin; k(-1) and t1/2 were 0.0803 min(-1) and 8.7 min, respectively. B(sp) was saturable (2500 +/- 256 cpm/mg protein); Scatchard-calculated values for the equilibrium dissociation constant (K(D)) and capacity (Bmax) were 0.48 nM, and 125 fmol/mg protein, respectively. B(sp) was differentially displaced by structurally related competitors, with a rank order of potency of ketanserin = mianserin > ritanserin > serotonin (5HT) = spiperone >> methiothepin mesylate > metergoline = DOI ((+/-)-2-5-dimethoxy-4-iodoamphetamine hyrobromide) > 2-methyl-5HT > alpha-methyl-5HT >>>> 5HIAA (5-hydroxyindole acetic acid) = reserpine. These findings provide pharmacological evidence for the presence of a 5HT2-like receptor subtype in the trout hypothalamus.

Levels of specifically bound [3H]ketanserin compared with levels of serotonin (5HT) in the brain regions of juvenile and sexually recrudescing female rainbow trout, Oncorhynchus mykiss.

This study compared the distribution of specifically bound [3H]ketanserin (Bsp) with serotonin (5HT) in brain regions of juvenile and sexually recrudescing female trout. Amounts of Bsp varied widely among brain regions and consistently differed between juvenile and sexually recrudescing females. Levels of Bsp were significantly greater in the hypothalamus than the olfactory lobe, which were at least threefold greater than in all other tissues examined (Kruskal-Wallis test, p < 0.05). Bsp densities in the hypothalamus, preoptic area, and optic lobe were significantly greater in juveniles compared with corresponding tissues from sexually recrudescing females (Mann-Whitney U test, p < 0.05); in contrast, Bsp in olfactory lobe and spinal cord did not differ significantly between the two classes of fish. 5HT concentration was determined by high performance liquid chromatography - electrochemical detection (HPLC-EC) analysis. Biogenic amine standards eluted in a stereotypic pattern, with peaks consistently separable in time. 5HT concentration was significantly greater in hypothalamus than in olfactory lobe and undetectable in the pituitary (Kruskal-Wallis test, p < 0.05). Trends in distribution of Bsp and 5HT were comparable in the hypothalamus and preoptic area in juvenile and sexually recrudescing females. In general, density of specific [3H]ketanserin binding sites was directly related to 5HT content of brain regions in juvenile and sexually recrudescing females. 5HT concentrations (pmol/g tissue) were approximately 900-fold greater than Bsp (fmol/g tissue) in all brain regions, and approximately 300-fold greater than Bsp in the olfactory lobe. These results suggest important regulatory role(s) for 5HT in the trout preoptic-hypothalamo-hypophysial axis, which may differ from 5HT role(s) in trout olfactory lobe.

Familial complete heart block in hypertrophic cardiomyopathy.

We report the finding of complete heart block in two siblings (brother and sister) with hypertrophic cardiomyopathy. Its relationship to the disease is discussed and the relevant literature is reviewed.

Mediastinal zygomycosis.

A young girl with pulmonary zygomycosis involving the mediastinum and presenting as superior vena caval obstruction is reported. Mediastinal involvement due to zygomycosis is a rare occurrence.