Attached Oral Mucosal Wound Closure using Blue Glue - A Prospective Clinical Study.

Introduction: Traditionally, sutures have been widely used to close intraoral wounds. Various alternatives have been developed amongst which newer tissue adhesives such as N-butyl-2-cyanoacrylate having accepted clinical properties are gaining popularity. The primary purpose of the present study is to evaluate the efficacy of N-butyl-2-cyanoacrylate for intraoral attached mucosal wound closure following alveoloplasty. Materials and Methods: In this prospective split-mouth study, 25 patients requiring alveoloplasty in either maxillary or mandibular arch bilaterally with a total of 50 sites were divided into two equal groups, namely silk suture (Group 1) and cyanoacrylate (Group 2). Each patient was evaluated on the first, third, seventh, 14th and 21st post-operative days. Parameters evaluated were time taken to close incision and to achieve haemostasis, pain, oedema, post-operative wound healing, patient discomfort and possible complications. Results: Time taken to close incision, time taken to achieve haemostasis, post-operative pain and oedema were found to be less in Group 2. Wound healing too was found to be better in Group 2. There was one case of adhesive peel off on the first post-operative day which was managed by reapplying the tissue adhesive. The incidence of wound dehiscence and wound infection was observed more in Group 1 on the third post-operative day. Suture breakage (16%) and adhesive dislodgement (8%) were reported on the seventh post-operative day. Discussion: The use of cyanoacrylates' inherent benefits, such as improved wound seal off in attached mucosa, quick polymerisation and bacteriostatic characteristics can be beneficial when performing minor oral surgical procedures on elderly, young and mentally challenged patients.

Comparison of bite force evaluation for mandibular angle fracture fixation by conventional miniplates versus new design miniplates: a clinical study.

PURPOSE: To evaluate postoperative masticatory efficacy of a new design non-compression titanium miniplate compared to conventional non-compression titanium miniplate on the basis of bite force for treatment of mandibular angle fractures. METHODOLOGY: The prospective study included 20 patients with mandibular angle fractures randomly categorized into 2 groups: Group I, fixation of angle fractures by conventional miniplates, and Group II, fixation of angle fractures by new design miniplates. Evaluation was done for clinical outcome, primarily bite force; radiological outcome; and associated postoperative morbidities at different time intervals. RESULTS: The results showed to be highly significant in terms of mean operating time for plate adaptation and fixation and bite force adaptation (p = 0.003 at follow-up of 6 months) for the newer miniplate compared to the conventional miniplate. No statistically significant difference was seen for postoperative paresthesia, malunion, non-union, occlusal discrepancy, or hardware failure. CONCLUSION: Within the limits of the study, it appears that the single, monocortical, non-compression, superior border new design miniplate proved to be a successful procedure for treating non-comminuted mandibular angle fractures specifically in terms of enhanced postoperative masticatory efficiency as compared to conventional miniplates. Further clinical studies with larger sample size can derive a more comprehensive conclusion.

Maxillofacial Osteomyelitis in Immunocompromised Patients: A Demographic Retrospective Study.

OBJECTIVE: To retrospectively study the cases diagnosed with osteomyelitis of jaw in AMC Dental Hospital. STUDY DESIGN: A total of 27 cases of osteomyelitis of jaw were analysed retrospectively from 2014 to 2018 at Department of oral and maxillofacial surgery, AMC Dental Hospital, Ahmedabad, India. RESULT: Totally 27 cases of osteomyelitis were noted; 12 (44.44%) patients had involvement of maxilla, and 15 (55.55%) patients had involvement of the mandible. Twenty-one patients had underlying systemic disease, and 13 patients had history of substance abuse. The underlying aetiology in 20 patients was found due to odontogenic cause. There were only 3 patients having osteomyelitis without any underlying disease or any other predisposing factors. CONCLUSION: Incidence of osteomyelitis and its outcome in the present study led to a better understanding of the aetiologic factors and its treatment. The results hypothesized a substantial correlation for onset of osteomyelitis with the underlying medical conditions and substance abuse. There was a higher correlation found between comorbid conditions and osteomyelitis of maxilla. Thorough study of the treatment revealed that conventional treatment plan is adequate for treating cases of osteomyelitis if the associated medical problem is also simultaneously treated and given due importance.

Analysis of Mandibular Fractures: A 7-year Retrospective Study.

BACKGROUND: Mandibular fractures contribute to a substantial proportion worldwide. Various variables related to mandibular fractures such as demographics, etiology, pattern of fracture, and treatment have been studied, but fewer reports on their correlations are published. Hence, this study attempts to understand these factors which can be useful for setting up clinical and research priorities. AIM: The purpose of this retrospective study is to establish a correlation between different factors associated with mandibular fractures. MATERIALS AND METHODS: A database of 277 patients between July 2011 and October 2018 with mandibular fractures was retrospectively retrieved. Information on age, gender, etiology, pattern of fracture, and treatment done was obtained, tabulated, and analyzed statistically. Entities such as age and gender, age and cause, gender and cause, site of fracture and cause, site of fracture and side, site of fracture and treatment done, and site of fracture and gender were correlated. STATISTICAL ANALYSIS USED: Descriptive and analytical statistics were calculated using the SPSS version 20 using Chi-square tests which include Pearson's Chi-square and likelihood ratio. RESULTS: In a total of 277 patients, a statistically significant correlation was found between age and the etiologic agent, site and side of fracture, and site of fracture and the treatment done with value of P < 0.05. CONCLUSION: A definite correlation between multitude of overlooked relevant co-factors has been studied which can provide an operating surgeon, a valuable impetus to be more vigilant in terms of medicolegal record maintenance, diagnosis, and possible clinical strategy for the treatment of mandibular fractures.

Causes and incidence of maxillofacial injuries in India: 12-year retrospective study of 4437 patients in a tertiary hospital in Gujarat.

Maxillofacial injuries are unique because of the anatomical complexity of the area and their associated psychological effects. An understanding of the epidemiology of these injuries is important if we are to develop preventive measures, increase the efficiency and delivery of health services, improve the skills of healthcare providers, and better distribute resources. We retrospectively evaluated data on 4455 patients (aged between 3 and 84 years) who presented with maxillofacial injuries to a tertiary referral hospital in Ahmedabad, India, between 1 January 1999 and 31 January 2010. Of these, 18 needed only rest and medication so 4437 were included. Data included patients'characteristics and the cause of injury. Details on the presentation and severity of injury, associated injuries including head injuries, the influence of alcohol and other drugs, treatment, and outcome, were also included. Around one-third were aged between 21and 30 years, and the male to female ratio was 5:1. The main causes of injury were road traffic accidents (n=2347, 53%) and interpersonal violence (n=1041, 23%). Most road traffic accidents involved two-wheeled vehicles. Alcohol was associated with 11% of injuries. A total of 2546 patients (57%) had mandibular fractures. To reduce the number of injuries we need better road safety laws with stringent enforcement, and the public, particularly those between 15 and 45 years of age, must be educated about road safety.

Autogeneous coronoid process as free graft for reconstruction of mandibular condyle in patients with temporomandibular ankylosis.

OBJECTIVE: This study was conducted to determine the efficacy of using the autogeneous coronoid process as free graft for reconstruction of mandibular condyle and to achieve structural, functional, as well as esthetic rehabilitation of patients with temporomandibular joint (TMJ) ankylosis. MATERIALS AND METHODS: This article presents the clinical results of an evaluation of ten cases of TMJ ankylosis treated by using autogeneous coronoid process as free graft for reconstruction of mandibular condyle after resection of ankylotic mass. RESULTS: Satisfactory mouth opening were obtained in all ten cases. No patient showed signs of re-ankylosis at 12 months follow-up. Preoperative mouth opening ranged from 0 to 15 mm with mean being 4.8 mm. As a result of successful procedure, the immediate postoperative mouth opening increased ranging from 24 to 31 mm (mean, 26.5 mm). Follow up of patients at the first and 12th month showed good results with increase in mouth opening from a range of 24 to 31 mm (mean, 27.8 mm ) to 26 to 36 mm (mean, 33.13 mm). CONCLUSION: The results of this study suggest that the autogeneous coronoid process as free graft is a suitable graft material for reconstruction of mandibular condyle after resection of ankylotic mass.

Desmoplastic ameloblastoma: report of a unique case and review of literature.

Desmoplastic Ameloblastoma is a rare variant of ameloblastoma. 90 cases of desmoplastic ameloblastoma have been reported so far in literature. We are presenting a rare case of desmoplastic ameloblastoma in the ramus region of mandible with regards to its clinical and radiographical viewpoints. Only one other case of desmoplastic ameloblastoma has been reported in the ramus region of mandible of the 90 cases that we have reviewed. Review of literature has revealed the tumour to most commonly occur in the 3rd to 5th decade of life with a high preponderance of Japanese males. The anterior region of either jaw was most commonly found to be affected. Radiological appearance was most commonly of a mixed radio-lucent/radio-opaque type with a high incidence of poorly defined borders. However our case differed from the reviewed cases as it was found to be a unilocular lesion with well defined borders. Histopathological findings of our case were consistent with the hisotpathological appearance of the reviewed cases and showed extensive stromal desmoplasia and small tumour nests of odontogenic epithelium scattered in stroma.