Rare Association of Ankyloblepharon Filiforme Adnatum (AFA) with Cleft Palate - Case Report.

The aim of this article is to discuss about rare representation of ankyloblepharon (an established chromosomal anomaly with aberration of p53 inherited as an autosomal dominant trait) with cleft of palate without any other feature of ectodermal dysplasia. The need to surgically address ankyloblepharon in order to avoid complications is also discussed.

The Difficult Route to Glottis in Cleft Patients Simplified.

INTRODUCTION: Cleft lip with or without palate is one of the most common craniofacial anomalies worldwide. Airway problems in children with cleft lip and palate were well recognized since very early times. OBJECTIVE: The aim of this technical note is to describe a unique method of performing direct laryngoscopy in children with cleft lip and palate by using a palatal obturator to cover the alveolar and palatal defect in these patients. METHODS: The palatal obturator was fabricated using cold cure acrylic after making an impression of the defect using putty-type impression material. RESULTS: The use of the palatal obturator facilitated the placement of the laryngoscope's blade by providing adequate leverage to it during the process of direct laryngoscopy prior to intubating children with cleft lip and palate defect. CONCLUSION: A discontinuous alveolar arch and palatal defect contribute to lack of effective leverage of the laryngoscope blade while attempting visualization of the glottis. This difficulty can be overcome by use of an obturator to cover the alveolar and palatal defect in order to provide adequate leverage while using a laryngoscope for visualizing the glottis.

Taenia Solium: A Rare Expression in Oral Cavity.

Cysticercosis is a helminthic infection caused by the larval stage of pork tapeworm, Taenia solium. The worm requires different hosts during its different stages of development. Humans are the definitive hosts and harbor the adult worms, while pigs harbor the larval stage and act as the intermediate hosts. This disease is endemic in developing countries of the world where poor sanitary conditions are prevalent. It manifests mostly in form of lesions in the subcutaneous tissues, brain and skeletal muscles. It is interesting to note that the oral cavity is a rare site for its occurence and pose as a diagnostic challenge for the clinicians. Here, we report one such rare case of an isolated lesion of the oral cavity involving the buccinator muscle.

Prevalence of True Median Cleft of Upper Lip as Reflected from a Small Central Indian Population: Attempt to Report and Review the True Median Cleft of Upper Lip.

AIMS AND OBJECTIVES: The median clefts of the facial skeleton and soft tissue are least in occurrence. Here we have attempted to analyze and review the prevalence of median clefts in our center. MATERIALS AND METHODS: All the patients who reported with congenital deformities from January 2013 to June 2016 were included in the study. A detailed list of patients was then re-evaluated to preclude duplication of the record which could have occurred during the admission process. All the characteristics which can be evaluated epidemiologically were individually tabulated and evaluated in detail. RESULTS: Out of the 1184 patients included in the study only 2 were affected with median cleft. The prevalence of true median cleft was hence determined to be 0.17% among the cleft population. CONCLUSION: The prevalence of the true median cleft lip is rare and hence makes it difficult to classify these clefts, and also the treatment protocol needs to be fabricated for the treatment of such clefts.

Simple Technique Overcoming a Persistent Problem in Cleft Palate Repair.

PURPOSE: Cleft palate repair mandates use of a mouth gag and Dingmans moth gag is the most commonly used for the same; but the use of Dingmans mouth gag may have the demerit of the suture getting tethered at various places of the instrument during cleft palate closure particularly in the hands of the beginner surgeon. METHOD: This article discusses about a simple technique of using a rubber dam sheet to cover the frame of the mouth gag. CONCLUSION: The technique discussed in this article is simple, cost effective method to overcome the potential disadvantage of suture adherence during repair of palatal tissue. The technique also has the potential to reduce the total operative time which needs a further study to validate the same.

Assessing the association of taurodontism with numeric dentition anomalies in an adult central Indian population.

AIM: To study the association between taurodontism and numeric anomalies in adult population. MATERIALS AND METHODS: Out of 1,012; 946 panoramic radiographs and dental records were retrospectively assessed to determine the presence of dental agenesis and supernumerary and taurodont teeth. RESULTS: Taurodontism of one or more teeth was observed in 164 cases (97 females and 67 males). Hypodontia was observed in 148 patients (84 females and 64 males) with 62 patients having associated taurodontism (38 females, 24 males), oligodontia in 12 patients (five females and seven males) of whom nine patients also had taurodontism of one or more teeth (five females and four males). Forty-five patients (32 females and 13 males) presented with 57 supernumerary teeth (ST) with 12 patients having simultaneous presence of taurodontic tooth (seven females and five males). CONCLUSION: Our study suggests a preferential association between tooth agenesis and taurodontism; however, such association was not observed in individuals with hyperdontia. Understanding the nature of this preferential association may be of importance in determining the etiology of both conditions. This association may also define a subphenotype for future genetic studies on dental development. Further molecular studies are necessary to verify the etiology and mechanism of taurodontism associated with tooth agenesis.

A large multifocal aggressive osteoblastoma of mandible: an immunohistochemistry case study report.

Aggressive osteoblastoma (AO) is a benign osteoblastic tumor which is rare in the head and neck region. Clinical and histo-logical features are therefore overlap with other benign and low-grade malignant tumors. The aim of this article is to report and discuss the differential diagnosis of an aggressive osteoblastoma in the mandible. A 25-year-old male patient reported with pain and asymmetry on the left side of the face since 8 months previously. Radiographic evaluation showed a mixed lesion extending from approximately the lower left premolar to the third molar region. After incisional biopsy, resection with continuity defect was carried out. Microscopic findings showed woven bone and bony trabeculae with varied degrees of mineralization along with sheets of osteoblast cells. Immunohistochemistry showed that p53 and cytokeratin (CK) were negative and ki-67 index was 7%. Postoperative follow-up for 15 months showed no evidence of recurrence.

A New Trend in Recording Subgingival Tissue around an Implant While Making a Direct Abutment Impression.

A successful implant-supported restoration must provide adequate function and esthetics. Osseointegrated implants have given an alternative choice for patients who have lost their teeth. Most commonly encountered problems while doing a transfer from patient to the master cast in restoring implant-supported crowns are an uneven distribution of occlusal loads and undue torquing forces on the various elements of implant. This is caused due to poor fit of frameworks connected to implant, which further leads to marginal bone loss, loosening of screws, fatigue fracture of implant components, and ultimately implant failure. This paper presents a simplified and easy solution to overcome such problems by introducing an innovative gingival retraction system for restoring implant-supported crowns to achieve superior and predictable long-term outcomes.

A sectional-splinting technique for impressing multiple implant units by eliminating the use of an open tray.

Since the inception of root form implant dentistry by P-I Branemark in the early 1980's, so many technical advances have been put forward by several authors. However, the open tray impression technique is still performed for impressing multiple implant fixtures as it was first described in the original Branemark procedure manual. The most critical aspect for a successful implant-supported restoration is the passive and an accurate fit of superstructures to avoid preload and loading stresses. Splinting impression technique in multiple implants has gained popularity. Auto-polymerizing acrylic resin is among the most routinely practiced splinting material for multiple implant units. However, unfortunately, it exhibits shrinkage, which makes an impression quite inaccurate. This case report presents the solution to minimize the shrinkage of resin by utilizing sectional-splinting technique as advocated in the previous implant literature.

Nonsyndromic familial oligodontia with multiple dens invaginatus: a case report of an unusual case.

Oligodontia is a rare dental anomaly with a prevalence of 0.3% in permanent teeth and much less frequency in the primary dentition. Familial oligodontia represents an absence of varying numbers of primary and/or secondary teeth as an isolated trait. It is a complex and multifactorial condition. Many explanations-evolutionary, genetic, and environmental-have been proposed as the etiology. Simultaneous with oligodontia are often the different positional changes of the existing teeth, their morphology, size, and growth disturbances of the maxillofacial skeleton. Early recognition is vital to provide adequate treatment and prevent squeal. Multidisciplinary referral or consultation is thus important in treatment planning to improve function and esthetics. The present paper reports a rare case of familial oligodontia associated with multiple dense invaginatus and microdontia.

A direct investment method of closed two-piece hollow bulb obturator.

Maxillary defects occur due to surgical treatment of benign and malignant tumors, congenital malformation, and trauma. Prosthetic rehabilitation in such patients is influenced by the size and location of the defect. The most common of all intraoral defects are seen in the maxilla, in the form of an opening into the maxillary sinus and nasopharynx. These defects create disabilities in speech, deglutition, and mastication. The prosthesis which closes such an opening and recreates the functional separation of the oral cavity and sinus and nasal cavities is referred to as an obturator. Numerous techniques of hollow bulb fabrication have been mentioned in the literature from time to time. But there are only a few methods for bulb fabrication in two-piece obturator. This technique describes a direct investment method of waxed-up closed hollow bulb two-piece obturator.

Atypical case of primary intraosseous adenoid cystic carcinoma of mandible.

The Primary central salivary gland neoplasms of the mandible are infrequent. Their clinical and radiographic features may be similar to odontogenic tumors, which are otherwise common. Their accurate diagnosis becomes troublesome. Hence, diagnosis should depend on stringent diagnostic criteria. Adenoid cystic carcinoma is well known for its prolonged clinical course and its tendency for delayed onset of distant metastases. The long-term survival of these patients is therefore poor. Treatment modalities include surgery, radiotherapy and chemotherapy. The purpose of this paper is to report a case of primary central adenoid cystic carcinoma of mandible with an atypical presentation.