RESUMEN
Inferior alveolar nerve (IAN) injury is most common in bilateral sagittal split osteotomy (BSSO) cases. The present standard is to always reposition the IAN from the proximal fragment to the distal fragment during surgery. This study aims to assess the severity and incidence of postoperative injury and the recovery of the inferior alveolar nerve in proximal fragment entrapment. Methods: - A total of 35 patients (70 BSSO osteotomies) with mandibular deformities requiring movements equal to or less than 6 mm were selected. Twenty out of 70 osteotomies had IAN on the proximal fragment (Group 1) while splitting. Group 2 included 20 osteotomies with IAN on the distal segment in the same patients. Therefore, 15 patients who had IAN on distal segments on both sides were excluded from this study. All the BSSO procedures were performed by the same surgeon. Postoperative recovery and follow-up were performed on the immediate 1st postoperative day and at 3-, 6- and 12-month intervals. The nociception (pin-prick discrimination) test and mechanoreceptive tactile skin test with cotton fibrils were performed by a third clinician who was blinded to the procedure to assess IAN sensation. Conclusion: There was no significant difference between the groups in the recovery of IAN sensation after 6 months and the 1-year period. Hence reposition of IAN from the proximal segment to the distal segment during BSSO surgery may not be mandatory if the required movement is within 6 mm. This avoids unnecessary manipulation of the IAN over the proximal fragment.
RESUMEN
Objectives: A single-blinded randomized controlled trial was designed to compare and evaluate the effectiveness of the periotome and piezotome as aids for atraumatic extraction and its sequalae. Materials and Methods: The study sample comprised 48 teeth, equally allotted to the piezotome or periotome groups by random allocation, in participants aged 19-62 years. All samples in both groups had either complete tooth structure or intact roots without crowns and had mobility ≤grade II. Clinical parameters of operative duration, presence or absence of gingival laceration, reported operative and postoperative pain, and intake of analgesics following extraction were recorded. IBM SPSS software package version 22 was used for data entry and analysis. Results: The mean operation time was significantly (P≤0.05) longer in the piezotome group than in the periotome group. However, fewer gingival lacerations were observed with use of a piezotome than with a periotome, although no significant difference was observed. The piezotome group reported significantly (P≤0.05) higher visual analog scale (VAS) pain scores during the procedure and non-significantly higher scores thereafter until the third postoperative day. In the piezotome group, the dosage of analgesic was higher, although the periotome group had a higher percentage of participants who used analgesics postoperatively; however, these differences were not statistically significant. Conclusion: The present clinical trial favors the use of periotome over piezotome for atraumatic extraction due to shorter operating time, lower postoperative VAS pain scores, and lower dosage of analgesics despite the superior ability of the piezotome to prevent gingival laceration.
RESUMEN
Oral Potentially Malignant Disorders such as leukoplakia, lichenplanus, Oral Submucous Fibrosis are most commonly encountered precancerous lesions in India. Although, usage of smoking tobacco has been decreased yet incidence of oral cancer seems to be in increasing trend. Apart from tobacco many non-tobacco causes are associated with the disease. Helicobacter pylori is a curved, flagellated bacterium that has been declared as group I carcinogen by WHO. They are proven causative agent for gastric carcinoma. They have been shown to harbour oral cavity by many authours. They produce onco-protein that causes DNA damage. CagA and VacA are such proteins that modulate certain oncogenes and tumour suppressor genes. In this study we have identified the organism from sub gingival plaque by PCR and those who harboured the organism were further subjected for identification of oncoproteins CagA and VacA by ELISA. This study shows that presence of organism in Oral leucoplakia, oral lichenplanus and Oral Submucous Fibrosis are statistically significant in comparison to control group (p>0.05). The presence of oncoproteins was also statistically significant in comparison to control group. These proteins are shown to accelerate inflammatory pathway thereby hasten the process of tumorigenesis. H.pylori infection as well the virulent strains can be diagnosed from oral cavity in the most non-invasive way at the earliest.
