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Purpose: The relationship of orthognathic surgery and temporomandibular disorders (TMD) has always been a topic of debate. The results have varied from mild/moderate improvement to actual worsening in some cases. The purpose of this study was to evaluate the effects of orthognathic surgery on TMD in patients with dentofacial deformities. Method: An observational study was conducted on 56 patients (112 condyles) of patients with dentofacial deformities with age range of 19-35 years who underwent orthognathic surgery. TMD was evaluated using seven types of disorders in diagnostic criteria for TMD (DC/TMD, 2010) pre-operatively and after 6-month follow-up. Results: There was minimal decrease in unassisted mouth opening without pain, maximum unassisted mouth opening and maximum assisted mouth opening after surgery. There was significant improvement in joint sounds and headache in 18 patients. Overall, there was improvement in 29 cases (33.93%), worsening in 8 cases (14.29%) and no change in 19 cases (33.93%). Conclusion: There was high prevalence of TMDs in dentofacial deformity patients. Most of the patients with pre-operative TMD improved with orthognathic surgery, whereas a small percentage of patients who were asymptomatic pre-operatively developed TMD after surgery and in some patients TMD worsened. The risk of developing TMD and worsening of severity conditions is low.
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AIM: To study whether the use of 3-D miniplate, when compared with conventional miniplate, gives better clinical outcomes with fewer complications in patients with fracture mandible. MATERIALS AND METHODS: A prospective study was conducted in the Department of Oral and Maxillofacial Surgery, Trauma Care Centre, on 40 patients. They were randomly divided into Group-I and Group-II with 20 patients in each group. In Group-I, 3-D miniplate was used and in Group-II, conventional miniplate was used. Parameters such as fracture stability, occlusal status, mouth opening, nerve paresthesia, infection, pain, swelling, and complications were evaluated on 1st, 7th postoperative day, 1st month and 3rd month. RESULTS: Fracture stability and occlusion were clinically better in Group-I than in Group-II on each follow-up; however, it was not statistically significant. Infection rate was lesser in Group-I than in Group-II (p = 0.003). Mouth opening was more in Group-II than in Group-I on immediate (p = 0.001) and 7th post-op day (p = 0.002). Overall complications were lesser in Group-I than in Group-II (p > 0.005). CONCLUSION: There is no major difference observed in clinical outcomes between 3-D miniplate and conventional miniplate. Either method of fixation can be used successfully in treatment of mandible fractures with comparable rates of complications.
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AIM: To evaluate whether the use of electrothermal bipolar vessel sealing system reduces the blood loss and operating time, with lesser complications as compared to suture ligation in selective neck dissection in patients with oral cancer. MATERIALS AND METHODS: The study was conducted in the Department of Oral and Maxillofacial Surgery of our institute from January 2015 to December 2016. The sample consisted of 60 patients, divided into Groups I and II with 30 subjects in each. In Group I electrothermal bipolar vessel sealer and in Group II suture ligation were used. The outcome measures recorded were: blood loss, operating time, quality of surgical field, postoperative pain on days 1, 2, and 3, drainage volume at 24, 48, and 72 h, edema, complications, and duration of hospital stay. RESULTS: There were 36 males and 24 females with a mean age of 50.76 ± 12.6 years. Blood loss was significantly less for Group I than for Group II (p = 0.001); the operating time was significantly less in Group I than in Group II (p = 0.001); Group I had better quality of surgical field (p = 0.001); less pain on postoperative evening, day 2 and day 3 (p < 0.05); and less drainage volume at 24 and 48 h (p < 0.05). Postoperative edema, complications, need for perioperative blood transfusion, and duration of hospital stay postsurgery were similar in both groups. CONCLUSION: The electrothermal bipolar vessel sealer was efficacious in terms of reducing blood loss and operating time while providing a better surgical field and patient compliance without increasing the perioperative morbidity.
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This paper highlights a rare case of melanotic neuroectodermal tumor of infancy involving the anterior maxilla in a 3-month-old infant. The tumor was excised completely, and the defect was reconstructed with a bilateral buccal pad of fat. The patient has been followed for 2 years without any evidence of recurrence. We propose that for similar anterior maxillary defects in infants and children, a buccal pad of fat can be utilized as an appropriate pedicled flap for coverage after tumor resection.
