Screening for maternal coeliac disease as a potential risk factor for orofacial clefts--a pilot study.

There is increasing evidence that dietary folic acid deficiency in utero may increase the risk of developing the 'cleft lip with or without cleft palate' (CL±P) variant of orofacial cleft. Coeliac disease is a common cause of folic acid malabsorption, and in the majority of cases remains undiagnosed. This pilot study assessed the seroprevalence of undiagnosed coeliac disease in a cohort of mothers of infants with CL±P in the Hyderabad area of India. The seroprevalence of coeliac disease of 1.15% (95% confidence interval 0.37-2.66%) was little different from the expected figure based on published population studies, making a clinically significant association unlikely.

Comparison of two impression techniques for auricular prosthesis: pilot study.

The purpose of this article was to compare the accuracy of a new impression technique, the triple-layer impression technique (TLIT), with the conventional impression technique (CIT) to fabricate an auricular prosthesis. Fifteen male subjects (aged 22-45 yr) were selected. Ten markings were made on the subject's ear (super aurale [sa], sub aurale [sba], pre aurale [pra], post aurale [poa], A, A1, B, B1, C, and C1) and five measurements (sa-sba, pra-poa, A-A1, B-B1, and C-C1) were made. Custom-made trays were used to record impression in CIT and TLIT. Impressions were made using alginate, and models were cast with type IV gypsum product. Markings were transferred on the cast. Measurements were rechecked on the models. Distribution analysis of difference in measurements between the two impression techniques and the subject's actual values was evaluated. Sign test was used to analyze the statistical significance. Statistically significant differences were found in measurements A-A1, B-B1, and C-C1 between the two techniques when compared with the subject's actual dimensions (p < 0.01). TLIT was found to produce accurate models when compared with CIT. The TLIT used in the study was cost effective, less technique sensitive, and tailor made to reduce chairside orientation time during wax try-in appointments for rehabilitating patients, especially those with unilateral auricular defects.

Myositis ossificans traumatica of the medial pterygoid.

Myositis ossificans traumatica (MOT) is a non-neoplastic, heterotopic bone formation within muscle or fascia, presumably due to acute trauma, a burn, surgical manipulation, or repeated injury. A 36-year-old woman presented with progressive limitation of mouth opening over the past 5 months. Computed tomography revealed an irregular ossified mass attached to the medial aspect of the left ramus, extending to the medial and lateral pterygoid plates. MOT of the medial pterygoid is rare, with only four previously reported cases in the English language literature. Surgical excision of the ossification is the main treatment modality. The authors were able to establish a cleavage plane of 3 cm between the bony mass and the medial surface of the ramus. Abdominal fat was placed as an interpositional material to prevent fibrosis and heterotopic bone formation.

Versatility of full thickness skin-subcutaneous fat grafts as interpositional material in the management of temporomandibular joint ankylosis.

The authors present a review of seven patients (eight joints) with temporomandibular ankylosis treated between 2007 and 2008. The aim of this retrospective study was to present the experience of using full thickness skin-subcutaneous fat grafts, harvested from the patient's abdomen as interpositional material after gap arthroplasty. All patients presented with osseous ankylosis and were graded according to Topazian's classification. Postoperative follow up ranged from 12 to 24 months. Maximal inter-incisal opening (MIO) on presentation ranged from 0 to 8mm, which stabilized to 27-44mm at follow up. There was no evidence of re-ankylosis. This study found merit in the use of autogenous full thickness skin-subcutaneous fat graft as an interpositional material for up to 2 years following ankylosis release.

Impact of impacted mandibular third molars in mandibular angle and condylar fractures.

Previous retrospective analyses prove that impacted mandibular third molars (M3s) increase the risk of angle fractures and decrease the risk of concomitant fractures to the condyle. The authors have attempted to verify these relationships and identify the underlying mechanism of injury. A retrospective cohort was designed for patients attending the Division of Oral and Maxillofacial Surgery from January 2001 till October 2008. The primary predictor variable was M3. The secondary predictor variables were: M3 position, classified using the Pell and Gregory system; angulation, classified using Shiller's method; and the number of visible dental roots. The outcome variables were angle and condyle fractures. Hospital charts and radiographs were used to determine and classify these variables. The study sample comprised 1102 mandibular fractures in 600 patients. For patients injured by moderate traumatic force resulting in two fractures of the mandible, the presence/absence of impacted M3s played an important role in angle/condylar fractures. Patients with impacted M3s were three times more likely to develop angle fractures and less likely to develop condylar fractures than those without impacted M3s. This study provides clinical evidence to suggest that the removal of unerupted mandibular third molars predisposes the mandible to condyle fractures.