Simple Method for Re-tightening IMF Wires without Breakage.

AIM: This clinical technique aims to retighten intermaxillary fixation (IMF) wires when loosened intra/postoperatively. BACKGROUND: Intermaxillary fixation is one of the most important steps to obtain stable and functional occlusion in maxillofacial trauma. However, IMF wires tend to loosen over time. This loosened wire is generally removed and a new wire is used for IMF. Removal and refixation is time-consuming for surgeon and unconformable for the patient. TECHNIQUE: We recommend a simple technique for re-tightening IMF wires without breakage, with the use of shepherd's crook explorer by making a small circular loop. CONCLUSION: This technique of re-tightening by looping further stretches and tightens the wire to regain stabilized occlusion with maximal intercuspation. CLINICAL SIGNIFICANCE: This technique eliminates the need for removal and refixation of IMF wires, thereby improving patient comfort, yet obtaining stable occlusion over a long period of time. How to cite this article: Madhu SK, Dominic S, Baptist J, et al. Simple Method for Re-tightening IMF Wires without Breakage. J Contemp Dent Pract 2024;25(3):289-291.

Validity of laser induced breakdown spectroscopy (LIBS) in determining age and sex from tooth specimens.

Background: To determine age and sex from tooth specimens using Laser-Induced Breakdown Spectroscopy (LIBS). Materials and methods: A total of 170 human teeth samples between age of 15-86 years of both male and female sex were obtained for the study based on the inclusion and exclusion criteria. All the tooth samples were mounted and ground sections of about 1.5-2 mm thickness were prepared. Each tooth sample was subjected to LIBS along the cemento-enamel junction and spectrographs were acquired that denoted the elemental presence in each tooth sample. Results: The elemental concentration of Ca I, Ca II, P and Fe in all the teeth samples declined as the age progressed. The Peak intensity of Ca, P and Fe was observed in the second decade of life. The overall concentration of Fe exhibited highest intensity in both male and female samples when compared with other elements assessed. The general concentration of all the elements were relatively higher in the female samples when compared to those in males. Conclusion: The CEJ seems to be a better site for elemental analysis of tooth since multiple tooth sites are represented in this region and the other sites of teeth such as enamel or roots of teeth may tend to get fractured, and my not be available for the analysis. The signal intensities of trace elements seen to reduce with increase in age. However, certain external factors also seemed to have an influence on these outcomes.

Problems in managing a co-morbid patient with no previous medical records undergoing alternative therapy.

Individuals with intellectual disability are often uncooperative for complete dental evaluation and treatment. Many of these patients fall within autistic spectrum disease. These patients are also said to be associated with other medically relevant disorders such as seizures, and metabolic and hormonal dysfunction. Undertaking treatment of such patients under general anaesthesia will require complete medical evaluation. As many of the antiepileptic drugs interact with anaesthetic agents, a sound knowledge of drugs taken by the patient is necessary. However, when the patient is under alternative therapy, this problem becomes multi-fold. This paper will discuss the basic, but real problems with the gap of understanding between allopathic and alternative therapy, the importance of reviewing the patients', previous medical records, and its medico-legal consequences. It will also raise the issue of delays in management with increased cost and time of hospitalisation in such patients.

Patterns of Tobacco Use and its Relation to Oral Precancers and Cancers among Individuals Visiting a Tertiary Hospital in South India.

AIM: The aim of this study was to evaluate the use of tobacco and its association with oral precancers and cancers. MATERIALS AND METHODS: Medical records of 1,007 individuals were assessed for the patterns of tobacco abuse and the presence of tobacco-related oral mucosal alterations. RESULTS: This study comprised 1,007 individuals (M:F: 95.4%:4.6%). In the cohort, 60.1% had smoking habit and 56.1% had smokeless habit. Of the bidi smokers, 18.2% developed carcinoma, 14.3% developed leukoplakia, which is statistically significant (p < 0.001). A logistic regression analysis of the development of oral submucous fibrosis (OSMF) shows that habit of smokeless forms of tobacco has an odds ratio (OR) of 18+ when compared with smoking. Combination of bidi and gutkha had 12.3 times higher risk of developing oral cancer and 4.4 times risk of developing leukoplakia. A total of 33.3% betel quid and gutkha chewers presented with tobacco pouch keratosis, which is statistically significant. CONCLUSION: Smoked and smokeless forms of tobacco were equally popular among the study population. The packeted form of smokeless tobacco (gutkha) was more prevalent. Oral submucous fibrosis was more common than leukoplakia, and oral cancer developed more frequently in elderly men smoking bidis. CLINICAL SIGNIFICANCE: This study throws light on the fact that the use of both smoke and smokeless forms of tobacco is still prevalent, and the use of gutkha was most prevalent. These findings will help tobacco cessation and counseling centers to focus their effort in motivating people to stop gutkha chewing habit. This also brings to the forefront the need to create better treatment strategies to manage OSMF.

Dautrey's Procedure Revisited in Management of Recurrent Mandibular Dislocation.

INTRODUCTION: Mandibular dislocation occurs when the condylar head glides out of the glenoid fossa with the condyle positioned in such a way that its posterior articulating surface lying ahead of the articular eminence. Recurrent mandibular dislocation is relatively uncommon. Patient is extremely distressed and goes through a lot of discomfort. Varied etiologies have been cited in the literature, such as keeping the mouth wide open for long periods of time during dental procedures, yawning, laughing, traumatic injuries to the mandible, psychiatric disturbances, and certain drugs. Acute dislocations are best managed immediately by reduction and intermaxillary fixation. However, dislocations that have remained over a period of a month are considered to be chronic and these cannot be reduced successfully by manual manipulation of the mandible. Such chronic recurrent dislocations are surgically managed with eminectomy, meniscectomy, and condylotomies. A downward and forward osteotomy of the zygomatic arch in front of the articular eminence so as to produce a mechanical obstruction was recommended by Dautrey and Gosserez. This article will highlight the surgical experience of managing six patients with chronic recurrent dislocations of the temporomandibular joints (TMJs) bilaterally employing Dautrey's procedure.

Rebamipide to Manage Stomatopyrosis in Oral Submucous Fibrosis.

INTRODUCTION: Oral submucous fibrosis (OSF) causes progressive debilitating symptoms, such as oral burning sensation (stomatopyrosis) and limited mouth opening. The standard of care (SOC) protocol includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. The objective of the study was to evaluate efficacy of rebamipide in alleviating burning sensation of the oral mucosa in OSF in comparison with SOC intralesional steroid injections. MATERIALS AND METHODS: Twenty OSF patients were divided into two groups [rebamipide (100 mg TID for 21 days) and betamethasone (4 mg/mL biweekly for 4 weeks)] of 10 each by random sampling. Burning sensation was assessed every week for 1 month. Burning sensation scores were analyzed using repeated measures analysis of variance (ANOVA) and paired t-test. RESULTS: Change in burning sensation score was significant (p < 0.05) in the first four visits. However, score between the 4th and 5th visit was not statistically significant (p > 0.05). CONCLUSION: Our study has shown that rebamipide can be considered as an effective modality to manage burning sensation in patients suffering from OSF. CLINICAL SIGNIFICANCE: Considering stomatopyrosis and trismus as a major cause for inability to eat in OSF, use of newer adjunctive modalities, such as rebamipide will ease patients suffering and also encourage them to consume food.

Fracture of the coronoid process associated with frontosphenoidal fractures.

Coronoid process fractures are rarely encountered, commonly undiagnosed, usually asymptomatic, and most commonly treated conservatively, hence very little written about. We present two cases of coronoid process fractures with associated frontosphenoidal injuries.

Myositis ossificans of infraorbital musculature in uncontrolled diabetic.

Myositis ossificans traumatica is a form of dystrophic calcification that leads to heterotopic ossification of intramuscular connective tissue. It is rare in the orofacial region. A history of trauma, conventional radiography and computed tomography, along with histopathological examination, can be used effectively to diagnose this condition. We present a unique case of infected myositis ossificans traumatica in the infraorbital region in an uncontrolled diabetic.

Dental considerations in hereditary epidermolysis bullosa.

Epidermolysis bullosa is an inherited mucocutaneous disorder characterized by blister formation due to a defect in collagen metabolism. Each of the three major subtypes of epidermolysis bullosa has distinct clinical and oral manifestations. A case report of the most classic form of epidermolysis bullosa, recessive dystrophic epidermolysis bullosa, is presented here, along with a review of the literature on the clinical features and management of the condition. An attempt has been made to highlight the anesthetic and oral surgical considerations when treating a patient with epidermolysis bullosa.