A Massive Craniofacial Polyostotic Fibrous Dysplasia of Midface - A Rare Case Report.

Rationale: Fibrous dysplasia (FD) is a fibro-osseous lesion of the osseous structures of the body. With an incidence of 1:4000-1:10,000, it seems to be a rare disease. Polyostotic craniofacial fibrous dysplasia involves the skull base bones and facial bones. Patient Concerns: The patient complained of a huge swelling over the right side of her face for the past 12 years. Diagnosis: Based on clinical, radiological and histopathological findings, the swelling was diagnosed as polyostotic craniofacial FD. Treatment: Swelling over the right side of the midface around 6 cm × 5 cm involving right maxilla, zygoma, floor of orbit, lateral side of nose (pyriform aperture) and skull base bones. Since the patient had no functional deficit, we opted for surgical recontouring. Outcomes: The patient was satisfied with post-operative results. Take-Away Lessons: In huge asymptomatic facial deformity, rather than going for resection, we can remove bone in a piecemeal manner followed by recontouring.

An Assessment of Factors Influencing the Difficulty in Third Molar Surgery.

BACKGROUND AND OBJECTIVES: Surgical removal of a mandibular impacted third molar is one among the most common oral surgical procedures. The objective of this study was to assess and identify risk indicators influencing extended operation time in relation to the surgical removal of mesioangular impacted mandibular third molar, position A, Class I and to evaluate the incidence of postoperative swelling, trismus, and pain. MATERIALS AND METHODS: A prospective cohort was implemented and the patients who presented for mandibular third molar removal which were impacted in position A, Class I were enlisted for the study. During 1 year between July 2014 and June 2015, a total of 40 patients were enrolled in the study. The evaluation of patient variables and radiographic variables was done preoperatively. Depending on the duration of time taken for an operation, patients were divided into three groups: Group I, Group II, and Group III. Postoperative complications such as swelling, trismus, and pain were assessed in each of the patients. STATISTICAL ANALYSIS: The statistical analysis was done among the groups using Chi-square test, and ANOVA. RESULTS: Among the six variables studied in this study including patient variables and radiographic variables, maximum interincisal opening, external oblique ridge, and root morphology were found to be dependent factors which influence the operating time. Moreover, other variables such as the crown root width ratio and the number of roots were independent factors. Swelling, trismus, and pain were statistically significant among groups and were directly related to operating time. CONCLUSION: We consider that the outcome of surgical removal of mandibular impacted third molar, position A, Class I depends significantly on relevant patients characteristics and radiographic variables which should be evaluated preoperatively as they are predetermined factors to avoid postoperative morbidity.

Van der woude syndrome with short review of the literature.

Van der Woude syndrome (VWS) is a rare autosomal dominant condition with high penetrance and variable expression. Clinical manifestation of this autosomal dominant clefting syndrome includes bilateral midline lower lip pits, cleft lip, and cleft palate along with hypodontia. These congenital lip pits appear as a malformation in the vermilion border of the lip, with or without excretion. Discomfort caused by spontaneous or induced drainage of saliva/mucus when pressure is applied or during a meal as well as poor aesthetic match is one of the main complaints of patients with congenital lip fistula. The pits are treated by surgical resection. Dentists should be aware of the congenital lip pits as in Van der Woude syndrome because they have been reported to be associated with a variety of malformations or other congenital disorders. Here, the authors report a rare case of Van der Woude syndrome with short review of the literature.

Heterotopic ossification: an unusual presentation.

Heterotopic ossification (HO) is usually seen after-trauma, following traumatic injuries, surgeries involving major joints, neurogenic injury, and burns; however, atraumatic cases have also been reported. HO tends to cause pain, swelling, and limitation of joint movements. HO has been reported in adults as well as in pediatric cases, however, our search in the English literature has not revealed a single case in the infratemporal region, especially in children of developing age, where HO tends to affect the development and growth of adjacent bones. We are reporting a case of HO in close proximity to TMJ affecting the development of mandible and maxilla.