Frequency of concomitant injuries in maxillofacial trauma in a tertiary health care centre in India: A 5-year retrospective study.

PURPOSE: Road traffic accidents (RTA), assaults, falls, and sports-related injuries are the leading causes of maxillofacial trauma. Due to quite different geographical environment and fast urbanization, the use of various protective equipment is restricted in India. Thus, compared to other countries, there might be a significant difference in the pattern and frequency of associated injuries among subjects with maxillofacial trauma. The present study was conducted to identify the causes and pattern of various maxillofacial fractures and the frequency of other related injuries among subjects with maxillofacial trauma. METHODS: This is a cross-sectional retrospective study recording 2617 subjects with maxillofacial trauma. The patient demographics, causes of trauma, types of maxillofacial injury, and associated soft and hard tissue injuries were recorded. The types of maxillofacial and associated injuries were diagnosed from details of clinical examinations and the interpretation of various radiographs available in the file. The associated injuries were divided into head injury, other bony injuries, and soft tissue and vital structure injuries. Descriptive statistics and the test of proportion were used. A p value < 0.05 was considered as a level of significance. RESULTS: The maxillofacial injuries were significantly common in patients aged 16 - 45 years (66.7%) than in patients aged ≤ 15 and > 46 years (33.3%) (p < 0.001). The RTA was the most common cause of maxillofacial injury (n = 2139, 81.7%), followed by fall (n = 206, 7.9%), other causes of injury (n = 178, 6.8%), and assaults (n = 94, 3.6%). The maxillofacial injury by 2-wheel vehicle accidents was significantly higher than that by 4-wheel vehicle and other vehicle accidents (p < 0.001). There was a significant correlation between alcohol and RTA (p < 0.001). The head injury (n = 931, 61.1%) was the most common associated injury, followed by soft tissue and vital structures injuries (n = 328, 21.5%) and other bone injuries (n = 264, 17.3%). DISCUSSION: Head injury was the most common associated injury followed by soft tissue and vital structures and bone injuries among subjects with maxillofacial trauma. Clavicle fracture and injury to the lower extremities were the most common hard and soft tissue-associated injuries.

Rhinosporidiosis of Parotid Duct: A Report of Five Case Series.

Rhinosporidiosis of the parotid duct is extremely rare. The sporadic cases of rhinosporidiosis are seen all over the world but more than 90% of the cases are reported from South Asia and Brazil. We report five male patients with parotid duct rhinosporidiosis ranging from eighteen to seventy-two years of age, hailing from the eastern part of India. All of them presented with right parotid swelling. Clinical examination revealed cystic swelling. Imaging studies of these patients suggested sialocele and abscess. Cytology was non-diagnostic. All five patients underwent complete surgical excision of the cyst. Histopathological examination of cysts confirmed the diagnosis of rhinosporidosis of the parotid duct. Regular follow-up was done and all were disease-free even after five years of follow-up.There is a need for a high index of suspicion of parotid swelling of this nature in endemic areas.

Emerging Trends of Zygomaticomaxillary Complex Fractures and Their Etiological Analysis in a Tertiary Health Centre from Eastern India: A Retrospective Study.

INTRODUCTION: Maxillofacial region is one of the most complicated arrangements of bony and soft tissues in human body, superiorly bounded by cranial bones and inferiorly by the mandible with interposed dentition. This is one of the reasons which make injuries to this region difficult to manage and often controversial. The severity and patterns of these injuries have changed considerably due to the increasing reliance on fast road transportation facilities and interpersonal violence. MATERIALS AND METHODS: The aim of the present study is to analyze retrospectively the changing patterns of mid-face fractures in a sample of patients reporting to Department of Oral and Maxillofacial Surgery in AIIMS Bhubaneswar, India, from April 2017 to April 2018. A performa was prepared which included age, sex, etiology of injury, alcohol influence, and treatment given during hospital stay. RESULTS: Road traffic accidents contributed 68.11% of zygomaticomaxillary complex (ZMC) fractures, followed by assault (18.11%) and fall from height (13.76%). RTA was the major cause of atypical ZMC fractures as compared to conventional ZMC fractures (P < 0.001). DISCUSSION: Due to modern lifestyle and changes in fast transportation, recent fracture patterns do not follow the tell-tale signs or patterns and often need unique and patient-specific treatment plan, making the skills of maxillofacial surgeons the pivotal factor in better prognosis.

Temporary deterioration of oral health-related quality of life (OHRQoL) in nonextraction and extraction modalities of comprehensive orthodontic treatment in adolescents.

OBJECTIVE: To evaluate the effects of nonextraction and all first premolar extraction modalities of orthodontic treatment on oral health-related quality of life (OHRQoL) among adolescents. MATERIALS AND METHODS: Sixty-eight adolescents of aged 12-18 years were chosen. Subjects who required nonextraction orthodontic treatment were included in group I, and those who required all first premolar extractions for orthodontic treatment were included in group II. Baseline OHRQoL data (T0) were recorded before the start of treatment. To evaluate the impact of orthodontic treatment on OHRQoL, the Oral Health Impact Profile-14 (OHIP-14) questionnaire was presented to all subjects for retrospective evaluation at 1 month (T1), 3 months (T2), 6 months (T3) and 1 year (T4) after the start of orthodontic treatment and 1 week after completion of orthodontic treatment (T5). RESULTS: At T1 and T2, the physical pain and physical disability domains of OHIP-14 were impacted significantly by comprehensive orthodontic treatment in both groups (P < .001). The negative impact of orthodontic treatment on OHRQoL was maximum at T1 and then slowly recovered to the pretreatment level at T3 in both groups. Recovery of OHIP-14 scores was relatively faster in group I subjects compared to group II subjects. At T1 and T2, social disability and handicap domains were deteriorated significantly in group II subjects compared to group I subjects (P < .01). CONCLUSIONS: The severity of OHRQoL deterioration was similar in both modalities of orthodontic treatment, but recovery from negative impacts was relatively slower in the first premolar extraction subjects.

Osteochondroma condyle: A journey of 20 years in a 52-year-old male patient causing severe facial asymmetry and occlusal derangement.

Mandibular condylar osteochondroma (OS) is a rare lesion though most common benign tumor of the axial skeleton. OSs are slow-growing tumors originating from the cortex of the bone resulting in facial asymmetry, temporomandibular dysfunction and occlusal derangement. We present an extremely rare case of OS of the mandibular condyle in a 52-year-old male patient who presented to our hospital with gradual deviation of the lower jaw, difficulty in opening the mouth and chewing the food for 20 years with clinicoradiological and pathological correlation.

Oral health-related quality of life among male subjects with oral submucous fibrosis in a tertiary care hospital.

BACKGROUND: Oral submucous fibrosis is very common in Asia. It has many deleterious effects on individual's oral functions. Thus, there is a need to assess the effect of oral submucous fibrosis on quality of life. OBJECTIVE: To assess the oral health-related quality of life (OHRQoL) in male subjects with oral submucous fibrosis. METHODS: Two hundred and thirty male subjects in the age range of 20-40 years were recruited in the cross-sectional, two-group comparative study. Of 230 male subjects, 115 were oral submucous fibrosis subjects who were included in the study group and 115 healthy subjects formed the control group. English version of the oral health impact profile-14 (OHIP-14) was used to assess the OHRQoL. Wilcoxon signed-rank, Kruskal-Wallis, and Bonferroni tests were applied, and the P = 0.05 was considered as level of significance. RESULTS: The mean and median OHIP-14 scores were 19.10 ± 0.66 and 18.00 in the study group and 3.98 ± 3.80 and 3.00 in the control group subjects, respectively (P < 0.001). Mean score of all the seven domains of OHIP-14 was significantly more in oral submucous fibrosis subjects (P < 0.001). All the oral submucous fibrosis subjects had one or more negative effects on OHRQoL compared to 64.34% of healthy subjects. Stage-4 of the oral submucous fibrosis had maximum effect on quality of life compared to other stages (P < 0.001). CONCLUSIONS: The quality of life among males is severely affected by oral submucous fibrosis, and Stage-4 of oral submucous fibrosis has maximum effect on the quality of life.

Vanishing Mandible in a 7-year Old Child: Response to Radiation Therapy.

Massive osteolysis in a 7-year old child is a rare condition. The etiology of massive osteolysis is unknown and it results in the progressive destruction of bony structures. There is no standard therapy available in the literature. Conservative treatment is often used for its management. Radiotherapy is considered as an accepted form of treatment with greater chance of success when it is used in the early course of disease. There are few case reports in the literature in which radiotherapy has been used for the treatment. This article highlights the literature update on various treatment modalities and a case managed by radiation therapy.

Phlebolith in arteriovenous malformation in buccal fat pad masquerading sialolith: A rare case report.

Arteriovenous malformations (AVMs) are rare vascular lesion in the buccal fat pad (BFP). One of the important complications associated with these lesions is phlebolith formation within it. To the best of authors' knowledge, there is no medical literature on AVM with phlebolith formation in BFP till date. The present case is a 12-year-old boy who presented with a swelling in the right side of the face, clinically diagnosed to be sialocele with sialolith. Excision of the mass was done, and histopathology revealed AVM with the formation of phlebolith. This rare entity needs to be kept in mind while evaluating a case of calcification in BFP. The first case of AVM with phlebolith formation in BFP is reported here along with brief review of literature.

Cemento-ossifying fibroma of mandible: An unusual case report and review of literature.

The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature.

Two rare cases of rhinosporidiosis of parotid duct: Case reports and review of literature.

Rhinosporidiosis is a chronic granulomatous infective disease caused by fungi, Rhinosporidium seeberi. It can occur universally, is endemic in India, Sri Lanka and in South Asia, mainly reported from Southern India and Sri Lanka. Rhinosporidiosis is a chronic disease classically involving nose and nasopharynx and presents as a localized polypoid mass. Rhinosporidiosis involving parotid duct is rare. We encountered two cases of rhinosporidiosis at extremely unusual extranasal site-parotid duct, presenting as a cyst without nasal manifestations, which was misdiagnosed clinically and on cytological examination.

Extraoral inverted teeth eruption: a case report.

A 14-year-old female presented with extraoral inverted eruption of left mandibular permanent molars 18 and 19 at the lower left inferior border of the mandible. Both the teeth started erupting 1 year after an extraoral surgical intervention for a discharging sinus 6 years ago. The subsequent eruption to the extraoral position of the permanent molars at the inferior border of mandible may be the result of the previous surgical procedure or pathology related to the abnormally positioned teeth. This case presents an infrequent complication affecting the adjacent permanent teeth.