Subcutaneous Emphysema of Periorbital and Canine Space Following Endodontic Treatment.

Emphysema of the subcutaneous tissue is an uncommon complication of dental procedures. Certain dental surgical procedures, such as extraction of teeth using air-driven handpieces and endodontic procedures are more prone to cause subcutaneous emphysema. Subcutaneous emphysema is typically self-limiting and only in a few instances has an impact on the long-term health of the patient. Patients with subcutaneous emphysema experience pain, distress and inconvenience. This paper presents a case of subcutaneous emphysema of the right canine and periorbital space following endodontic treatment of the upper right front tooth.

Clinical Evaluation of Modified Technique of Alar Base Cinch Suture to Prevent Widening of Alar Base.

Introduction: Following Lefort I osteotomy, widening of the alar base is the most common secondary postoperative change resulting in deepening of the alar facial groove, which may be unaesthetic. Therefore, various surgical techniques to control lateralization of the alar base have been widely described in the literature. The purpose of this study was to analyze the cause and to prevent the changes in the nasolabial region, especially excessive widening of the alar base following Lefort I osteotomy by using modified alar base cinch suture. Materials and Method: Twenty patients with the diagnosis of maxillary retrognathism or vertical maxillary excess requiring Lefort I osteotomy with superior repositioning or advancement were included in this prospective, non-randomized clinical study. Following Lefort I osteotomy, the widening of alar base was managed using modified alar base cinch suture. Result: The mean alar width preoperatively was 41.09 ± .38 mm, intra-operatively it was 43.69 ± .28 mm, and after 6 months, it was 41.93 ± .47 mm. Statistical analysis using paired t test revealed that there was a significant change in alar width after placing alar base cinch suture. Discussion: The results of the current study show that the modified alar cinch suture technique is effective in preventing flaring of the alar base in case of Lefort I osteotomies with superior repositioning or advancement.

Unicystic ameloblastoma - A case series.

Ameloblastoma is a benign, locally aggressive neoplasm that constitutes about 1-3% of the tumors of the jaw. Wide surgical excision with adequate safe margin is the most common treatment of choice. The study aimed to manage cases with unicystic ameloblastoma while preserving the continuity of the mandible (without resection). This article presents a series of cases ranging from 18 to 40 years old patients of both sexes with unicystic ameloblastoma, especially in the mandible showing more male predilection than female. All the cases presented in this article were treated by enucleation and curettage. None of the patients presented post-operative paresthesia. None of the cases went in for resection. Post-operative recovery was uneventful in all the patients. All the patients were followed up for a period of 3.5-5 years. None of the cases reported recurrence at the date of publication.

Single Versus Two Plate Osteosynthesis for Parasymphysis Fractures of the Mandible: A Prospective Comparative Study.

Background The treatment of mandibular fractures has undergone a revolutionary change after the invention of miniplate osteosynthesis. There aren't many studies in the literature comparing the outcomes of treating mandibular parasymphysis fractures with two miniplates versus one miniplate.  Aim To evaluate the outcomes of single vs. two plate osteosynthesis in the management of parasymphysis fractures of the mandible. Materials and methods Sixteen patients with parasymphysis fracture of the mandible treated with a single high-profile miniplate or with two miniplates were included in the study. Multiple outcome variables such as fracture union, wound infection, dehiscence, iatrogenic dental injury, intraoperative time, plate exposure, and need for plate removal were recorded and analyzed statistically using the Student's t-test. Results The occurrence of iatrogenic dental injury (P= 0.021) and the mean operating time showed a statistically significant difference between the groups, whereas variables such as osseous healing, plate exposure, wound dehiscence, and postoperative paresthesia had no significant difference (P > 0.05). Conclusion Despite both systems providing enough stability for osseous healing, the use of a single high-profile miniplate demonstrated fewer post-operative problems, such as iatrogenic injury to the dental roots and occurrence of infection/dehiscence and plate exposure, than the use of two miniplates.

Langerhans Cell Histiocytosis of the Mandible.

The unusual disorder known as Langerhans cell histiocytosis, which is most frequently seen in children and young adults, is caused by the clonal proliferation of Langerhans cells. Even if clinical signs and radiographic evidence of destructive bone lesions may raise suspicion of the disease, a reliable diagnosis without a thorough pathological examination is challenging. This report describes a case of eosinophilic granuloma of the mandible in a nine-year-old child with characteristic radiological, histopathological, and immunohistochemical features.

Evaluation of 3D Trapezoidal Plates in Open Reduction and Internal Fixation of Subcondylar Fractures of Mandible: A Clinical Trial.

Background  Fractures of the mandibular condyle are common and account for 25% to 50% of all fractures of the mandible. Various methods exist for open reduction and internal fixation (ORIF) of condylar fractures. This study was done to explore three-dimensional (3D) plates as a viable option. Aim  This study aims to evaluate the effectiveness of 3D trapezoidal plates in open reduction and internal fixation of subcondylar fractures. Materials and methodology This was a non-randomized clinical trial conducted on 20 patients who reported at the Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, India. The ORIF was done under general anesthesia. A retromandibular transmasseteric approach was used to expose the fracture site, and the fracture was stabilized using 3D titanium trapezoidal plates. Parameters, such as mouth opening, mandibular deviation, occlusion, surgical accessibility, fracture reduction, adaptability, the difference in ramal height, angulation of the fractured condyle, operative time, facial nerve weakness, implant failure, complications, and scar formation were assessed. Statistical analysis was done using Statistical Package for Social Sciences (SPSS), version 21 (IBM SPSS Statistics for Windows, Armonk, NY). Results  There was an improvement in mouth opening and occlusion in the immediate postoperative period. The surgical accessibility ranged from good to excellent. The fracture reduction was excellent in 60% of patients and good in 40%. In one patient, there was a transient weakness of the marginal mandibular nerve which recovered by three months. Another patient had a wound infection that subsided within the first postoperative week. None of the patients had a device failure during the six-month follow-up period. Conclusion  The trapezoidal 3D plates could be considered as a viable option for treating subcondylar fractures of the mandible in terms of surgical accessibility, stability, ease of device placement, stability of reduced fracture, reduced osteosynthesis material requirement, and minimal damage to the surrounding tissues.