Custom-made ocular prosthesis: solitary method to improve facial aesthetics (a case report).

Loss of facial structures has a physical, social and psychological impact on affected individuals. Ocular trauma caused by assaults, falls, road traffic accidents, and household or work-related accidents may necessitate eye enucleation. Enucleation is also performed to treat severe infections of the eye, intraocular tumours and painful blind eyes. This procedure can result in post-enucleation socket syndrome with facial disfigurement and severely compromising facial aesthetics. Our patient complained of facial disfigurement because of a defect associated with the right eye. History and clinical features were suggestive of post-enucleation socket syndrome. The defect was rehabilitated with an ocular prosthesis. The rehabilitation procedure provided satisfactory results and a happy patient with good aesthetics. Maxillofacial prosthesis can restore and rehabilitate lost facial structures with artificial substitutes and helps in regaining patient´s natural appearance, the health of adjoining structures and subsequently, provide physical, social and psychological well-being.

Diabetic Maxillary Osteomyelitis: A Worrisome Vulnerability-Our Experience.

Background: Osteomyelitis is inflammation of medullary cavities, haversian system and adjacent cortex of bone. It is devastating to patients when invasive. Aim: The purpose of this study is to retrospectively review patients diagnosed with diabetic maxillary osteomyelitis and evaluate factors relating infection & diabetes. Methodology: Case records of patients diagnosed with diabetic maxillary osteomyelitis were studied. Patient's demographic data, predisposing factors, etiology, clinical features, culture sensitivity reports, microbiology, treatment and complications were studied. Diabetic status was confirmed by glycosylated hemoglobin (HbA1c) test. Duration of diabetes and anti-diabetic medication adherence was also studied. Results: There were 28 patients diagnosed with diabetic maxillary osteomyelitis, (23-male; 5-female). Majority of the patients (60.7%) belonged to fourth & fifth decades. Twenty (71.4%) patients had poorly controlled diabetes (HbA1c > 8%). All patients reported with random blood sugar > 200 mg/dl. Thirteen patients (46.4%) were diagnosed for diabetes on admission and 11 patients (39.3%) had poor anti-diabetic medication adherence. Predominant etiology was odontogenic infection (50%). Cases of bacterial osteomyelitis (50%) were more frequent than those of fungal osteomyelitis (32.1%). Recurrence was observed in three cases. Conclusion: Non-cognizance about diabetes mellitus can prove devastating for maxillofacial region and may prove fatal for the patient.

Direct maxillary sinus floor augmentation and simultaneous implant placement for rehabilitation of the severely resorbed posterior maxilla: A prospective clinical study.

AIMS AND OBJECTIVES: The aim of this prospective clinical study was to evaluate the success of one-stage direct (lateral) sinus lift procedure in severely atrophic posterior maxilla. MATERIALS AND METHODS: One-stage direct (lateral) sinus lift procedure was carried out at 15 sites in 13 patients. All patients included in the study presented with partially edentulous posterior maxilla with one or more missing teeth and residual bone height less than 5 mm. Three months after surgery, patients were evaluated to access increase in residual bone height, density of new bone formed and implant stability. Patients were also evaluated after 3 months of prosthetic placement for the success of implant-supported prosthesis. RESULTS: At 3 months post-operatively, increase in residual bone height was 8.31 ± 1.63 mm and the mean density of the newly formed bone around the implants was 417 ± 66.61 HU. All implants were stable and successfully osseointegrated, except one implant that was lost. The success rate of implant stability was 96.3% during the study period. CONCLUSION: Single-stage direct (lateral) maxillary sinus floor augmentation is a good treatment option with predictable outcome for patients with deficient alveolar bone in posterior maxilla.

Miniplate removal in operated cases of maxillofacial region in a dental institute in Rajasthan, India.

BACKGROUND: The long term management of miniplate fixation osteosynthesis remains debatable and controversial with few authors advocating routine removal of the miniplates after 3-6 months of placement, while others recommend retention of the miniplates unless their removal is clinically indicated. OBJECTIVE: The aim was to study the incidence, indications, time gap, role of metallic composition and site of removal of miniplates in operated cases of maxillofacial region over a two-year period. METHODS: Patients undergoing removal of miniplates over 2-year period were studied and evaluated regarding the number of miniplates removed, time gap present between fixation and removal of miniplates, indications for removal, metallic composition of miniplates removed, sites of removal and complications. Correlations between indications for miniplate removal based upon time gap, metallic composition, age group and number of miniplates present were determined using Chi-square test. Correlation between metallic composition of miniplate and time gap was also determined using Chi-square test. RESULTS: The miniplates were removed in 20 patients (16 males and 4 females). Most common indication for removal was infection (45%). Forty-five percent of the patients underwent miniplate removal within 1 year of placement. Thirty-four miniplates and 118 screws were removed. The correlation between indications for miniplate removal and time gap was found to be statistically significant (P = 0.04). CONCLUSION: Most of the hardware removal is performed subsequent to complications associated with hardware and local factors play more important role than metallic composition. Routine asymptomatic miniplates do not require removal and is not recommended.

Prevalence, Characteristics, and Morphology of Supernumerary Teeth among Patients Visiting a Dental Institution in Rajasthan.

CONTEXT: Supernumerary teeth/tooth (ST) is a developmental anomaly of dentition. Variation in developmental and eruption pattern of ST can lead to the development of numerous complications in oral cavity. AIM: The aim of this study was to investigate prevalence, characteristics, and morphology of ST among patients visiting a dental institution in Rajasthan, India. MATERIALS AND METHODS: During 1-year study, clinical examination of 9248 participants was performed. Morphology, type, location, number, position of eruption, state of eruption of ST, and associated complications were determined. Correlations between location of ST based on position of eruption, state of eruption, and associated complications were also determined using Chi-square test. RESULTS: The frequency of presence of ST in the studied population was 0.63% (58 participants). In these 58 participants, eighty-two supernumeraries were found. Forty-six participants (79.32%) presented with one ST. Males were more affected than females (2.05:1), and the maxilla was the most commonly affected region. Among 82 identified supernumeraries, we noted highest incidence of parapremolars (39.02%) and conical morphology (46.35%). The most common position of eruption was normal (68.30%) and most of these 82 teeth were erupted in oral cavity (57.31%). These ST have led to various endodontic, orthodontic, periodontal, and other complications in the studied population. The relation of varying complications with different location of supernumerary was found to be highly significant (P = 0.000). CONCLUSION: ST are best detected and diagnosed by thorough clinical examination and radiographic investigation. Early detection and adequate treatment plan should eradicate the potential future complications caused by ST.

Impacted Foreign Bodies in the Maxillofacial Region-A Series of Three Cases.

Penetrating injuries to the maxillofacial region are very common. Foreign bodies embedded deep in the maxillofacial region due to these injuries pose a challenge to an oral and maxillofacial surgeon. These objects may become a potent source of pain and infection. Early diagnosis of these foreign bodies can be achieved by the use of plain radiographs, ultrasonography, computed tomographic scans, and magnetic resonance imaging. Once diagnosed and located, these foreign bodies should be removed. Here, we report three such cases where early diagnosis of these foreign bodies embedded in the maxillofacial region lead to their early and successful removal without complications.

Management of Oro-antral Communication and Fistula: Various Surgical Options.

Oro-antral communication and fistula can occur as a result of inadequate and improper treatment. Inadvertent communication with the maxillary sinus can occur during certain surgical procedures in the maxillary posterior region. Though, spontaneous healing may occur in defects which are smaller than 2 mm but larger communications require immediate attention and should be treated without delay, in order to avoid sinusitis and further complications leading to patient discomfort.

Mystery behind Non-Healing Wound at Chin Region - Myiasis due to Neglected Trauma - A Case Report with Review of Literature.

Myiasis is the infestation of human beings with fly larvae which feed on host's living or dead tissue. Diagnosis of this condition is made by the presence of larvae in affected body parts. The standard treatment is the mechanical removal of the maggots from the lesion and management of the general systemic condition. This paper report a case of myiasis at the chin region in a 45-year-old male managed by manual removal of larvae after topical application of turpentine oil, surgical debridement of necrotic tissues and antimicrobial therapy.

Modified Occlusal Table - An Aid to Enhance Function of Hemimandibulectomy Patient: A Case Report.

Completely edentulous patients who have undergone hemimandibulectomy suffer severe anatomic and functional loss. Functions like mastication, speech and deglutition are severely compromised. The mandibular deviation towards the resected side leads to inefficient mastication. In order to alleviate the difficulties encountered by the patient, construction of a modified occlusal table into conventional complete denture has been described in this article. This simple modification enables the patient to articulate teeth on a broader surface area. The inclines of the cusps also help in mandibular guidance. Thus, prosthetic rehabilitation of hemimandibulectomy patients with two rows of teeth on the unresected side serves to restore function and aaesthetics providing them with an added psychological comfort.

Management of maxillofacial injuries in humans due to animal bites and mauling: A report of three cases.

Animal attacks and bite injuries are common occurrences as the natural habitat of animals is diminishing due to human encroachment. Individuals injured in animal attacks present with different types of injuries. Urgent and effective management of these injuries would have a significant effect on the final outcome. Rabies is a fatal disease in humans, and, till date, only those that received vaccination before the onset of illness survived this disease. The goal of the case reports presented in the article was to document the injuries suffered in animal bite injuries and add to the literature on the management with minimal complications.