The retromandibular transparotid approach vs. retromandibular retroparotid approach for the mandibular condyle: our clinical experience

Aim: The mandible is regarded as a frequently fractured bone in patients who present with maxillofacial trauma accounting for almost 15.5% to 59% of all facial fractures. Managing condylar trauma has remained to be a point of contention amongst experts, regardless of the advances in surgical modalities and methodologies, and the treatment plan is often determined by the preference and the experience of the surgeon. There exist various approaches in the literature, each with its own specific benefits and drawbacks. With this study, we aimed to evaluate the prevalence of post-operative complications in patients who experienced ORIF by means of the retromandibular approach, by comparing the outcomes of one group having undergone transparotid surgery, with another that underwent retroparotid surgery. Methods: An experimental trial was undertaken. Convenience sampling was done from among the cases of condylar neck and base fracture visiting the department of OMFS, Dow University of Health Sciences from January 2017 to December 2019. An overall 26 patients were divided into 2 groups of 13 members each; one was managed using Open Reduction Internal Fixation (ORIF) by means of a retromandibular transparotid approach while the other group was treated with ORIF by means of a retromandibular retroparotid approach. A 6 month follow-up was done to assess range of active motion, occlusion, and complications such as deviation/deflection, neural injury, infections, sialocele, salivary fistulae and Frey's syndrome in both groups. Results: There was no statistically significant difference between the two groups in terms of inter-incisal opening, right and left lateral movements, or protrusion. One patient in the retroparotid group had deviation on mouth opening (7.69%), while one in the transparotid group reported with infection (7.69%), and 2 developed post operative seromas (15.38%). None had persisting facial nerve palsy at 6 months. Conclusion: We find no significant disparity between the 2 approaches at a follow-up of 6 months; therefore, the primary determining factor for selection of either technique is surgeon preference and appropriate case selection

Comparison Of The Adaptability Of Two Fissure Sealants In Various Tooth Fissure Morphology Patterns: An In Vitro Experimental Study.

BACKGROUND: This study was conducted to compare the adaptation of resin-based sealants with that of Resin modified glass ionome-based sealants in various tooth fissure morphologies. METHODS: It was an in vitro experimental study done at the Dow University and NED University, Karachi, Pakistan. Ten extracted human molars were randomly assigned to two groups, (n=5) each. Fissure sealant material (Resin based sealant or resin modified glass ionomer-based sealant) was applied on the occlusal surface of the tooth according to manufacturer's recommendations. Specimens were thermocycled and then sectioned into three longitudinal parts in the bucco- lingual direction. Specimens were examined using scanning electron microscope for the adaptation of the sealant in the occlusal fissure. Mann-Whitney -U test and Kruskall-Wallis test were applied to compare the adaptability scores of sealant materials in the tooth fissure. Level of significance was kept at 0.05. RESULTS: There were no significant differences in the adaptability scores among U-shaped (p-value=0.35), V-shaped (p-value=0.89), IK-shaped (p-value=0.52), I-shaped (p-value- =0.41) and Y-shaped (p-value=1.00) fissure patterns. Similarly, there were no significant differences observed between the resin-based sealant (p-value=0.95) versus RMGIC based sealant (p-value=0.63) for the adaptability scores in various tooth fissure morphologies. CONCLUSIONS: No significant difference was found between resin-based sealants and resin modified glass ionomerbased sealants for the adaptation in various tooth fissure patterns.