A Long Term Follow-Up Study of the Reconstruction of the Oral Cavity at a Tertiary Care Center: An Original Research.

Introduction: In the subcontinent of India as well as for the other nations, the most usual cancer that affects the oral cavity the "squamous cell carcinoma". The main side effects of the intervention of the SCC are the large defect and disfigurement. This study sought to investigate the various interventions of the SCC in a designated cancer institute. Material and Methods: A retrospective clinical study of the records was done between 2000-2020 years. The operated cases were analysed for various patient demographics as well as the site of the lesion and number distributions. The change in the techniques and the preference flaps over the periods was noted, and the values were compared for every 5 years. Results: A1001 patients were treated between the intended periods. Though there were larger number of men, the variation was not significant. Common sites were floor of the mouth (FOM) and tongue. The common interventions were primary closure, soft tissue free flaps and bone flaps. The shift was seen towards the free flaps. Conclusion: The Free flaps were the common applications in the constructions. Bone free flaps overtook the other procedures that were commonly applied. The quality of life and the aesthetics are seen to be better with the free flaps.

To Study the Impact of Tooth Sectioning on Postoperative Pain, Swelling and Trismus After Surgical Extraction of Impacted Mandibular Third Molars.

AIM: To study the impact of tooth sectioning on postoperative pain, swelling, and trismus after surgical extraction of impacted mandibular third molars. MATERIALS AND METHODS: The present research was conducted on a sample of 100 individuals who were in good health. The participants had an average age of 28 years and were seeking treatment at the Department of Oral and Maxillofacial Surgery for the extraction of impacted mandibular third molars. The participants were allocated randomly to one of the two experimental conditions. The patients in Group A are receiving a surgical procedure to remove the mandibular third molar without the need for tooth sectioning. The study focuses on patients classified as Group B who are having a surgical procedure for the extraction of the mandibular third molar using dental sectioning. RESULTS: The Group B patients saw a notable decrease in pain intensity on the third and seventh days after the surgery. The mean difference in pain scores was 4.15±0.54 and 1.69±0.11, respectively, indicating statistically significant findings with a p-value of less than 0.05. The study observed statistically significant differences in swelling between the 1st, 3rd, and 7th postoperative days for group II. The mean differences were recorded as 149.85±5.86, 119.25±4.22, and 107.52±, respectively. The significance level was determined to be P<0.05. The study observed that the degree of mouth opening in Group B exhibited a significant rise on the 3rd and 7th postoperative days, with a mean difference of 40.87±3.69 and 43.15±3.29, respectively, as compared to Group A. This difference was found to be statistically significant, with a p-value of less than 0.05.  Conclusion: The findings of our research indicate that the technique of sectioning the tooth is the preferable approach for surgical extraction of impacted third molars, as it effectively reduces the occurrence of post-operative problems.

Evaluation of Efficiency of Dyes in Detection of Cancer Cells: An Original Research.

Introduction: The early detection of the cancer will dramatically improve the prognosis. There are many diagnostic aids that can be employed for screening. Hence, in our study, we aim to evaluate the efficiency of dyes in detection of cancer cells. Materials and Methods: We piloted a prospective clinical study among 30 subjects to detect the efficiency of two dyes-Lugol's iodine and toluidine blue. They were grouped equally for potentially malignant and malignant lesions. The areas were analyzed for the diagnostic accuracy of the dyes using the histopathological examination and compared using chi square test deliberating P < 0.05 as significant. Results: We observed that both the dyes showed a diagnostic accuracy of over 90% when used alone or in combination. Both the dyes had greater sensitivity while specificity was 20%. Conclusion: The combination of these two dyes can be used as an efficient screening aid for the identification of the cancer cells.

Comparative Evaluation of Three-Dimensional Plating Systems in Maxillofacial Trauma: An Original Research.

Introduction: Many advanced techniques and materials have been introduced in the recent years with the advent of the new designing technology. Hence, in our study, we aimed to compare in maxillofacial trauma, the three-dimensional (3D) plating systems. Materials and Methods: We piloted a prospective clinical study among 50 subjects of both genders with mandibular parasymphysis fracture. We compared the 3D miniplates with the two-dimensional (2D) miniplates where the subjects were divided into 2 groups equally. The clinical parameters were compared at different times of follow-up after the surgery. Results: We observed that there was a similar distribution of the genders and the side of the fracture of the parasymphysis. There was a significant difference between the groups for the mouth opening while there was no significant difference for the sensory deficit. The subjects recovered better with the 3D mini-plates. Conclusion: The mandibular fractures can be successfully treated with the 3D miniplates that help in a quick and efficient recovery.

A Comparative Evaluation of 2.0mm Two-Dimensional Miniplates Versus 2.0mm Three-Dimensional Miniplates in Mandibular Fractures.

BACKGROUND: In the past few decades, there has been an increasing interest in obtaining a more instantaneous return to normal function using diverse methods of direct fixation. AIMS AND OBJECTIVES: To compare the conventional 2-mm 2D (two-dimensional) miniplates and 2-mm 3D (three-dimensional) miniplates in terms of treatment outcome, stability, duration of surgery, and complications of treatment of symphysis and parasymphysis mandibular fractures. MATERIALS AND METHODS: 16 patients with clinical and radiological evidence of fractures of the mandible in symphysis and parasymphysis areas treated by open reduction and internal fixation with 2D miniplates and 3D miniplates. The patients were followed up for three months and assessed clinically and radiographically by taking orthopantomograms. The assessment was made on the immediate postoperative day, third day, fifth day, the seventh day, two weeks, three weeks, four weeks, two months, and three months. RESULTS: Mean intraoperative time taken for 2D miniplate was 54.8 min and for 3D miniplate was 40.6 min. Mild paraesthesia at the soft tissue region supplied by mental nerve was noticed in two patients (25%) of group I, whereas there was no such paraesthesia observed in group II patients. Wound dehiscence and infection were noticed in one patient in group I. CONCLUSION: 3D plates seem to be better than conventional 2-mm miniplates for symphysis and parasymphysis fractures.

Clinicopathologic Correlation of White, Non scrapable Oral Mucosal Surface Lesions: A Study of 100 Cases.

INTRODUCTION: White, non scrapable lesions are commonly seen in the oral cavity. Based on their history and clinical appearance, most of these lesions can be easily diagnosed, but sometimes diagnosis may go wrong. In order to arrive to a confirmative diagnosis, histopathological assessment is needed in many cases, if not all. AIMS: 1) To find out the prevalence of clinically diagnosed oral white, non scrapable lesions. 2) To find out the prevalence of histopathologically diagnosed oral white, non scrapable lesions. 3) To correlate the clinical and histopathological diagnosis in the above lesions. MATERIALS AND METHODS: A total of 100 cases of oral white, non scrapable lesions were included in the study. Based on their history and clinical presentation, clinical provisional diagnosis was made. Then biopsy was done and confirmatory histopathological diagnosis was given and both were correlated. In order to correlate clinical and histopathological diagnosis Discrepancy Index (DI) was calculated for all the cases. RESULTS: Based on clinical diagnosis, there were 59 cases (59%) of leukoplakia, 29 cases (29%) of lichen planus and six cases (6%) of lichenoid reaction; whereas, based on histopathological diagnosis, there were 66 cases (66%) of leukoplakia epithelial hyperplasia and hyperkeratosis (leukoplakia) and 30 cases (30%) of lichen planus. Seventy eight clinically diagnosed cases (78%) correlated with the histopathological diagnosis and 22 cases (22%) did not correlate. The total discrepancy index was 22%. CONCLUSION: A clinician needs to be aware of oral white, non scrapable lesions. Due to the overlapping of many clinical features in some of these lesions and also due to their malignant potential, a histopathological confirmative diagnosis is recommended.

Effect of proteolytic enzyme bromelain on pain and swelling after removal of third molars.

AIMS AND OBJECTIVES: To evaluate the effect of bromelain on pain and swelling after surgical removal of third molars. MATERIALS AND METHODS: A prospective randomized clinical study was conducted among 40 patients requiring surgical removal of impacted mandibular third molars. All the impacted molars were surgically removed, and the patients were administered bromelain along with amoxicillin. Patients were recalled on day 1, day 3, and day 7 for postoperative pain assessment using visual analogue scale (VAS) and postoperative swelling assessment using facial reference points tragus and pogonion. VAS score was statistically analyzed using repeated analysis of variance with post-hoc Bonferroni test postoperatively on day 1, day 3, and day 7 using the Statistical Package for the Social Sciences software version 14. RESULTS: Out of the total 40 patients, bromelain was effective in 28 (70%) patients. In these patients, there was reduction in swelling and pain after taking bromelain. CONCLUSION: Bromelain can be used as a successful oral enzyme therapy for oral surgery patients, especially after removal of impacted third molars.

A Rare Entity of Giant Epidermal Exophytic Naevus of Hemifacial Region.

The term nevi constitute a hamartomatous growth of either skin or mucosa that is generally found at birth or shortly after birth. An epidermal nevus consisting chiefly of sebaceous glands is called as nevus sebaceous. Typically this entity is seen as a solitary bald patch over the scalp at birth. We report a case of exophytic lesion following blaschko's lines at birth. We find this case as peculiar because of the multiplicity of lesions, their pattern of distribution, as well as their atypical morphology.

Evaluation of bacterial spectrum of orofacial infections and their antibiotic susceptibility.

INTRODUCTION: The inappropriate use of antibiotics has contributed to a worldwide problem of antimicrobial resistance. The objective of present study is to assess the most common microorganisms causing orofacial infections and their antimicrobial susceptibility to routinely used antibiotics in this part of India. MATERIALS AND METHODS: Sixty eight patients with orofacial infection were selected on the basis of a series of predefined inclusion and exclusion criteria. Samples were collected under aseptic conditions and subjected to culture and antibiotic susceptibility testing. Descriptive statistics were provided. RESULTS: A total of 64 aerobic and 87 anaerobic strains were isolated. The predominant bacteria were Streptococci viridans (64%), Prevotella (43%), Peptostreptococcus (26%), Porphyromonas (7%), and Fusobacterium (14%). The isolated strains seemed to be highly sensitive to the routinely used antibiotics such as amoxicillin - clavulanate and amoxicillin alone, clindamycin, and levofloxacin. In contrast, more resistance to erythromycin was observed. CONCLUSION: Amoxicillin still possesses powerful antimicrobial activity against major pathogens in orofacial odontogenic infections. Amoxicillin/clavulanate and clindamycin would also be advocated as being useful alternatives for the management of severe orofacial infections. However, the findings of this study indicate that erythromycin is of questionable benefit in the treatment of severe orofacial odontogenic infections.