The Safety and Effectiveness of Superficial Cervical Plexus Block in Oral and Maxillofacial Surgery as an Alternative to General Anesthesia in Selective Cases: A Clinical Study.

AIM: To assess the safety and effectiveness of superficial cervical plexus (SCP) block in oral and maxillofacial surgical (OMFS) practice as an alternative to general anesthesia in selective cases. SUBJECTS AND METHODS: The total number of patients was 10, out of which 6 were male and 4 were female patients. Five patients had incision and drainage of perimandibular space infections, two patients had enucleation of cyst in the body of mandible, one patient had open reduction and internal fixation isolated angle fracture, and two patients had submandibular lymph node biopsies. Informed & written consent were obtained from the patients after they had the procedure explained to them. Medically compromised patients and those who were excessively anxious and apprehensive, patient who did not want the procedure to be done under regional anesthesia, and patients with a history of allergy to local anesthetic were excluded. All patients had their surgical procedures under regional anesthesia (SCP block with supplemental nerve blocks) performed by the same surgeon under the supervision of anesthesiologist with continuous monitoring. RESULTS: SCP block with concomitant mandibular nerve and long buccal nerve block has a high success rate, low complication rate, and high patient acceptability as shown in the study. CONCLUSION: Superficial cervical plexus block anesthesia is a safe and useful anesthetic technique with the low risk of accidents and complications, thus a good alternative for regional anesthesia in selected cases in oral and maxillofacial surgery.

Healing Potential of Platelet Rich Fibrin in Impacted Mandibular Third Molar Extraction Sockets.

BACKGROUND: Healing of both hard and soft tissues have become one of the great challenges, faced in clinical research in development of bioactive surgical additives responsible for regulating inflammation and increasing healing. Platelet-rich fibrin (PRF) represents a new step in the platelet gel therapeutic concept with simplified processing minus artificial biochemical modification. AIMS AND OBJECTIVES: The aim of this study is to evaluate the effectiveness of PRF on soft-tissue healing and bone tissue healing in terms of postoperative pain, postoperative swelling, soft tissue healing, and the quality of bone healing at the mandibular third molar socket. MATERIALS AND METHODS: A clinical study will be done on patients reporting to the Department of Oral and Maxillofacial Surgery in Government Dental College, Srinagar, requiring disimpaction of bilateral mesioangular impacted mandibular third molars in 60 patients. RESULTS: The present prospective clinical study evaluates the effect of PRF in healing of mandibular third molar extraction sockets. There was no difference in the age gender and type of impaction between the two groups as the mean postoperative pain score (visual analog scale) was lower for the PRF group (Group A) at all points of time when compared with the control (Group B), and this was statistically significant (P < 0.05). The mean percentage swelling was lower for the PRF group (Group A) at all points of time when compared with the control (Group B). Evaluating the effect of treatments (with or without PRF) on lamina dura score shows that in both the groups at different time periods, significant (P < 0.001) difference was observed on lamina dura score. CONCLUSION: The results of the present study suggest that application of autologous PRF gel has a beneficial effect on the healing of extraction sockets after third molar surgery.

Multiple Dentigerous Cysts as a Rare Presentation of Maroteaux-Lamy Syndrome.

Maroteaux-Lamy syndrome is one of the genetic disorders involving disturbances in mucopolysaccaride metabolism, due to deficiency of aryl sulfatase-B which leads to accumulation of dermatan sulfate in tissues and their excretion in urine. The diseases has several oral and dental manifestations, is first diagnosed on the basis of clinical findings. It is characterized by coarse facial features, normal intelligence, organomegaly, enlarged head, short neck, corneal clouding, enlarged tongue, and prominent metachromatic inclusions in leukocytes. Death is usually a result of either respiratory tract infection or cardiac disease, which is caused by the deposition of mucopolysaccharides. An 18-year-old with Maroteaux-Lamy syndrome is described in this article with multiple dentigerous cysts as the first presentation.