Access Leads to Success: Management of Gunshot Injury to Maxillofacial Region with Access Osteotomy for Bullet Retrieval.

Head, face and neck are three highly separate frame area that behave in a different way in phrases of gunshot injuries. Interpersonal violence, assaults, accidents and suicide attempts being the most common reason in most developed and developing countries. Morbidity and mortality to this area depends on the type of weapon used,entry and exit path and the distance from where it is fired. The complexity of facial skeleton and its close association with important vital structure makes the management of these gunshot wounds challenging in terms of accessibility, visibility and wound management. Here we present a case of access osteotomy in the form of maxillary Lefort I osteotomy for bullet retrieval lodged in nasopharyngeal area following gunshot injury due to interpersonal violence.

Study of Normal Anatomy of Mandibular Canal and its Variations in Indian Population Using CBCT.

INTRODUCTION: Identification of detailed anatomy of mandibular canal (MC) with its contents including the position, course, and morphology is extremely important for the management of various surgical procedures including dental implant placement, third molar surgery, dental anesthesia, mandibular osteotomy, bone-harvesting procedure from the ramus and body of mandible, bone plating in angle and body region of mandible, or any other surgical procedure involving the mandible. METHODS: This prospective randomized study was carried out in the Department of Oral and Maxillofacial Surgery, Saraswati Dental College, Lucknow, on 100 randomly selected cone-beam computed tomography (CBCT) mandibular views displaying the entire mandible. RESULTS: Various parameters of the canal were studied in detail and subjected to statistical analysis using SPSS 20 software. For all the observations, paired t test was applied to compare right and left sides and independent t test for the comparison of gender. CONCLUSION: For centuries MC has been a paramount topic of discussion, and with the contraption of CBCT, we can finally decipher the canal in great detail. CBCT acts as a guide to prevent damage to the neurovascular bundle as the canal traverses its course and sometimes with certain variations.

Comparison between immediate vs. delayed lateral expansion technique to augment narrow alveolar ridges for placement of implants - A pilot study.

OBJECTIVE: Narrow alveolar ridges pose a serious challenge for successful placement of endosseous implants and alveolar ridge widening procedure is indicated in cases of crest thickness of ≤4.0 mm. The study evaluated and compared, immediate and delayed techniques of implant placement using split crest technique to augment atrophic narrow alveolar ridges. METHODS: The study was carried out in 10 patients randomly divided into two groups of five each for immediate or delayed placement of implants. Implants were placed simultaneously after split crest procedure in immediate technique and after 3-4 weeks of healing in delayed technique. Data collected was statistically analyzed by SPSS version 22 using unpaired t-test, ANOVA and Pearson's correlation with p value = 0.05. RESULTS: Statistically significant (p = 0.000) difference was observed for implant stability at intra-op, 4 months and 6 months post-op between the two groups, however there was no statistically significant difference in amount of augmentation achieved between the two groups. CONCLUSION: We observed that both the techniques were comparable on the basis of augmentation achieved, implant success and survival rates, whereas implant stability was significantly higher in delayed technique group.

Eagle's syndrome mimicking dental pain: A case report with a novel surgical approach.

PAIN in the craniofacial and neck region can be both intriguing and equally frustrating for the surgeon. This is principally because there is a multitude of related pain syndromes in this region, many of which are lacking in physical signs. Diagnosis then becomes even more dependent on an accurate description of the pain in terms of character, localization, duration, radiation, relieving and exacerbating factors. Familiarity and identification of a more obscure causative factor in a particular case lends itself not only to liberate the patient but also an increased awareness of the practitioner for the need to consider the coinciding minute diagnostic points of otolaryngology, ophthalmology and rhinology besides dentistry and oral surgery. The characteristic elongation of a styloid process may explain some occasions of pharyngeal, ear pain and sometimes headache, which have defied exhaustive diagnostic studies. A large spectrum of signs and symptoms has been mentioned in various reports of Eagle's syndrome. Diagnosis can be made with careful clinical evaluation and confirmed with radiographs showing an elongated styloid process or calcification of the stylohyoid complex. Styloidectomy is the procedural choice for Eagle's syndrome having high success rate. In our case, the intraoral approach for styloidectomy was not the routine one, for which the post-operative outcome was exceptionally good without any complications.