Mandibular condyle fracture- effect of treatment on occlusal relationship

The incidence of fractures involving the mandibular condyle are stated by most authors to be the second-most common type of fracture of the mandible with male-female ratio 2:1. Condylar fracture may result in restricted mouth opening, restricted movement of the jaw and malocclusion, Malocclusion following condylar trauma may result from alteration in the condylar growth center or union of the fractured segments in a position other than that existing prior to injury. Therefore, the aim of the treatment should be to achieve normal static and dynamic occlusal relationships after treatment. The purpose of this study was to see the improvements in the occlusal relationships after the treatment of the fractured mandibular condyle. Two different treatment modalities surgical and nonsurgical were used to assess their impact on occlusion. The study followed a prospective comparative design and was carried out at the Department of Oral and Maxillofacial Surgery, Children Hospital, Lahore, Pakistan on sixty patients with unilateral condylar fractures. Thirty patients were treated by nonsurgical method and thirty by surgical method. At different intervals of their post-operative visits, patients were evaluated in terms of occlusion to assess the difference between the two groups. Patients treated by nonsurgical method, i.e., closed reduction had greater percentage of malocclusions [44%] at the final post-operative visit i.e. one year, as compared with patients treated by surgical treatment [8.3%] p=0.005.. Based on this study, more consistent occlusion can be expected when fractures of the condyle are treated by the open reduction and internal fixation technique

Alveolar clefts reconstruction: a comparison of autogenous bone graft versus autogenous combined with alloplasts

Alveolar cleft reconstruction is a major challenge in cleft lip and/or palate [CLP] patients and golden standard protocol is to perform bone grafting [BG] before canine eruption and subsequent orthodontic closure. Objective of this study was to compare the post operative morbidity of two procedures in terms of complications i.e. the average operation time, intra-operative blood loss, postoperative pain and to demonstrate the surgical procedure and clinical outcome in terms of preservation of the grafted alveoli. This was a prospective comparative study conducted at the Department of Oral and Maxillofacial Surgery, Children Hospital, Lahore on twenty patients with residual alveolar clefts. The patients were randomly divided into two groups A and B. In group A, the cancellous bone graft was harvested from the anterior iliac crest while in group B, the cancellous bone was harvested from the anterior iliac crest and mixed with Synthetic bone substitutes in 1:1 by volume. The patients in group B recovered from walking uncomfortably statistically faster than those in group A. The duration of the hospital stay was significantly shorter in group B than in group A. The average bone graft densities of both groups significantly reduced within 6 months after grafting then seemed to be stable until month 24. The bone graft heights gradually decreased with time, in both groups by 24 months postoperatively. It was concluded that efficacy of hydroxylapatite is comparable with that of autogenous bone alone in terms of bone remodeling and tooth eruption, either spontaneous or orthodontically assisted

skeletal morphologic structure of openbite in adult Pakistani sample

The purpose of this study was to identify the cephalometric skeletal morphological features of anterior open-bite [AOB] in adult Pakistanis. It was a cross sectional descriptive study having quantitative study design. Lateral cephalograms of 30 pre treatment anterior open-bite patients with the age range 17 to 27 years, coming to the department of Orthodontics were taken [18 females and 12 males]. Subjects of study sample were clinically diagnosed as having open bite.In addition the subjects were considered as having skeletal AOB when SN-GoGn angle was equal to or more than 32.5 degree. Ten linear and angular measurements were recorded. The results showed significantly increased values of linear measurements [PHF, AFH, UFH] and angular measurement[SN-GoGn].One angular measurement[SN-PP] was closer to the mean Caucasian sample values but there was more obliquity to the Gonial angle. The ratio PFH/AFH was small as compared to white anterior AOB subjects. Sexually dimorphic variables were also identified by independent sample t-test