Pattern of presentation of mandibular condylar fractures in relation with known risk factors

Mandibular fractures are one of the most common fractures of facial bones. Parasymphysis is the most common site followed by condylar and subcondylar areas of the mandible. A descriptive study was carried out at Department of Oral and Maxillofacidl Surgery, King Edward Medical University I Mayo Hospital, Lahore from 27th September 2011 to 26th September 2012. The study was carried out on forty patients with mandibular condylar fractures. The fractures were classified according to the Spiessl and Schroll classification system. Objective of this study was to describe pattern of presentation of mandibular condylar fractures and to evaluate factors leading to mandibular condylar fractures in a tertiary care hospital. 32 [80%] were males and 8 [20%] females. The age ranged from 1% to 65 years with mean of 26 years [SD +/- 16.90]. Road traffic accidents including motor bike, auto-rickshaw and car accidents were found to be predominant risk factors [15 patients - 37.5%]. Type II fractures [low neck displacement] comprised the highest proportion - 16 out of 48 fractures [33.3%]

Road traffic accidents and falls were the leading risk factors for mandibular condylar fractures identified in this study. Type II fractures were seen to be the most frequent variant of condylar fracture. It was noted that no specific pattern of condylar fracture was associated with any specific risk factors

5-years retrospective study of oral pathological lesions in 425 Saudi patients

Objective of this study was aimed to highlight the frequency and prevalence of oral pathological lesions. Four hundred and twenty five patients visiting the Department of Oral and Maxillofacial Surgery/ Oral Medicine of Qurayyat Specialized Dental Center, Al-Qurayyat, Saudi Arabia, were included in the study. The study was conducted from year 2011 to 2015

Frequency of patients was noted. Males were 260/425 [61.2%] and females 165/425 [38.8%]. Age range was 6-77 years with mean 38.4 + 13.65. Reactive lesions were the most common occurrences, diagnosed in 425 cases [8.94%], and followed by fungal infections [7.8%], lichen planus [7.1%] and pulp andperiapical lesions [6.82%]. Most common malignant lesion was squamous cell carcinoma 4.7% [30/425]. Most common salivary gland pathology was mucoepidermoid carcinoma 3.1% [13/425]

Prevalence and localization of impacted canine among al-qurayyat orthodontic patients: a study conducted over the period of 4 years

Objective of this study was to highlight the prevalence of impacted canines in orthodontic patients ofAl-Qurayyat, Al-Jouf, Saudi Arabia. Two thousand two hundred and thirty nine patients visiting the Department of Orthodontics, Qurayyat Specialized Dental Center, were included in this study. The study was conducted from year 2012 to 2015

Frequency and percentages of the patients were recorded. Total number of males were n= 836[37.34% and females n= 1403 [62.66%]. The mean age of the patients was 22.92 +/- 8.43. N=9712239 [4.33%] patients were diagnosed with impacted canines. Maxilla was the most common site of impaction, n=89l97 [91.75%]. Within maxilla, impacted canines were seen mostly as unilateral n=75 [84.27%] and on left side n=59 [66.3%]

Utilization of nasolabial flap for reconstruction of oral cavity defects

Objective of this study was to highlight the utilization of nasolabial flap for reconstruction of oral cavity defects. The study revealed the results of 21 nasolabial flaps in 14 patients over the period of two and a half year. The patients presented at the Department of Oral and Maxillofacial Surgery, King Edward Medical University/Mayo Hospital, Lahore from November 2009 to November 2011 and at the Department of Oral and Maxillofacial Surgery, Fatima Memorial Hospital Lahore from May 2012 to October 2012. In 08[57.14%] patients the defects were secondary to Oral Submucous Fibrosis of buccal mucosae; 03[21.43%] patients were with biopsy proven Squamous Cell Carcinoma of the oral cavity and in 02[14.28%] patients flap was used to cover the post traumatic oro-antral defects secondary to firearm and machine injuries to the maxilla. One patient [7.14%] had the defect after resection of the cystic lesion of the maxilla. Uneventful flap healing was observed in 20[95.24%] and partial flap loss occurred in only 01[4.76%]. It was concluded that the nasolabial flap is a reliable and minimally traumatic local flap for reconstruction of small-to-medium sized oral cavity defects with predictable functional and good aesthetic results

Postoperative complications in primary definitive management of hard and soft tissues in mandibular gunshot injuries; a review of 47 cases

Background: Firearm injuries cause significant morbidity and mortality among its victims. The type and extent of tissue damage vary from simple small size wound to a large soft tissue or skeletal defect. The selection of the appropriate surgical technique is as important as the timing because incorrect selection or improper application of surgical techniques may also lead to infection, sequestration, wound dehiscence, graft rejection, facial deformity and subsequent re-visional operations

Objective: The present study, carried out at Oral and Maxillofacial Surgery department, King Edward Medical University/ Mayo Hospital, Lahore, was aimed at highlighting the frequency of Postoperative complications in primary definitive management of hard and soft tissues in mandibular gunshot injuries

Study design: Descriptive case series

Setting: Department of Oral and Maxillofacial Surgery, King Edward Medical University/ Mayo Hospital, Lahore, from November 2010 to November 2012; including 6 months follow up

Patients and methods: The study was conducted on 47 patients. All patients suffered gunshot injuries to the mandible and had soft and hard tissue defects at a single site. Patients ranged in age from 17 to 54 years with a mean age of 32.31 years. Males dominated in the study and were n=37 and females n=10. All patients were treated definitively in the first operation by addressing the hard and soft tissue defects

Results: All had single site fracture with angle of the mandible being most common 27 [57.44%]. For reconstruction of soft tissue defect local advancement by undermining and primary closure was carried out in 35 [74.47%] patients, buccal pad of fat in 4 [8.51%] patient, deltopectoral flap in 5 [10.64%] patients and skin graft in 3 [6.38%] patient. For hard tissue reconstruction, nonvascularized bone graft was given in all cases i.e. n=47 [100%]. Iliac crest bone graft was given in 34 [72.34%] patients, rib graft in 6 [12.77%] patients and symphyseal outer cortex bone graft in 7 [14.89%] patients. Post-operative complications were noted in terms of infection, plate exposure, plate fracture and malocclusion which appeared to be 9 [19.1%], 5 [10.6%], 2 [4.3%], 5 [10.6%] respectively

Conclusion: All patients in this series required surgical intervention for treatment of their facial gunshot wounds. Primary definitive hard and soft tissue management can be considered in patients suffering from gunshot injuries to the mandible. Although post-operative complications can result at higher rates in such injuries yet properly selected surgical techniques and post-operative infection control can produce excellent desired esthetic and functional results

Efficacy of chlorhexidine gel vs chlorhexidine rinses in reducing incidence of dry socket in mandibular third molar surgery

Objective of this study was to highlight the efficacy of chlorhexidine gel in prevention of dry socket in the post-operative period of mandibular third molar surgical extraction in comparison to chlorhexidine rinses. One hundred patients seen at the department of Oral and Maxillofacial Surgery, Institute of Dentistry, CMH Lahore Medical College, were included in this study. The study was conducted from July 2012 to June 2013. The trial group [n=50] was instructed to apply 0.2% chlorhexidine gel to the extraction wound during the first postoperative week, while the control group [n=50] was prescribed a 0.2% chlorhexidine rinse for the same period. Results of this study revealed a 67% reduction in postoperative dry socket in the gel group [P < 0.05]. The incidence of postoperative dry socket in the gel group was 6% [3/50] as compared to 18% [9/50] in the mouthwash group. It was concluded that topical application of chlorhexidine gel to the extraction wound significantly reduced the incidence of dry socket

Frequency and management of temporomandibular joint ankylosis: a study conducted over the period of 13 years

Objective of this study was to highlight the frequency and management of temporomandibular joint ankylosis. One hundred and forty patients visiting the Department of Oral and Maxillofacial Surgery, Ayub Medical College and Teaching Hospital, Abbottabad were included in this study. It was conducted from year 2000 to 2012. Frequency of patients was noted and interpositional gap arthroplasty was conducted on each one. Males were 90/140 [64.3%] and females 50/140 [35.7%]. Causes of ankylosis were birth trauma 7[5%], falls from roofs 39[27.9%], falls from trees 61[43.6%], infection 3[2.1%] and road traffic accident 30[21.4%]. Post operative mouth opening at one year follow-up was normal in 112[80%] patients and restricted in 28[20%]. Falls from roofs and trees were common causes of temporomandibular joint ankylosis in this region and most of the patients were males with unilateral presentation. Interpositional Gap Arthroplasty was found highly effective and safe surgical management option for temporomandibular joint with acceptable immediate and long term outcome, particularly when temporalis fascia or muscle and iliac crest grafts were used for adults and costochondral grafts with fascia interposition used for children